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Celeski M, Segreti A, Piscione M, Monticelli LM, Di Gioia G, Fossati C, Ussia GP, Pigozzi F, Grigioni F. The current paradigm of cardiac troponin increase among athletes. Monaldi Arch Chest Dis 2024. [PMID: 38700130 DOI: 10.4081/monaldi.2024.2878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/16/2024] [Indexed: 05/05/2024] Open
Abstract
Although it is known that exercise improves cardiovascular health and extends life expectancy, a significant number of people may also experience an elevation in cardiac troponin levels as a result of exercise. For many years, researchers have argued whether exercise-induced cardiac troponin rises are a consequence of a physiological or pathological reaction and whether they are clinically significant. Differences in cardiac troponin elevation and cardiac remodeling can be seen between athletes participating in different types of sports. When forecasting the exercise-induced cardiac troponin rise, there are many additional parameters to consider, as there is a large amount of interindividual heterogeneity in the degree of cardiac troponin elevation. Although it was previously believed that cardiac troponin increases in athletes represented a benign phenomenon, numerous recent studies disproved this notion by demonstrating that, in specific individuals, cardiac troponin increases may have clinical and prognostic repercussions. This review aims to examine the role of cardiac troponin in athletes and its role in various sporting contexts. This review also discusses potential prognostic and clinical implications, as well as future research methods, and provides a straightforward step-by-step algorithm to help clinicians interpret cardiac troponin rise in athletes in both ischemic and non-ischemic circumstances.
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Affiliation(s)
- Mihail Celeski
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome.
| | - Andrea Segreti
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico".
| | - Mariagrazia Piscione
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome.
| | - Luigi Maria Monticelli
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome.
| | - Giuseppe Di Gioia
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico"; Institute of Sport Medicine and Science, Italian National Olympic Committee, Rome.
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico".
| | - Gian Paolo Ussia
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome.
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico".
| | - Francesco Grigioni
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma; Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome.
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Goliniewski J, Czuba M, Płoszczyca K, Chalimoniuk M, Gajda R, Niemaszyk A, Kaczmarczyk K, Langfort J. The Impact of Normobaric Hypoxia and Intermittent Hypoxic Training on Cardiac Biomarkers in Endurance Athletes: A Pilot Study. Int J Mol Sci 2024; 25:4584. [PMID: 38731803 PMCID: PMC11083773 DOI: 10.3390/ijms25094584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/15/2024] [Accepted: 04/20/2024] [Indexed: 05/13/2024] Open
Abstract
This study explores the effects of normobaric hypoxia and intermittent hypoxic training (IHT) on the physiological condition of the cardiac muscle in swimmers. Hypoxia has been reported to elicit both beneficial and adverse changes in the cardiovascular system, but its impact on the myocardium during acute exercise and altitude/hypoxic training remains less understood. We aimed to determine how a single bout of intense interval exercise and a four-week period of high-intensity endurance training under normobaric hypoxia affect cardiac marker activity in swimmers. Sixteen young male swimmers were divided into two groups: one undergoing training in hypoxia and the other in normoxia. Cardiac markers, including troponin I and T (cTnI and cTnT), heart-type fatty acid-binding protein (H-FABP), creatine kinase-MB isoenzyme (CK-MB), and myoglobin (Mb), were analyzed to assess the myocardium's response. We found no significant differences in the physiological response of the cardiac muscle to intense physical exertion between hypoxia and normoxia. Four weeks of IHT did not alter the resting levels of cTnT, cTnI, and H-FABP, but it resulted in a noteworthy decrease in the resting concentration of CK-MB, suggesting enhanced cardiac muscle adaptation to exercise. In contrast, a reduction in resting Mb levels was observed in the control group training in normoxia. These findings suggest that IHT at moderate altitudes does not adversely affect cardiac muscle condition and may support cardiac muscle adaptation, affirming the safety and efficacy of IHT as a training method for athletes.
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Affiliation(s)
- Jakub Goliniewski
- Department of Sports Theory, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (J.G.); (J.L.)
| | - Miłosz Czuba
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland; (K.P.); (A.N.); (K.K.)
| | - Kamila Płoszczyca
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland; (K.P.); (A.N.); (K.K.)
| | - Małgorzata Chalimoniuk
- Department of Tourism and Health in Biała Podlaska, The Józef Piłsudski University of Physical Education, 00-968 Warsaw, Poland;
| | - Robert Gajda
- Department of Kinesiology and Health Prevention, Jan Dlugosz University, 42-200 Czestochowa, Poland;
- Center for Sports Cardiology at the Gajda-Med Medical Center in Pultusk, 06-100 Pultusk, Poland
| | - Adam Niemaszyk
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland; (K.P.); (A.N.); (K.K.)
| | - Katarzyna Kaczmarczyk
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warsaw, Poland; (K.P.); (A.N.); (K.K.)
| | - Józef Langfort
- Department of Sports Theory, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland; (J.G.); (J.L.)
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Conesa-Milian E, Cirer-Sastre R, Hernández-González V, Legaz-Arrese A, Corbi F, Reverter-Masia J. Cardiac Troponin Release after Exercise in Healthy Young Athletes: A Systematic Review. Healthcare (Basel) 2023; 11:2342. [PMID: 37628539 PMCID: PMC10454241 DOI: 10.3390/healthcare11162342] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Cardiac troponin (cTn) is a recognized marker used to assess damage to the heart muscle. Actual research has indicated that the levels of cTn increase after doing exercise in individuals who are in good health, and this is believed to be a result of a normal cellular process rather than a pathological one. The main goal of this study was to investigate the evidence of a postexercise release of cTn in child and adolescent athletes (6-17.9 years old) of different ages, sex, and sports disciplines. The Web of Science, MEDLINE, and Scopus databases were used to conduct the research up to March 2023. Three hundred and twenty-eight records were identified from the databases, however, only twenty-three studies were included in the review after being screened and quality-assessed by two independent authors. The gender, age of the participants, maturational status, and training level of the participants, the timing of sample collection, the exercise modality, and the number of participants with values above the cut-off reference were the data analyzed. Males, older young people, and individual sports seemed to have higher levels of serum cTn after practice exercise. Different methodologies, analyzers, and cut-off reference values make it difficult to compare the data among studies.
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Affiliation(s)
- Enric Conesa-Milian
- Department of Education Science, Faculty of Education, Psychology and Social Work, University of Lleida, 25003 Lleida, Spain; (V.H.-G.); (J.R.-M.)
- Consolidated Research Group Human Movement Generalitat de Catalunya, University of Lleida, 25003 Lleida, Spain; (R.C.-S.); (A.L.-A.); (F.C.)
| | - Rafel Cirer-Sastre
- Consolidated Research Group Human Movement Generalitat de Catalunya, University of Lleida, 25003 Lleida, Spain; (R.C.-S.); (A.L.-A.); (F.C.)
- National Institute of Physical Education of Catalonia (INEFC), University of Lleida, 25192 Lleida, Spain
| | - Vicenç Hernández-González
- Department of Education Science, Faculty of Education, Psychology and Social Work, University of Lleida, 25003 Lleida, Spain; (V.H.-G.); (J.R.-M.)
- Consolidated Research Group Human Movement Generalitat de Catalunya, University of Lleida, 25003 Lleida, Spain; (R.C.-S.); (A.L.-A.); (F.C.)
| | - Alejandro Legaz-Arrese
- Consolidated Research Group Human Movement Generalitat de Catalunya, University of Lleida, 25003 Lleida, Spain; (R.C.-S.); (A.L.-A.); (F.C.)
- National Institute of Physical Education of Catalonia (INEFC), University of Lleida, 25192 Lleida, Spain
- Section of Physical Education and Sports, Faculty of Health and Sports Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Francisco Corbi
- Consolidated Research Group Human Movement Generalitat de Catalunya, University of Lleida, 25003 Lleida, Spain; (R.C.-S.); (A.L.-A.); (F.C.)
- National Institute of Physical Education of Catalonia (INEFC), University of Lleida, 25192 Lleida, Spain
| | - Joaquin Reverter-Masia
- Department of Education Science, Faculty of Education, Psychology and Social Work, University of Lleida, 25003 Lleida, Spain; (V.H.-G.); (J.R.-M.)
- Consolidated Research Group Human Movement Generalitat de Catalunya, University of Lleida, 25003 Lleida, Spain; (R.C.-S.); (A.L.-A.); (F.C.)
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Abstract
BACKGROUND Chest pain is a common complaint among paediatric patients and cardiac troponin (cTn) level is often part of the initial emergency department evaluation. It is well known that after intense endurance exercise cTn levels can be elevated in patients with otherwise healthy hearts, however the effect shorter duration exercise has on cTn levels in this population is not known. OBJECTIVE Determine the behaviour of cTn levels in healthy children and adolescent patients after short burst, high-intensity aerobic exercise. METHODS Patients without haemodynamically significant heart disease referred for a treadmill exercise stress test (EST) were recruited over a 6-month period. cTn levels were measured prior to exercise and 4 hours after exercise. RESULTS Thirteen patients enrolled. Indications for EST were exertional syncope (six), chest pain (four), and long QT syndrome (three). The median exercise time was 12.9 (9.9-13.7) minutes with an average endurance at the fiftieth percentile for age and maximum heart rate rose to an average of 92 (74-98)% of the predicted peak for age. cTn levels prior to exercise were undetectable in all patients. There was no cTn rise in any patient after exercise. There were no ischaemic changes or arrhythmias on exercise electrocardiograms. CONCLUSION Serum cTn levels do not rise significantly in healthy children after short duration, high-intensity aerobic exercise. Physicians evaluating paediatric patients with an elevated cTn level after less than prolonged strenuous activity likely cannot attribute this lab value solely to exercise and may need to undertake further cardiac investigation.
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Cantinotti M, Clerico A, Giordano R, Assanta N, Franchi E, Koestenberger M, Marchese P, Storti S, D'Ascenzi F. Cardiac Troponin-T Release After Sport and Differences by Age, Sex, Training Type, Volume, and Intensity: A Critical Review. Clin J Sport Med 2022; 32:e230-e242. [PMID: 34009785 DOI: 10.1097/jsm.0000000000000940] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 03/28/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Postexercise release of cardiac troponin (cTn) is a well-known phenomenon, although the influence of various confounders remains unclear. The aim of this critical review was to analyze the postexercise release of cTn according to age, sex, different types of sport, exercise intensity and duration, and training level. DATA SOURCES A literature search was performed within the National Library of Medicine using the following keywords: cTn, peak, release, and exercise. The search was further refined by adding the keywords athletes, children/adolescents, and sport. MAIN RESULTS For final analysis, 52 studies were included: 43 adult studies, 4 pediatric studies, and 5 with a mixed population of adults and children. Several studies have investigated the kinetics of cTn response after exercise with different biomarkers. The current evidence suggests that sport intensity and duration have significant effects on postexercise cTn elevation, whereas the influence of the type of sport, age, and sex have been not completely defined yet. Most data were obtained during endurance races, whereas evidence is limited (or almost absent), particularly for mixed sports. Data on young adults and professional athletes are limited. Finally, studies on women are extremely limited, and those for non-White are absent. CONCLUSIONS Postexercise release of cTn can be observed both in young and master athletes and usually represents a physiological phenomenon; however, more rarely, it may unmask a subclinical cardiac disease. The influence of different confounders (age, sex, sport type/intensity/duration, and training level) should be better clarified to establish individualized ranges of normality for postexercise cTn elevation.
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Affiliation(s)
- Massimiliano Cantinotti
- Pediatric Cardiology Unit, Fondazione CNR-Regione Toscana G. Monasterio, Massa, Italy
- Pediatric Cardiology Unit, Institute of Clinical Physiology (IFC) National Research Institute (CNR), Pisa, Italy
| | - Aldo Clerico
- Pediatric Cardiology Unit, Fondazione CNR-Regione Toscana G. Monasterio, Massa, Italy
| | - Raffaele Giordano
- Department Advanced Biomedica Sciences, University of Naples Federico II, Naples, Italy
| | - Nadia Assanta
- Pediatric Cardiology Unit, Fondazione CNR-Regione Toscana G. Monasterio, Massa, Italy
| | - Eliana Franchi
- Pediatric Cardiology Unit, Fondazione CNR-Regione Toscana G. Monasterio, Massa, Italy
| | - Martin Koestenberger
- Department Advanced Biomedica Sciences, University of Naples Federico II, Naples, Italy
- Division of Pediatric Cardiology, Department of Pediatrics, Medical University Graz, Austria; and
| | - Pietro Marchese
- Pediatric Cardiology Unit, Fondazione CNR-Regione Toscana G. Monasterio, Massa, Italy
| | - Simona Storti
- Pediatric Cardiology Unit, Fondazione CNR-Regione Toscana G. Monasterio, Massa, Italy
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Italy
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Kashef A, Nikoo AS. Effects of short duration high intensity competition on cardiac and cell damage biomarkers. COMPARATIVE EXERCISE PHYSIOLOGY 2021. [DOI: 10.3920/cep200047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to investigate the cardiac biomarkers like cardiac troponin T (cTnT), cardiac troponin I, and creatine kinase-MB (CK-MB) and the cell damage biomarkers including creatine phosphokinase (CPK), C-reactive protein (CRP), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in response to a short-duration high-intensity competition with correction of the post-exercise raw data with the plasma volume loss in trained athletes. Thirty-two male athletes (age, 26.9±4.7 years) competed in 8 min high-intensity competition. The competition items included: running for 400 meters; three-stage deadlifting; bar pulling up; and 30 kg kettlebell swinging. Venous blood samples were obtained before and immediately after the competition and biomarkers analysed. Plasma volume changes were estimated from haemoglobin and haematocrit readings before and after the competition. A significant increase was shown immediately after the competition compared to resting in cTnT, AST, ALT, CPK, and CRP (P<0/001). CK-MB showed no significant difference. When raw data were corrected for plasma volume loss, CPK showed a significant increase (P<0.001), and LDH and CK-MB a significant decrease (P<0.001), however cTnT, AST, ALT and CRP showed no significant difference. The plasma volume loss can affect the response of cardiac and cellular damage biomarkers to exercise. High-intensity competition for 8 min did not elevate the cardiac biomarkers, but elevated the muscle biomarkers.
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Affiliation(s)
- A. Kashef
- Exercise Physiology Department, Shahid Rajaee Teacher Training University, Lavizan St., Tehran, 1678815811, Iran
| | - A. Sadeghi Nikoo
- Oxygen Medical and Research Center, Seoul St., Tehran, 1468973141, Iran
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The Influence of Floorball on Hematological Parameters: Consequences in Health Assessment and Antidoping Testing. JOURNAL OF SPORTS MEDICINE 2020; 2020:6109308. [PMID: 32802889 PMCID: PMC7403938 DOI: 10.1155/2020/6109308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/06/2020] [Indexed: 02/04/2023]
Abstract
Assessment of hematological parameters is common in sports medicine. Although physical exercise is an important preanalytical variable, data about acute hematological changes after high-intensity intermittent exercise are scarce. This study aimed to examine floorball as a potential preanalytical variable for hematological parameters used in health assessment and antidoping testing. Twenty-three professional male floorball players participated in a floorball game. Hematological parameters including hemoglobin, erythrocyte count and erythrocyte indices, reticulocytes, white blood cells (WBC), platelets, reticulocytes, and OFF-hr score were assessed at baseline, immediately postgame, and at 2 h postgame. Median hemoglobin concentration decreased significantly from 146 g/L pregame to 141 g/L immediately postgame (p < 0.001). WBC count increased from 7.2 × 109/L pregame to 10.1 × 109/L 2 h postgame (p < 0.001). The median OFF-hr score decreased from 99.5 to 94.2 immediately postgame and remained significantly lower than baseline at 2 h postgame (94.4, p=0.030). Looking at individual results, the highest OFF-hr score increased from 120 at baseline to 124 at 2 h postgame. Our findings suggest that participation in a floorball game affects several hematological parameters and consequently can affect health assessment and antidoping testing.
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Watkins ER, Hayes M, Watt P, Renshaw D, Richardson AJ. Extreme occupational heat exposure is associated with elevated haematological and inflammatory markers in Fire Service Instructors. Exp Physiol 2020; 106:233-243. [PMID: 32462715 DOI: 10.1113/ep088386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/20/2020] [Indexed: 12/22/2022]
Abstract
NEW FINDINGS What is the central question of this study? Fire service instructors are frequently exposed to live fire scenarios, representing the most extreme chronic occupational heat exposure. These individuals report a series of unique health issues. We sought to identify whether the number of exposures completed was associated with inflammatory and immunological markers and symptoms of ill health. What is the main finding and its importance? Fire service instructors exhibit greater levels of inflammatory markers in comparison to firefighters. The number of exposures to fire is positively related to the prevalence of ill health and inflammation. Implementation of a proposed limit of nine exposures per month might be appropriate to minimize health issues. ABSTRACT Fire Service Instructors (FSIs) experience ∼10 times more fire exposures than firefighters (FFs), and the increased physiological stress from this potentially puts them at risk of ill health and future cardiac events. The aim of the study was to establish whether FSIs exhibit elevated biomarkers associated with cardiac event risk, identify whether FSIs experience systemic inflammation linked to the frequency of fire exposure and evaluate a proposed exposure limit of nine exposures per month. Blood samples were collected from 110 Fire Service personnel (mean ± SD, age,44 ± 7 years; height, 178.1 ± 7.1 cm; and body mass, 84.3 ± 12.0 kg; FSIs n = 53 and FFs n = 57) for biomarker analysis. Work history details were collected from all participants. Participants with biomarker concentrations above healthy reference ranges were classified as being 'at risk'. The neutrophil-to-lymphocyte ratio, platelet count, cardiac troponin T, interleukin (IL)-6, IL-1β, C-reactive protein and immunoglobulin G were greater in FSIs than in FFs (P < 0.05). Multiple regression analysis revealed that 18.8% of IL-6, 24.9% of IL-1β, 29.2% of C-reactive protein and 10.9% of immunoglobulin G variance could be explained by the number of exposures to heat per month. Odds ratios revealed that those FSIs above the nine per month exposure limit were six to 12 times more likely to be classified as 'at risk' and were 16 times more likely to experience symptoms of ill health. Increased cytokine levels suggest that FSIs experience systemic inflammation, which is related to symptoms of ill health. We propose that an exposure limit could reduce the prevalence of these biomarker risk factors and ill health.
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Affiliation(s)
- Emily R Watkins
- Department of Life Sciences, University of Roehampton, London, UK
| | - Mark Hayes
- Environmental Extremes Laboratory, Welkin Laboratories, University of Brighton, Eastbourne, UK
| | - Peter Watt
- Environmental Extremes Laboratory, Welkin Laboratories, University of Brighton, Eastbourne, UK
| | - Derek Renshaw
- Centre for Sport, Exercise & Life Sciences, Coventry University, Coventry, UK
| | - Alan J Richardson
- Environmental Extremes Laboratory, Welkin Laboratories, University of Brighton, Eastbourne, UK
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Wedin JO, Nyberg NS, Henriksson AE. Impact of training specificity on exercise-induced cardiac troponin elevation in professional athletes: A pilot study. World J Cardiol 2020; 12:35-43. [PMID: 31984126 PMCID: PMC6952726 DOI: 10.4330/wjc.v12.i1.35] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/20/2019] [Accepted: 10/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Release of cardiac biomarkers is common after strenuous endurance exercise, but data on intermittent exercise are scarce. It has not been investigated whether cardiac troponin elevation is influenced depending on the type of exercise that an athlete is adapted to perform. We hypothesized that intermittent but not continuous exercise induces cardiac troponin elevation in professional athletes adapted to high-intensity intermittent exercise. AIM To examine how training specificity impacts high-sensitivity cardiac troponin T (hs-cTnT) release. METHODS Nine professional floorball players participated in the study, which comprised two different exercise tests: a continuous incremental cycle ergometer test and a Yo-Yo Intermittent Recovery 2 (Yo-Yo IR2) test. Serial assessment of hs-cTnT was performed after the cycle ergometer test and the Yo-Yo IR2 test (baseline, 0, 2, 6, and 24 h). RESULTS No hs-cTnT elevation above the myocardial damage cutoff (≥ 14 ng/L) was shown after the cycle ergometer test, whereas hs-cTnT levels rose over the cutoff in three of nine participants after the Yo-Yo IR2 test. The hs-cTnT levels peaked at 6 h after both tests, but were significantly higher after the Yo-Yo IR2 test compared to the cycle ergometer test (median hs-cTnT concentration 10.6 ng/L vs 7.8 ng/L, P = 0.038). All levels returned to baseline within 24 h. CONCLUSION In professional athletes adapted to high-intensity intermittent exercise, hs-cTnT was significantly elevated after intermittent but not continuous exercise. This principle of specificity training should be considered when designing future studies to avoid misinterpretation of hs-cTnT elevation.
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Affiliation(s)
- Johan O Wedin
- Department of Clinical Physiology, Sundsvall County Hospital, Sundsvall 851 86, Sweden
- Department of Clinical Chemistry, Sundsvall County Hospital, Sundsvall 851 86, Sweden
| | - Nicolena S Nyberg
- Department of Clinical Chemistry, Sundsvall County Hospital, Sundsvall 851 86, Sweden
| | - Anders E Henriksson
- Department of Clinical Chemistry, Sundsvall County Hospital, Sundsvall 851 86, Sweden
- Department of Natural Sciences, Mid Sweden University, Sundsvall 851 70, Sweden.
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Acute effects of recreational soccer on inflammatory response and cardiac and skeletal muscle damage indicators. REV ROMANA MED LAB 2019. [DOI: 10.2478/rrlm-2019-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Introduction: Previous studies have indicated that acute bouts of strenuous, long duration exercise induce significant increases in the inflammatory profile and cardiovascular risk markers. Although recreational soccer (RS) is a widespread activity, there are no data on this topic. Thus, the aim of this study was to examine RS-induced changes in inflammatory, cardiac, and skeletal muscle damage indicators in young and middle-aged males.
Methods: Twelve young and 11 middle-aged males participated in the study. The participants played 6v6 1 h RS, where heart rate (HR) responses and external loads (distance covered, number of accelerations/decelerations) were determined. Blood samples were taken immediately prior to and following the matches, and 2 h, 4 h, 24 h, 48 h, and 72 h later.
Results: Absolute HR responses and the number of accelerations and decelerations were higher in young participants than the middle-aged participants (p < 0.05). RS increased high sensitivity cardiac troponin I (hs-cTnI) in almost all participants. A total of 83.3% of the young participants exceeded the upper reference limit (URL), whereas none of the middle-aged participants exceeded the URL. Hs-cTnI levels returned to baseline after 24 and 48 h in the middle-aged and young participants, respectively. High sensitivity C-reactive protein (hs-CRP) and creatine kinase (CK) increased in the middle-aged participants (p < 0.05), and in the young participants, though not significantly (p > 0.05). RS also led to significant increases in lactate dehydrogenase (LDH) in both groups (p < 0.05). Hs-CRP, CK, and LDH values returned to baseline levels within 48 to 72 h, except for the LDH values of the young participants.
Conclusion: RS induced short-term increases in cardiac and skeletal muscle damage markers and the inflammatory profile in young and middle-aged RS participants.
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Li F, Yi L, Yan H, Wang X, Nie J, Zhang H, Fu FHK, Zang Y, Yang S, Lu Y. High-sensitivity cardiac troponin T release after a single bout of high-intensity interval exercise in experienced marathon runners. J Exerc Sci Fit 2017; 15:49-54. [PMID: 29541132 PMCID: PMC5812874 DOI: 10.1016/j.jesf.2017.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/31/2017] [Accepted: 08/08/2017] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of a single bout of high-intensity interval exercise (HIIE) on high-sensitivity cardiac troponin T (hs-cTnT) release and to explore the potential influencing factors. METHODS Twenty-one experienced marathon runners completed HIIE on treadmill. Each bout of HIIE included a hard run (15.8 ± 1.3 km·h-1) at 90% vVO2max for 2 min followed by an easy run (8.8 ± 0.7 km·h-1) at 50% vVO2max for 2 min performed 23 times within 92 min. Heart rate (HR) was recorded every 2 min during HIIE. The hs-cTnT level was measured before (pre), immediately after (0 h), and at 4 and 24 h after exercise. RESULTS The hs-cTnT level was elevated at 0 h, peaked at 4 h, and had not returned to the baseline value at 24 h after exercise. The response of hs-cTnT at 4 h was positively related to exercise HR. Subjects with a greater increase in hs-cTnT level had a higher exercise HR under fixed exercise intensity. CONCLUSION HIIE at 90% vVO2max interspersed with 50% vVO2max for recovery can elicit hs-cTnT elevation. HR is a good predictor of exercise-induced cardiac troponin (cTn) release under fixed exercise intensity. Further study should consider to correct for HR when constructing impact factors contributing to exercise-induced cTn release.
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Affiliation(s)
- Feifei Li
- Department of Rehabilitation, Beijing Sport University, Beijing, China
| | - Longyan Yi
- Sport Science Research Centre, Beijing Sport University, Beijing, China
| | - Huiping Yan
- Department of Rehabilitation, Beijing Sport University, Beijing, China
| | - Xuejing Wang
- Clinical Laboratory, Civil Aviation General Hospital, Beijing, China
| | - Jinlei Nie
- School of Physical Education and Sports, Macao Polytechnic Institute, Macao, China
| | - Haifeng Zhang
- Physical Education College, Hebei Normal University, Shijiazhuang, China
- Provincial Key Lab of Measurement and Evaluation in Human Movement and Bio-Information, Hebei, China
| | - Frank Hoo Kin Fu
- Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Department of Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Yanpeng Zang
- Department of Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Shuo Yang
- Department of Rehabilitation, Beijing Sport University, Beijing, China
| | - Yifan Lu
- Department of Rehabilitation, Beijing Sport University, Beijing, China
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12
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Danielsson T, Carlsson J, Schreyer H, Ahnesjö J, Ten Siethoff L, Ragnarsson T, Tugetam Å, Bergman P. Blood biomarkers in male and female participants after an Ironman-distance triathlon. PLoS One 2017; 12:e0179324. [PMID: 28609447 PMCID: PMC5469473 DOI: 10.1371/journal.pone.0179324] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 05/26/2017] [Indexed: 11/18/2022] Open
Abstract
Background While overall physical activity is clearly associated with a better short-term and long-term health, prolonged strenuous physical activity may result in a rise in acute levels of blood-biomarkers used in clinical practice for diagnosis of various conditions or diseases. In this study, we explored the acute effects of a full Ironman-distance triathlon on biomarkers related to heart-, liver-, kidney- and skeletal muscle damage immediately post-race and after one week’s rest. We also examined if sex, age, finishing time and body composition influenced the post-race values of the biomarkers. Methods A sample of 30 subjects was recruited (50% women) to the study. The subjects were evaluated for body composition and blood samples were taken at three occasions, before the race (T1), immediately after (T2) and one week after the race (T3). Linear regression models were fitted to analyse the independent contribution of sex and finishing time controlled for weight, body fat percentage and age, on the biomarkers at the termination of the race (T2). Linear mixed models were fitted to examine if the biomarkers differed between the sexes over time (T1-T3). Results Being male was a significant predictor of higher post-race (T2) levels of myoglobin, CK, and creatinine levels and body weight was negatively associated with myoglobin. In general, the models were unable to explain the variation of the dependent variables. In the linear mixed models, an interaction between time (T1-T3) and sex was seen for myoglobin and creatinine, in which women had a less pronounced response to the race. Conclusion Overall women appear to tolerate the effects of prolonged strenuous physical activity better than men as illustrated by their lower values of the biomarkers both post-race as well as during recovery.
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Affiliation(s)
- Tom Danielsson
- Department of Sport Sciences, Linneaus University, Kalmar, Sweden
| | - Jörg Carlsson
- Department of Biosciences, Linneaus University, Kalmar, Sweden
- Department of Cardiology, Kalmar Hospital, Kalmar, Sweden
| | | | - Jonas Ahnesjö
- Department of Sport Sciences, Linneaus University, Kalmar, Sweden
| | | | - Thony Ragnarsson
- Department of Sport Sciences, Linneaus University, Kalmar, Sweden
| | - Åsa Tugetam
- Department of Sport Sciences, Linneaus University, Kalmar, Sweden
- Department of Pedagogics, Linneaus University, Kalmar, Sweden
| | - Patrick Bergman
- Department of Sport Sciences, Linneaus University, Kalmar, Sweden
- * E-mail:
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13
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Ranjbar R, Ahmadi MA, Zar A, Krustrup P. Acute effect of intermittent and continuous aerobic exercise on release of cardiac troponin T in sedentary men. Int J Cardiol 2017; 236:493-497. [PMID: 28096042 DOI: 10.1016/j.ijcard.2017.01.065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 01/06/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Studies have shown that acute exercise can increase serum concentrations of cardiac biomarkers, including cardiac troponin T (cTnT). We investigated the acute effects of intermittent (IE) and continuous (CE) exercise at the same cardiac workload on myocardial necrosis biomarkers in sedentary men. METHODS Eleven sedentary healthy men aged 22.3±1.9years completed the study. The subjects were divided into two groups and performed, in random order, IE (intensity alternating between 50% (2min) and 80% (1min) HRreserve) or CE (60% HRreserve). The study was designed as a single-blinded randomised crossover trial performed on two distinct experimental days separated by a 1-week washout period. Each session consisted of 40min of aerobic exercise, either IE or CE, on a treadmill. Blood samples were taken before (PRE), immediately after (POST) and 1h after (POST-1) each exercise session. RESULTS hs-cTnT significantly increased immediately after exercise in both protocols and remained elevated at POST-1 (P<0.05). There was no significant difference between POST and POST-1 values(P>0.05). Neither CE nor IE caused any significant change in CK-MB (P>0.05). The results also showed that HR and RPP increased significantly following both exercise protocols (P=0.001). CONCLUSIONS In summary, both CE and IE results in increased serum concentrations of hs-cTnT in sedentary men. However, this increase does not seem to be caused by the irreversible death of cardiomyocytes. CE resulted in a greater hs-cTnT concentration than IE.
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Affiliation(s)
- Rouhollah Ranjbar
- Department of Exercise Physiology, Faculty of Physical Education and Sport Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Mohammad Amin Ahmadi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran.
| | - Abdossaleh Zar
- Department of Sport Science, Jahrom University, Jahrom, Iran
| | - Peter Krustrup
- College of Life and Environmental Sciences, St Luke's Campus, University of Exeter, Exeter, UK; Department of Nutrition, Exercise and Sports, The August Krogh Building, University of Copenhagen, Copenhagen, Denmark
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14
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The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications. ACTA ACUST UNITED AC 2017; 55:1634-1651. [DOI: 10.1515/cclm-2016-0933] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/28/2017] [Indexed: 01/10/2023]
Abstract
AbstractAccording to recent international guidelines, including the 2012 Third Universal Definiton of Myocardial Infarction by the Joint ESC/ACCF/AHA/WHF Task Force, an increase in cardiac troponin (cTn) levels over the 99th percentile upper reference limit (99th URL) should be considered clinically relevant, this cut-off being measured with an imprecision ≤10 CV%. In theory 99th URL values strongly depend not only on demographic and physiological variables (i.e. criteria for considering the reference population “healthy”), but also on the analytical performance of cTn methods and mathematical algorithms used for the calculation. The aim of the present article was therefore to review the methodological and pathophysiological factors affecting the evaluation and calculation of the 99th URL for cTn assay. The critical analysis made showed that no uniform procedure is followed, and nor have experts or regulatory bodies provided uniform guidelines for researchers or cTn assays manufacturers as an aid in “their quest to define normality”. In particular, little attention has been paid to the way in which a healthy reference population is to be selected, or the criteria for calculating the 99th URL value for cTn assays, thus highlighting the need for international recommendations not only for demographic and physiological variables criteria for defining a healthy reference population, but also for calculating mathematical algorithms for establishing/calculating clinical decision values. An expert consensus group, comprising laboratory and clinical scientists, biomedical statisticians, industrial and regulatory representatives, should be responsible for drawing up these guidelines.
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15
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Petersmann A, Ittermann T, Frieß C, Lubenow N, Kohlmann T, Greinacher A, Masuch A, Nauck M. Impact of physical activity of individuals and creatine kinase on 99th percentiles of troponin I assays. Clin Chim Acta 2016; 462:187-192. [PMID: 27712987 DOI: 10.1016/j.cca.2016.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/14/2016] [Accepted: 10/02/2016] [Indexed: 01/04/2023]
Abstract
Determination of cardiac troponin I (cTnI) is one central means for diagnosis of myocardial infarction. Assay performance of three troponin I assays was compared previously in a large reference population detecting sex-differences in the 99th percentile only for the Dimension Vista cTnI assay. The present study examined the underlying effects. Values for cTnI were reused. Creatine kinase (CK) activity was determined in 2358 samples from blood donors. Information on physical activity was evaluated from health questionnaires. Using quantile regression data were analysed to investigate the impact of sex, physical activity, and CK on the 99th percentile of the cTnI assay. We report significant sex-differences for the 99th percentile of cTnI. Physical activity was significantly associated with cTnI values. Strong association of CK activity with cTnI values was detected only in men. Adjustment for CK in quantile regression abolished sex-differences in the 99th percentile. Two other contemporary sensitive cTnI assays were not relevantly affected by physical activity or CK. Sex-differences in the 99th percentile for the Dimension Vista cTnI assay arise from a positive association between cTnI and physical activity and were abrogated when data were adjusted for CK activity. These findings should be taken into account when using this assay.
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Affiliation(s)
- Astrid Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald, Germany.
| | - Till Ittermann
- Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald, Germany; Institute of Community Medicine, University of Greifswald, Germany
| | - Cornelia Frieß
- Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald, Germany
| | - Norbert Lubenow
- Institute of Immunology and Transfusion Medicine, Division Transfusion Medicine, University of Greifswald, Germany; Department of Immunology, Genetics and Pathology (IGP), Uppsala University, Sweden
| | - Thomas Kohlmann
- Institute of Community Medicine, University of Greifswald, Germany
| | - Andreas Greinacher
- Institute of Immunology and Transfusion Medicine, Division Transfusion Medicine, University of Greifswald, Germany
| | - Annette Masuch
- Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University of Greifswald, Germany
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16
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López-Laval I, Legaz-Arrese A, George K, Serveto-Galindo O, González-Rave JM, Reverter-Masia J, Munguía-Izquierdo D. Cardiac troponin I release after a basketball match in elite, amateur and junior players. Clin Chem Lab Med 2016; 54:333-8. [PMID: 26136302 DOI: 10.1515/cclm-2015-0304] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 06/08/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND Available scientific data related to cardiac troponin I (cTnI) release after intermittent exercise is limited. It is also of interest to determine what personal or environmental factors mediate the exercise-induced release of cTnI. This study had two objectives: 1) to examine the individual release of cTnI to a basketball match; and 2) to establish the influence of athlete status as well as biological age on cTnI release. METHODS Thirty-six basketball players (12 adult elite [PBA]: 27.3±4.1 years, 12 adult amateur [ABA]: 29.6±2.9 years, and 12 junior elite [JBA]: 16.6±0.9 years) participated in a simulated basketball match with serial assessment of cTnI at rest, immediately post- and at 1, 3, 6, 12, and 24 h post-exercise. RESULTS The basketball match increased cTnI levels (pre: median [range]; 0.006 [0.001-0.026]; peak post: 0.024 [0.004-0.244] μg/L; p=0.000), with substantial individual variability in peak values. PBA and JBA players showed higher baseline and post-exercise cTnI values than ABA (all p<0.05). Peak cTnI exceeded the upper reference limit (URL) in the 26% of players (3 PBA; 6 JBA). CONCLUSIONS The current results suggest that intermittent exercise can promote the appearance of cTnI and that this is potentially mediated by athlete status.
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17
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Influence of a 10-Day Mimic of Our Ancient Lifestyle on Anthropometrics and Parameters of Metabolism and Inflammation: The "Study of Origin". BIOMED RESEARCH INTERNATIONAL 2016; 2016:6935123. [PMID: 27366752 PMCID: PMC4913061 DOI: 10.1155/2016/6935123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 05/08/2016] [Accepted: 05/15/2016] [Indexed: 01/21/2023]
Abstract
Chronic low-grade inflammation and insulin resistance are intimately related entities that are common to most, if not all, chronic diseases of affluence. We hypothesized that a short-term intervention based on “ancient stress factors” may improve anthropometrics and clinical chemical indices. We executed a pilot study of whether a 10-day mimic of a hunter-gatherer lifestyle favorably affects anthropometrics and clinical chemical indices. Fifty-five apparently healthy subjects, in 5 groups, engaged in a 10-day trip through the Pyrenees. They walked 14 km/day on average, carrying an 8-kilo backpack. Raw food was provided and self-prepared and water was obtained from waterholes. They slept outside in sleeping bags and were exposed to temperatures ranging from 12 to 42°C. Anthropometric data and fasting blood samples were collected at baseline and the study end. We found important significant changes in most outcomes favoring better metabolic functioning and improved anthropometrics. Coping with “ancient mild stress factors,” including physical exercise, thirst, hunger, and climate, may influence immune status and improve anthropometrics and metabolic indices in healthy subjects and possibly patients suffering from metabolic and immunological disorders.
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18
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Sedaghat-Hamedani F, Kayvanpour E, Frankenstein L, Mereles D, Amr A, Buss S, Keller A, Giannitsis E, Jensen K, Katus HA, Meder B. Biomarker Changes after Strenuous Exercise Can Mimic Pulmonary Embolism and Cardiac Injury—A Metaanalysis of 45 Studies. Clin Chem 2015; 61:1246-55. [DOI: 10.1373/clinchem.2015.240796] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 06/18/2015] [Indexed: 11/06/2022]
Abstract
Abstract
BACKGROUND
Biomarkers are well established for diagnosis of myocardial infarction [cardiac troponins, high-sensitivity cardiac troponins (hs-cTn)], exclusion of acute and chronic heart failure [B-type natriuretic peptide (BNP), N-terminal proBNP (NT-proBNP)] and venous thromboembolism (d-dimers). Several studies have demonstrated acute increases in cardiac biomarkers and altered cardiac function after strenuous sports that can pretend a cardiovascular emergency and interfere with state-of-the-art clinical assessment.
METHODS
We performed a systematic review and metaanalysis of biomarker and cardiovascular imaging changes after endurance exercise. We searched for observational studies published in the English language from 1997 to 2014 that assessed these biomarkers or cardiac function and morphology directly after endurance exercise. Of 1787 identified abstracts, 45 studies were included.
RESULTS
Across all studies cardiac troponin T (cTnT) exceeded the cutoff value (0.01 ng/mL) in 51% (95% CI, 37%–64%) of participants. The measured pooled changes from baseline for high-sensitivity cTnT (hs-cTnT) were +26 ng/L (95% CI, 5.2–46.0), for cTnI +40 ng/L (95% CI, 21.4; 58.0), for BNP +10 ng/L (95% CI, 4.3; 16.6), for NT-proBNP +67 ng/L (95% CI, 49.9; 84.7), and for d-dimer +262 ng/mL (95% CI, 165.9; 358.7). Right ventricular end diastolic diameter increased and right ventricular ejection fraction as well as the ratio of the early to late transmitral flow velocities decreased after exercise, while no significant changes were observed in left ventricular ejection fraction.
CONCLUSIONS
Current cardiovascular biomarkers (cTnT, hs-cTnT, BNP, NT-proBNP, and d-dimer) that are used in clinical diagnosis of pulmonary embolism, acute coronary syndrome, and heart failure are prone to alterations due to strenuous exercise. Hence, it is necessary to take previous physical exercise into account when a cardiac emergency is suspected.
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Affiliation(s)
- Farbod Sedaghat-Hamedani
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Germany
| | - Elham Kayvanpour
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Germany
| | - Lutz Frankenstein
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
| | - Derliz Mereles
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Germany
| | - Ali Amr
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Germany
| | - Sebastian Buss
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
| | - Andreas Keller
- Chair for Clinical Bioinformatics, Saarland University, Saarbrücken, Germany
| | | | - Katrin Jensen
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Hugo A Katus
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Germany
| | - Benjamin Meder
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
- DZHK (German Centre for Cardiovascular Research), Germany
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19
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Legaz-Arrese A, López-Laval I, George K, Puente-Lanzarote JJ, Mayolas-Pi C, Serrano-Ostáriz E, Revilla-Martí P, Moliner-Urdiales D, Reverter-Masià J. Impact of an endurance training program on exercise-induced cardiac biomarker release. Am J Physiol Heart Circ Physiol 2015; 308:H913-20. [DOI: 10.1152/ajpheart.00914.2014] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 02/05/2015] [Indexed: 11/22/2022]
Abstract
We evaluated the influence of a 14-wk endurance running program on the exercise-induced release of high-sensitivity cardiac troponin T (hs-cTnT) and NH2-terminal pro-brain natriuretic peptide (NT-proBNP). Fifty-eight untrained participants were randomized to supervised endurance exercise (14 wk, 3–4 days/wk, 120–240 min/wk, 65–85% of maximum heart rate) or a control group. At baseline and after the training program, hs-cTnT and NT-proBNP were assessed before and 5 min, 1 h, 3 h, 6 h, 12 h, and 24 h after a 60-min maximal running test. Before training, hs-cTnT was significantly elevated in both groups with acute exercise ( P < 0.0001) with no between-group differences. There was considerable heterogeneity in peak hs-cTnT concentration with the upper reference limit exceeded in 71% of the exercise tests. After training, both baseline and postexercise hs-cTnT were significantly higher compared with pretraining and the response of the control group ( P = 0.008). Acute exercise led to a small but significant increase in NT-proBNP, but this was not mediated by training ( P = 0.121). In summary, a controlled endurance training intervention resulted in higher pre- and postexercise values of hs-cTnT with no changes in NT-proBNP.
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Affiliation(s)
| | - Isaac López-Laval
- Section of Physical Education and Sports, University of Zaragoza, Zaragoza, Spain
| | - Keith George
- Resarch Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | | | - Carmen Mayolas-Pi
- Section of Physical Education and Sports, University of Zaragoza, Zaragoza, Spain
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