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Falahati A, Arazi H. Cardiac biomarker responses following high-intensity interval and continuous exercise: the influence of ACE-I/D gene polymorphism and training status in men. Physiol Genomics 2024; 56:436-444. [PMID: 38586874 DOI: 10.1152/physiolgenomics.00129.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/03/2024] [Accepted: 04/01/2024] [Indexed: 04/09/2024] Open
Abstract
This study aimed to investigate the relationship between pre- and postexercise cardiac biomarker release according to athletic status (trained vs. untrained) and to establish whether the I/D polymorphism in the angiotensin-converting enzyme (ACE) gene had an influence on cardiac biomarkers release with specific regard on the influence of the training state. We determined cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in 29 trained and 27 untrained male soccer players before and after moderate-intensity continuous exercise (MICE) and high-intensity interval exercise (HIIE) running tests. Trained soccer players had higher pre (trained: 0.014 ± 0.007 ng/mL; untrained: 0.010 ± 0.005 ng/mL) and post HIIE (trained: 0.031 ± 0.008 ng/mL; untrained: 0.0179 ± 0.007) and MICE (trained: 0.030 ± 0.007 ng/mL; untrained: 0.018 ± 0.007) cTnI values than untrained subjects, but the change with exercise (ΔcTnI) was similar between groups. There was no significant difference in baseline and postexercise NT-proBNP between groups. NT-proBNP levels were elevated after both HIIE and MICE. Considering three ACE genotypes, the mean pre exercise cTnI values of the trained group (DD: 0.015 ± 0.008 ng/mL, ID: 0.015 ± 0.007 ng/mL, and II: 0.014 ± 0.008 ng/mL) and their untrained counterparts (DD: 0.010 ± 0.004 ng/mL, ID: 0.011 ± 0.004 ng/mL, and II: 0.010 ± 0.006 ng/mL) did not show any significant difference. To sum up, noticeable difference in baseline cTnI was observed, which was related to athletic status but not ACE genotypes. Neither athletic status nor ACE genotypes seemed to affect the changes in cardiac biomarkers in response to HIIE and MICE, indicating that the ACE gene does not play a significant role in the release of exercise-induced cardiac biomarkers indicative of cardiac damage in Iranian soccer players.NEW & NOTEWORTHY Our study investigated the impact of athletic status and angiotensin-converting enzyme (ACE) gene I/D polymorphism on cardiac biomarkers in soccer players. Trained players showed higher baseline cardiac troponin I (cTnI) levels, whereas postexercise ΔcTnI remained consistent across groups. N-terminal pro-brain natriuretic peptide increased after exercise in both groups, staying within normal limits. ACE genotypes did not significantly affect pre-exercise cTnI. Overall, athletic status influences baseline cTnI, but neither it nor ACE genotypes significantly impact exercise-induced cardiac biomarker responses in this population.
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Affiliation(s)
- Akram Falahati
- Department of Exercise Physiology, University Campus, University of Guilan, Rasht, Iran
| | - Hamid Arazi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht, Iran
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2
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Lasocka-Koriat Z, Lewicka-Potocka Z, Kaleta-Duss A, Siekierzycka A, Kalinowski L, Lewicka E, Dąbrowska-Kugacka A. Differences in cardiac adaptation to exercise in male and female athletes assessed by noninvasive techniques: a state-of-the-art review. Am J Physiol Heart Circ Physiol 2024; 326:H1065-H1079. [PMID: 38391314 DOI: 10.1152/ajpheart.00756.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 02/24/2024]
Abstract
Athlete's heart is generally regarded as a physiological adaptation to regular training, with specific morphological and functional alterations in the cardiovascular system. Development of the noninvasive imaging techniques over the past several years enabled better assessment of cardiac remodeling in athletes, which may eventually mimic certain pathological conditions with the potential for sudden cardiac death, or disease progression. The current literature provides a compelling overview of the available methods that target the interrelation of prolonged exercise with cardiac structure and function. However, this data stems from scientific studies that included mostly male athletes. Despite the growing participation of females in competitive sport meetings, little is known about the long-term cardiac effects of repetitive training in this population. There are several factors-biochemical, physiological and psychological, that determine sex-dependent cardiac response. Herein, the aim of this review was to compare cardiac adaptation to endurance exercise in male and female athletes with the use of electrocardiographic, echocardiographic, and biochemical examination, to determine the sex-specific phenotypes, and to improve the healthcare providers' awareness of cardiac remodeling in athletes. Finally, we discuss the possible exercise-induced alternations that should arouse suspicion of pathology and be further evaluated.
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Affiliation(s)
- Zofia Lasocka-Koriat
- Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland
- First Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Zuzanna Lewicka-Potocka
- Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland
- First Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Kaleta-Duss
- Institute for Radiology, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Anna Siekierzycka
- Department of Medical Laboratory Diagnostics-Fahrenheit Biobank BBMRI.pl, Medical University of Gdańsk, Gdańsk, Poland
| | - Leszek Kalinowski
- Department of Medical Laboratory Diagnostics-Fahrenheit Biobank BBMRI.pl, Medical University of Gdańsk, Gdańsk, Poland
- BioTechMed Centre/Department of Mechanics of Materials and Structures, Gdańsk University of Technology, Gdańsk, Poland
| | - Ewa Lewicka
- Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland
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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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Hernández-González V, Conesa-Milian E, Jové-Deltell C, Pano-Rodríguez Á, Legaz-Arrese A, Reverter-Masia J. Global research trends on cardiac troponin and physical activity among pediatric populations: a bibliometric analysis and science mapping study. Front Pediatr 2024; 12:1285794. [PMID: 38374876 PMCID: PMC10875851 DOI: 10.3389/fped.2024.1285794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/16/2024] [Indexed: 02/21/2024] Open
Abstract
Background Cardiac troponin (cTn) is a reliable marker for evaluating myocardial damage. cTn is a very specific protein involved in myocardial injury, and it is a key factor in the diagnosis of coronary syndromes. Bibliometric analysis was applied in the present work, with the main goal of evaluating global research on the topic of cardiac troponin in pediatric populations. Methods Publications about cardiac troponin and physical activity in pediatric populations were retrieved from the Social Sciences Citation Index (SSCI) and the Science Citation Index Expanded (SCIE) of the Web of Science Core Collection, and they were then analyzed. The study was able to identify the key bibliometric indicators, such as publications, keywords, authors, countries, institutions, and journals. For the analysis, VOSviewer, R-based Bibliometrix (4.2.2), and MapChart were used. Results Initially, 98 documents were identified; however, once inclusion and exclusion criteria were applied, the number of documents decreased to 88. The search yielded 79 original research articles and 9 reviews, almost all of which were published in the past 2 decades. The total number of citations (Nc) of the retrieved publications was 1,468, and the average number of citations per article (Na) was 16.68. In general, 508 authors were found to have participated in research about troponin; they were associated with 256 institutions, and their work was published in 65 different journals from around the world. The authors hailed from 30 countries and/or regions. The year 2022 was the most productive year for the publication of the selected documents. The bibliometric analysis provided information regarding levels of cooperation among authors and institutions. In fact, China, the United States, and England were the most productive nations, and the journal with the greatest number of publications on the topic was Pediatric Cardiology. Summary The number of publications and the trend line show that research on this topic has not yet reached a stage of maturity. There are referent investigators, countries, and institutions that have laid the foundations for subsequent studies on the analyzed topic.
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Affiliation(s)
- Vicenç Hernández-González
- Human Movement Research Group (RGHM), University of Lleida, Lleida, Spain
- Physical Education and Sport Section, University of Lleida, Lleida, Spain
| | - Enric Conesa-Milian
- Human Movement Research Group (RGHM), University of Lleida, Lleida, Spain
- Physical Education and Sport Section, University of Lleida, Lleida, Spain
| | - Carme Jové-Deltell
- Human Movement Research Group (RGHM), University of Lleida, Lleida, Spain
- Physical Education and Sport Section, University of Lleida, Lleida, Spain
| | - Álvaro Pano-Rodríguez
- Human Movement Research Group (RGHM), University of Lleida, Lleida, Spain
- Physical Education and Sport Section, University of Lleida, Lleida, Spain
| | - Alejandro Legaz-Arrese
- Section of Physical Education and Sports, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
| | - Joaquin Reverter-Masia
- Human Movement Research Group (RGHM), University of Lleida, Lleida, Spain
- Physical Education and Sport Section, University of Lleida, Lleida, Spain
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Wuestenfeld JC, Kastner T, Hesse J, Fesseler L, Frohberg F, Rossbach C, Wolfarth B. Differences in Troponin I and Troponin T Release in High-Performance Athletes Outside of Competition. Int J Mol Sci 2024; 25:1062. [PMID: 38256135 PMCID: PMC10816948 DOI: 10.3390/ijms25021062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Troponin I and troponin T are critical biomarkers for myocardial infarction and damage and are pivotal in cardiological and laboratory diagnostics, including emergency settings. Rapid testing protocols have been developed for urgent care, particularly in emergency outpatient clinics. Studies indicate that strenuous physical activity can cause transient increases in these troponin levels, which are typically considered benign. This research focused on 219 elite athletes from national teams, evaluating their troponin I and T levels as part of routine sports medical exams, independent of competition-related physical stress. The results showed that 9.2% (18 athletes) had elevated troponin I levels above the reporting threshold, while their troponin T levels remained within the normal range. Conversely, only 0.9% (two athletes) had normal troponin I but raised troponin T levels, and 2.3% (five athletes) exhibited increases in both markers. No significant cardiovascular differences were noted between those with elevated troponin levels and those without. This study concludes that elevated troponin I is a common response to the intense physical training endured by high-performance endurance athletes, whereas troponin T elevation does not seem to be directly linked to physical exertion in this group. For cardiac assessments, particularly when ruling out cardiac damage in these athletes, troponin T might be a more reliable indicator than troponin I.
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Affiliation(s)
- Jan C. Wuestenfeld
- Institute for Applied Training Science, Marschnerstrasse 29, 04109 Leipzig, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Sports Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Tom Kastner
- Institute for Applied Training Science, Marschnerstrasse 29, 04109 Leipzig, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Sports Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Judith Hesse
- Institute for Applied Training Science, Marschnerstrasse 29, 04109 Leipzig, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Sports Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Leon Fesseler
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Sports Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Florian Frohberg
- Institute for Applied Training Science, Marschnerstrasse 29, 04109 Leipzig, Germany
| | - Cornelius Rossbach
- Institute for Applied Training Science, Marschnerstrasse 29, 04109 Leipzig, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Sports Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - Bernd Wolfarth
- Institute for Applied Training Science, Marschnerstrasse 29, 04109 Leipzig, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Sports Medicine, Charitéplatz 1, 10117 Berlin, Germany
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Pesova P, Jiravska Godula B, Jiravsky O, Jelinek L, Sovova M, Moravcova K, Ozana J, Gajdusek L, Miklik R, Sknouril L, Neuwirth R, Sovova E. Exercise-Induced Blood Pressure Dynamics: Insights from the General Population and the Athletic Cohort. J Cardiovasc Dev Dis 2023; 10:480. [PMID: 38132648 PMCID: PMC10743421 DOI: 10.3390/jcdd10120480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/19/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
Blood pressure (BP) dynamics during graded exercise testing provide important insights into cardiovascular health, particularly in athletes. These measurements, taken during intense physical exertion, complement and often enhance our understanding beyond traditional resting BP measurements. Historically, the challenge has been to distinguish 'normal' from 'exaggerated' BP responses in the athletic environment. While basic guidelines have served their purpose, they may not fully account for the complex nature of BP responses in today's athletes, as illuminated by contemporary research. This review critically evaluates existing guidelines in the context of athletic performance and cardiovascular health. Through a rigorous analysis of the current literature, we highlight the multifaceted nature of exercise-induced BP fluctuations in athletes, emphasising the myriad determinants that influence these responses, from specific training regimens to inherent physiological nuances. Our aim is to advocate a tailored, athlete-centred approach to BP assessment during exercise. Such a paradigm shift is intended to set the stage for evidence-based guidelines to improve athletic training, performance and overall cardiovascular well-being.
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Affiliation(s)
- Petra Pesova
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic; (P.P.); (B.J.G.)
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic (R.N.)
| | - Bogna Jiravska Godula
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic; (P.P.); (B.J.G.)
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic (R.N.)
| | - Otakar Jiravsky
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic (R.N.)
- Faculty of Medicine, Masaryk University, Kamenice 735/5, 625 00 Brno, Czech Republic
| | - Libor Jelinek
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic; (P.P.); (B.J.G.)
| | - Marketa Sovova
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic; (P.P.); (B.J.G.)
| | - Katarina Moravcova
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic; (P.P.); (B.J.G.)
| | - Jaromir Ozana
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic; (P.P.); (B.J.G.)
| | - Libor Gajdusek
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic (R.N.)
- Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic
| | - Roman Miklik
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic (R.N.)
- Faculty of Medicine, Masaryk University, Kamenice 735/5, 625 00 Brno, Czech Republic
| | - Libor Sknouril
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic (R.N.)
| | - Radek Neuwirth
- Sports Cardiology Center, Nemocnice Agel Trinec-Podlesi, Konska 453, 739 61 Trinec, Czech Republic (R.N.)
- Faculty of Medicine, Masaryk University, Kamenice 735/5, 625 00 Brno, Czech Republic
| | - Eliska Sovova
- Faculty of Medicine, Palacky University, Krizkovskeho 511/8, 779 00 Olomouc, Czech Republic; (P.P.); (B.J.G.)
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Giers J, Bartel A, Kirsch K, Müller SF, Horstmann S, Gehlen H. Blood-Based Markers for Skeletal and Cardiac Muscle Function in Eventing Horses before and after Cross-Country Rides and How They Are Influenced by Plasma Volume Shift. Animals (Basel) 2023; 13:3110. [PMID: 37835716 PMCID: PMC10572052 DOI: 10.3390/ani13193110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
Horses competing in cross-country tests are subjected to high physical demands. Within the scope of this prospective longitudinal study, blood values of 20 elite eventing horses were examined before and after two- to four-star cross-country rides. The aim was to find out whether blood-based markers for skeletal muscle and cardiac muscle function change after cross-country exercise. Parameters that provide information about fluid balance, muscle enzymes, metabolites and cardiac muscle-specific markers were investigated. We developed an approach to eliminate the concentration changes caused by reduced plasma volume. Parameters were measured pre, 10 and 30 min post exercise and the next morning and were evaluated using a mixed model. Thirty minutes after exercise, most parameter concentrations changed in an exercise-dependent manner. The next morning, most exercise-related markers recovered rapidly, while creatine kinase (CK) (26% increase; p = 0.008) and lactate dehydrogenase (LDH) (15% increase; p < 0.001) showed a declining but sustained increase. Cardiac troponin I (cTnI) increased above the reference range in 40 of the 55 rides (73%) and in 18 of 20 horses in the morning after exercise.
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Affiliation(s)
- Johanna Giers
- Equine Clinic, Internal Medicine, Freie Universität Berlin, Oertzenweg 19b, 14193 Berlin, Germany
| | - Alexander Bartel
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, Königsweg 67, 14163 Berlin, Germany;
| | - Katharina Kirsch
- Department Sensors and Modeling, Leibniz Institute for Agricultural Engineering and Bioeconomy (ATB), Max-Eyth Allee 100, 14469 Potsdam, Germany;
| | - Simon Franz Müller
- Laboklin Veterinary Laboratory Diagnostics, Steubenstrasse 4, 97688 Bad Kissingen, Germany;
| | - Stephanie Horstmann
- German Olympic Committee for Equestrian Sports (DOKR), Freiherr-von-Langen-Straße 15, 48231 Warendorf, Germany;
| | - Heidrun Gehlen
- Equine Clinic, Internal Medicine, Freie Universität Berlin, Oertzenweg 19b, 14193 Berlin, Germany
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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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Papamichail A, Androulakis E, Xanthopoulos A, Briasoulis A. Effect of Training Load on Post-Exercise Cardiac Biomarkers in Healthy Children and Adolescents: A Systematic Review of the Existing Literature. J Clin Med 2023; 12:jcm12062419. [PMID: 36983423 PMCID: PMC10056214 DOI: 10.3390/jcm12062419] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Postexercise release of cardiac biomarkers (cardiac troponins, cTn, and N-terminal pro b-type natriuretic peptide, NT-proBNP) is a well-known phenomenon in adults, although it remains unclear how it manifests in children. The aim of this review is to compare the pre-exercise with the post-exercise measurement of serum cardiac biomarkers, as well as to analyze their post-exercise release based on age, sex, and exercise intensity and duration. METHODS The terms troponin, football, swimmers, marathon, run, and exercise were used in a literature search at National Library of Medicine. The search was further refined by adding the keywords athletes, children, adolescents, and sport. RESULTS Fifteen pediatric studies and four studies with a mixed population of adults and children totaled 19 studies for the final analysis. In addition to them, some adult studies have been included for comparison. The kinetics of the cTn and NT-proBNP response after exercise have been the subject of our interest. While the impact of sport type, age, and sex has not yet been fully characterized, the existing data points to considerable impacts of sport intensity and duration on post-exercise biomarkers elevation. Most of the findings came from endurance sports, but the evidence is sparse. Furthermore, there is only limited data on women and less on young adults, African Caribbeans, and professional athletes. CONCLUSIONS Both amateur and competitive athletes can exhibit post-exercise release of both cTn and NT-proBNP. This is transient and lacks pathological significance, in contrast with adult population, in which exercise-induced increases in in these biomarker levels may not always be benign. While NT-proBNP release is still primarily driven by activity duration, cTnT release is additionally affected by exercise intensity. To define individual ranges of normality for postexercise cTn and NT-proBNP elevation, the role of several confounders (age, sex, sport type/intensity etc.) remains to be further elucidated.
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Affiliation(s)
| | - Emmanuel Androulakis
- Cardiology Department, St George's University of London, Blackshaw Road, London SW17 0QT, UK
| | - Andrew Xanthopoulos
- Medical School of Athens, National and Kapodistrian University of Athens, Goudi, 11527 Athens, Greece
| | - Alexandros Briasoulis
- Medical School of Athens, National and Kapodistrian University of Athens, Goudi, 11527 Athens, Greece
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10
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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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11
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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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12
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Stavroulakis G, Methenitis S, Koutroulis G, Xanthis D, Cherouveim E, Kroupis C, Anastasiadis G, Ketselidi K, Vlachopoulou E, Tsolakis C, Koulouvaris P. Exploring the predictors and prognostic significance of exercise-induced cardiac troponin release in master athletes following a 28km mountain race. The Vamvakou Research Project. Biomarkers 2022; 27:418-426. [PMID: 35383512 DOI: 10.1080/1354750x.2022.2062449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Ιntroduction. Etiology and significance of exercise-induced troponin release remains a contentious issue. We investigated the effect of a 28km mountain run on cardiac troponin I (cTnI), in relation to training, performance, nutritional, biochemical and echocardiography variables, in a group of 25 recreational male master athletes.Μaterial and methods. A comprehensive list of variables related with nutrition, training, performance and echocardiography, was collected pre- and post-race. Twenty four months later, outcomes regarding cardiovascular events was obtained.Results. Serum cTnI values were increased after the race, with mean values rising from 7.2 ± 2.2 (before) to 80.0 ± 33.2ng/L (post race), (p < 0.001) and 23/25(92%) exceeding Upper Reference limit (50ng/L). Echocardiography did not reveal significant alterations, or correlations with cTnI values. The % difference in hs-cTnI concentrations pre- and post race correlated positively with age, race-induced changes of selected muscle damage indices, resistance training volume, and negatively with endurance capacity and training volume (r: -0.727 to 0.725, p < 0.05). All athletes reported no cardiovascular event during the 24 month period post race.Conclusion. cTnI elevation induced by a 28km mountain running race was not correlated with echocardiographic, nutritional parameters and was less pronounced in athletes with larger endurance training history, in contrast with resistance training and age.
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Affiliation(s)
- George Stavroulakis
- Sports Excellence, 1st Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Greece.,Division of Cardiology, Hygeias Melathron, Athens, Greece
| | - Spyridon Methenitis
- Sports Excellence, 1st Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Greece.,Sports Performance Laboratory, School of Physical Education & Sports Science, National and Kapodistrian University of Athens, Greece
| | | | | | - Eugenia Cherouveim
- Sports Excellence, 1st Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Greece.,Sports Performance Laboratory, School of Physical Education & Sports Science, National and Kapodistrian University of Athens, Greece
| | - Christos Kroupis
- Sports Excellence, 1st Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | | | - Kleopatra Ketselidi
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University of Athens, Greece
| | - Elpiniki Vlachopoulou
- Department of Nutrition Sciences and Dietology, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Charilaos Tsolakis
- Sports Excellence, 1st Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Greece.,Sports Performance Laboratory, School of Physical Education & Sports Science, National and Kapodistrian University of Athens, Greece
| | - Panagiotis Koulouvaris
- Sports Excellence, 1st Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Greece
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13
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Aengevaeren VL, Baggish AL, Chung EH, George K, Kleiven Ø, Mingels AMA, Ørn S, Shave RE, Thompson PD, Eijsvogels TMH. Exercise-Induced Cardiac Troponin Elevations: From Underlying Mechanisms to Clinical Relevance. Circulation 2021; 144:1955-1972. [PMID: 34898243 PMCID: PMC8663527 DOI: 10.1161/circulationaha.121.056208] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Supplemental Digital Content is available in the text. Serological assessment of cardiac troponins (cTn) is the gold standard to assess myocardial injury in clinical practice. A greater magnitude of acutely or chronically elevated cTn concentrations is associated with lower event-free survival in patients and the general population. Exercise training is known to improve cardiovascular function and promote longevity, but exercise can produce an acute rise in cTn concentrations, which may exceed the upper reference limit in a substantial number of individuals. Whether exercise-induced cTn elevations are attributable to a physiological or pathological response and if they are clinically relevant has been debated for decades. Thus far, exercise-induced cTn elevations have been viewed as the only benign form of cTn elevations. However, recent studies report intriguing findings that shed new light on the underlying mechanisms and clinical relevance of exercise-induced cTn elevations. We will review the biochemical characteristics of cTn assays, key factors determining the magnitude of postexercise cTn concentrations, the release kinetics, underlying mechanisms causing and contributing to exercise-induced cTn release, and the clinical relevance of exercise-induced cTn elevations. We will also explain the association with cardiac function, correlates with (subclinical) cardiovascular diseases and exercise-induced cTn elevations predictive value for future cardiovascular events. Last, we will provide recommendations for interpretation of these findings and provide direction for future research in this field.
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Affiliation(s)
- Vincent L Aengevaeren
- Radboud Institute for Health Sciences, Departments of Physiology (V.L.A., T.M.H.E.), Radboud University Medical Center, Nijmegen, The Netherlands.,Cardiology (V.L.A.), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston (A.L.B.)
| | - Eugene H Chung
- Michigan Medicine, University of Michigan, Ann Arbor (E.H.C.)
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (K.G.)
| | - Øyunn Kleiven
- Cardiology Department, Stavanger University Hospital, Norway (Ø.K., S.Ø.)
| | - Alma M A Mingels
- Department of Clinical Chemistry, Central Diagnostic Laboratory, Maastricht University Medical Center Maastricht, The Netherlands (A.M.A.M.)
| | - Stein Ørn
- Cardiology Department, Stavanger University Hospital, Norway (Ø.K., S.Ø.).,Department of Electrical Engineering and Computer Science, University of Stavanger, Norway (S.Ø.)
| | - Rob E Shave
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Vancouver, Canada (R.E.S.)
| | | | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Departments of Physiology (V.L.A., T.M.H.E.), Radboud University Medical Center, Nijmegen, The Netherlands
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14
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Kong Z, Zhang H, Nie J, Wen L, Shi Q, Ng SF, Huang C, George K. Exercise Training Increases Serum Cardiac Troponin T Independent of Left Ventricular Mass. Int J Sports Med 2021; 43:505-511. [PMID: 34872117 DOI: 10.1055/a-1670-7707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this study was to determine whether exercise training mediated cardiac troponin T (cTnT) and whether this was associated with increases in left ventricular mass (LVM). Fifty-four sedentary obese women were randomised to high-intensity interval training (HIIT, repeated 4-min cycling at 90% V̇O2max interspersed with 3-min rest), work-equivalent continuous aerobic training (CAT, continuous cycling at 60% V̇O2max) or a control group (CON). Resting serum cTnT was assessed using a high-sensitivity assay before and after 12 weeks of training. LVM was determined from 2D echocardiography at the same timepoints. Both HIIT and CAT induced a similar elevation (median 3.07 to 3.76 ng.l-1, p<0.05) in resting cTnT compared with pre-training and the CON (3.49 to 3.45 ng.l-1, p>0.05). LVM index in HIIT increased (62.2±7.8 to 73.1±14.1 g.m-2, p<0.05), but not in CAT (66.1±9.7 to 67.6±9.6 g.m-2, p>0.05) and CON (67.9±9.5 to 70.2±9.1 g.m-2, p>0.05). Training-induced changes in resting cTnT did not correlate with changes in LVM index (r=-0.025, p=0.857). These findings suggest that twelve weeks of either HIIT or CAT increased resting cTnT, but the effects were independent of any changes in LVM in sedentary obese women.
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Affiliation(s)
- Zhaowei Kong
- Faculty of Education, University of Macau, Taipa, Macao
| | - Haifeng Zhang
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Jinlei Nie
- School of Health Sciences and Sports, Macao Polytechnic Institute, Macao, Macao
| | - Li Wen
- Nanjing Sport Institute, Nanjing, China
| | - Qingde Shi
- School of Health Sciences and Sports, Macao Polytechnic Institute, Macao, Macao
| | - San Fan Ng
- School of Health Sciences and Sports, Macao Polytechnic Institute, Macao, Macao
| | - Chuanye Huang
- Graduate School, Shandong Sport University, Jinan, China
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
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15
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Le Goff C, Kaux JF, Dulgheru R, Seidel L, Pincemail J, Cavalier E, Melon P. The impact of an ultra-trail on the dynamic of cardiac, inflammatory, renal and oxidative stress biological markers correlated with electrocardiogram and echocardiogram. Acta Cardiol 2021; 76:739-747. [PMID: 32539581 DOI: 10.1080/00015385.2020.1778871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The aim of this study was to describe the effects of a 64.2 km ultra-trail on the biomarkers of muscle damage, inflammation and oxidative stress, and compare the results observed with an ECG and an echocardiogram, both performed before and after the race.Thirty-three ultra-trail volunteers (45.8 ± 8.7 years old) were enrolled in our study. Three blood tests were drawn from each runner, one just before (TPRE), one just after (TPOST) and the last 3 h after the end of the race (TPOST3h).All the markers increased. The maximum concentrations observed were at TPOST3h and were significant (p < 0.001) for creatine kinase, creatine kinase isoform MB, high-sensitivity C-reactive protein, uric acid and for the ratio of reduced glutathione to oxidised glutathione. However, in the case of myoglobin, high-sensitive troponin T, N-terminal pro-brain natriuretic peptide, oxidised glutathione, myeloperoxidase, cystatin C and creatinine, the most significant increases were at TPOST (p < 0.001). Modifications were observed in the medical imaging using echocardiography such as reduction of left ventricule end-sytolic and diastolic volumes and left ventricular global longitudinal strain. ECG showed electrical criteria for left ventricular hypertrophy and incomplete right bundle branch block after the race.Endurance races cause significant physiological stress to the body that can be measured by the increase of different biomarkers. From a laboratory perspective, it is important to take into account the possible exercise performed previous to the testing to avoid a misinterpretation of the results. From a training perspective, due to these increases in biomarkers, it is recommended that runners wait at least 72 h after an ultra-trail before subsequent training. In addition a transient impairment of ventricular function due to dehydration were observed.
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Affiliation(s)
- C. Le Goff
- Clinical Chemistry Department, University and University Hospital of Liège, Liège, Belgium
| | - J-F. Kaux
- Physical Medicine and Sports Traumatology Department, SportS2, FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIMS Collaborating Center of Sports Medicine, University and University Hospital of Liège, Liège, Belgium
| | - R. Dulgheru
- Department of Cardiology, University and University Hospital of Liège, Liège, Belgium
| | - L. Seidel
- Biostatistic Department, University Hosptial of Liège, Liège, Belgium
| | | | - E. Cavalier
- Clinical Chemistry Department, University and University Hospital of Liège, Liège, Belgium
| | - P. Melon
- Department of Cardiology, University and University Hospital of Liège, Liège, Belgium
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16
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Tesema G, George M. Associations between cardiac troponin I and cardiovascular parameters after 12-week endurance training in young moderately trained amateur athletes. BMJ Open Sport Exerc Med 2021; 7:e001065. [PMID: 33791107 PMCID: PMC7978269 DOI: 10.1136/bmjsem-2021-001065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 11/19/2022] Open
Abstract
Background Previous studies were conducted only on elite athletes, and they investigate acute training responses of cardiac troponin I (CTnI). However, cardiac troponin was found to be elevated in young and inexperienced athletes than adults, and immature myocardium is more susceptible to injury, which needs further consideration. Aim Therefore, we aimed to observe the association between CTnI and cardiovascular parameters in response to chronic endurance training adaptation in young athletes. Methods Fifteen participants aged (19.5±1.3) years were selected and placed in endurance running at 70%–80% HRmax intensity for 35 min per training for the first week and additional 2 min each week from the second to the last week for 12 weeks. Serum cardiac troponin and cardiovascular parameters were assessed at pre-training and after 12 weeks of training. Result We find a significant CTnI level (p<0.05) and it is positively correlated with systolic blood pressure (BP) (r=0.425). Moreover, CTnI was statistically significant (p<0.01) and positively associated with mean arterial pressure (r=0.516) with a moderate correlation. Besides, CTnI showed a significant (p<0.001) and positive relationship with resting heart rate (r=0.605) and a moderate correlation. We did not find a significant relationship between CTnI and diastolic BP in response to endurance training adaptation. Conclusion In conclusion, serum CTnI was significantly and positively associated with cardiovascular parameters in young amateur athletes in response to 12-week endurance training adaptation.
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Affiliation(s)
- Gashaw Tesema
- Sport Science, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | - Mala George
- Biochemistry, Arba Minch University, Arba Minch, Southern Nations, Ethiopia
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17
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Li F, Hopkins WG, Wang X, Baker JS, Nie J, Qiu J, Quach B, Wang K, Yi L. Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis. Front Physiol 2021; 12:651851. [PMID: 33841187 PMCID: PMC8033011 DOI: 10.3389/fphys.2021.651851] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/01/2021] [Indexed: 01/26/2023] Open
Abstract
Background: Kinetics, moderators and reference limits for exercise-induced cardiac troponin T (cTnT) elevations are still unclear. Methods: A systematic review of published literature was conducted adhering to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies reporting high-sensitivity cardiac troponin T (hs-cTnT) concentrations before and after a bout of exercise in athletes were included and analyzed. The final dataset consisted of 62 estimates from 16 bouts in 13 studies of 5-1,002 athletes (1,421 in total). Meta-analysis was performed using general linear mixed modeling and Bayesian inferences about effect magnitudes. Modifying fixed-effect moderators of gender, age, baseline level, exercise duration, intensity and modalities were investigated. Simulation was used to derive 99th percentile with 95% limits of upper reference ranges for hs-cTnT of athletic populations. Results: The mean and upper reference limits of hs-cTnT before exercise were 4.4 and 19 ng.L-1. Clear increases in hs-cTnT ranging from large to very large (factor changes of 2.1-7.5, 90% compatibility limits, ×/÷1.3) were evident from 0.7 through 25 h, peaking at 2.9 h after the midpoint of a 2.5-h bout of running, when the mean and upper reference limit for hs-cTnT were 33 and 390 ng L-1. A four-fold increase in exercise duration produced a large clear increase (2.4, ×/÷1.7) in post-exercise hs-cTnT. Rowing exercise demonstrated an extremely large clear reduction (0.1 ×/÷2.4). Conclusions: The kinetics of cTnT elevation following exercise, the positive effect of exercise duration, the impact of exercise modality and 99th upper reference limits for athletic populations were reasonably well defined by this meta-analysis.
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Affiliation(s)
- Feifei Li
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Will G. Hopkins
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Xuejing Wang
- Clinical Laboratory, Civil Aviation General Hospital, Beijing, China
| | - Julien S. Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Jinlei Nie
- School of Health Sciences and Sports, Macao Polytechnic Institute, Macao, China
| | - Junqiang Qiu
- College of Sport Science School, Beijing Sport University, Beijing, China
| | - Binh Quach
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Kun Wang
- College of Physical Education, Hebei Normal University, Shijiazhuang, China
| | - Longyan Yi
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
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18
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Stavroulakis GA, George KP. Exercise-induced release of troponin. Clin Cardiol 2020; 43:872-881. [PMID: 31975465 PMCID: PMC7403670 DOI: 10.1002/clc.23337] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 01/19/2023] Open
Abstract
It is well established that regular physical activity reduces cardiovascular disease risk; however, numerous studies have demonstrated postexercise elevations in cardiac troponin (cTn), indicative of cardiac injury in apparently healthy individuals. The prevalence of these findings in different exercise settings and population groups, as well as potential underlying mechanisms and clinical significance of exercise-induced cTn release are not yet quite determined. The present review will discuss the cTn response to exercise in light of developing cTn assays and the correlation between postexercise cTn release and cardiac function. Additionally, recent data regarding the potential link between strenuous endurance exercise and its relationship with unfavorable cardiac effects in athletes, as well as the management of patients presenting at emergency care after sport events will be briefly reviewed.
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Affiliation(s)
| | - Keith P. George
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUK
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19
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Cirer-Sastre R, Legaz-Arrese A, Corbi F, López-Laval I, George K, Reverter-Masia J. Influence of maturational status in the exercise-induced release of cardiac troponin T in healthy young swimmers. J Sci Med Sport 2020; 24:116-121. [PMID: 32680701 DOI: 10.1016/j.jsams.2020.06.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/17/2020] [Accepted: 06/27/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To determine the influence of maturational status on the release of cardiac troponin T (cTnT) induced by a bout of 30min, high-intensity, continuous exercise. DESIGN Quasi-experimental, cross-sectional study. METHODS Seventy male, young, well trained swimmers (age range 7-18 years, training experience 1-11 years) were classified by maturational stages: Tanner stage I (n=14), II (n=15), III (n=15), IV (n=13), and V (n=13). Participants underwent a distance-trial of 30min continuous swimming, and cTnT was measured before, immediately after and 3h after exercise. Changes in cTnT over time were compared among groups, and associated with exercise load. RESULTS Basal cTnT was higher in Tanner-V (3.8-8.1ng/L) compared with I (1.5-5.5ng/L, p<0.001), II (1.5-4.5ng/L, p<0.001) and III (1.5-6.8ng/L, p=0.003), and in IV (1.5-6.3ng/L) compared with II (p=0.036). Maximal elevations of cTnT from baseline were notable (p<0.001) and comparable among maturational stages (p=0.078). The upper reference limit for myocardial injury was exceeded in 35.7% of the participants, without differences among groups (p=0.18). Baseline cTnT correlated with participant characteristics, and maximal cTnT elevations from baseline with exercise internal load (%HRpeak, rs=0.34, p= 0.003; %HRmean, rs=0.28, p=0.02). CONCLUSIONS Maturational status influences positively absolute pre- and post-exercise cTnT but not its elevation after a bout of 30min, high-intensity, continuous exercise.
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Affiliation(s)
- Rafel Cirer-Sastre
- National Institute of Physical Education of Catalonia (INEFC), Universitat de Lleida (UdL), Spain; Grup de Recerca Moviment Humà, Universitat de Lleida (UdL), Spain.
| | | | - Francisco Corbi
- National Institute of Physical Education of Catalonia (INEFC), Universitat de Lleida (UdL), Spain; Grup de Recerca Moviment Humà, Universitat de Lleida (UdL), Spain
| | - Isaac López-Laval
- Section of Physical Education and Sports, University of Zaragoza, Spain
| | - Keith George
- Research Institute for Sport and Exercise Sciences, School of Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom
| | - Joaquín Reverter-Masia
- Grup de Recerca Moviment Humà, Universitat de Lleida (UdL), Spain; Section of Physical Education, Universitat de Lleida (UdL), Spain
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20
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Lippi G, Sanchis-Gomar F. Cardiac troponin release during and after endurance exercise: epidemiologic health implications. Future Cardiol 2020; 16:147-150. [PMID: 32125185 DOI: 10.2217/fca-2019-0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Giuseppe Lippi
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Fabian Sanchis-Gomar
- Department of Physiology, Faculty of Medicine, University of Valencia & INCLIVA Biomedical Research Institute, Valencia, Spain
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21
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Rodríguez-Rosell D, Yáñez-García JM, Mora-Custodio R, Pareja-Blanco F, Ravelo-García AG, Ribas-Serna J, González-Badillo JJ. Velocity-based resistance training: impact of velocity loss in the set on neuromuscular performance and hormonal response. Appl Physiol Nutr Metab 2020; 45:817-828. [PMID: 32017598 DOI: 10.1139/apnm-2019-0829] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study aimed to compare the effects of 2 resistance training (RT) programs with different velocity losses (VLs) allowed in each set: 10% (VL10%) versus 30% (VL30%) on neuromuscular performance and hormonal response. Twenty-five young healthy males were randomly assigned into 2 groups: VL10% (n = 12) or VL30% (n = 13). Subjects followed a velocity-based RT program for 8 weeks (2 sessions per week) using only the full-squat (SQ) exercise at 70%-85% 1-repetition maximum (1RM). Repetition velocity was recorded in all training sessions. A 20-m running sprint, countermovement jump (CMJ), 1RM, muscle endurance, and electromyogram (EMG) during SQ exercise and resting hormonal concentrations were assessed before and after the RT program. Both groups showed similar improvements in muscle strength and endurance variables (VL10%: 7.0%-74.8%; VL30%: 4.2%-73.2%). The VL10% resulted in greater percentage increments in CMJ (9.2% vs. 5.4%) and sprint performance (-1.5% vs. 0.4%) than VL30%, despite VL10% performing less than half of the repetitions than VL30% during RT. In addition, only VL10% showed slight increments in EMG variables, whereas no significant changes in resting hormonal concentrations were observed. Therefore, our results suggest that velocity losses in the set as low as 10% are enough to achieve significant improvements in neuromuscular performance, which means greater efficiency during RT. Novelty The VL10% group showed similar or even greater percentage of changes in physical performance compared with VL30%. No significant changes in resting hormonal concentrations were observed for any training group. Curvilinear relationships between percentage VL in the set and changes in strength and CMJ performance were observed.
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Affiliation(s)
- David Rodríguez-Rosell
- Physical Performance & Sports Research Center, Universidad Pablo de Olavide, Seville 41013, Spain.,Department of Sport and Informatics, Universidad Pablo de Olavide, Seville 41013, Spain
| | - Juan Manuel Yáñez-García
- Physical Performance & Sports Research Center, Universidad Pablo de Olavide, Seville 41013, Spain.,Department of Sport and Informatics, Universidad Pablo de Olavide, Seville 41013, Spain
| | - Ricardo Mora-Custodio
- Physical Performance & Sports Research Center, Universidad Pablo de Olavide, Seville 41013, Spain.,Department of Sport and Informatics, Universidad Pablo de Olavide, Seville 41013, Spain
| | - Fernando Pareja-Blanco
- Physical Performance & Sports Research Center, Universidad Pablo de Olavide, Seville 41013, Spain.,Department of Sport and Informatics, Universidad Pablo de Olavide, Seville 41013, Spain
| | - Antonio G Ravelo-García
- Institute for Technological Development and Innovation in Communications, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria 35017, Spain
| | - Juan Ribas-Serna
- Department of Medical Physiology and Biophysics, University of Seville, Seville 41009, Spain
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22
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Le Goff C, Kaux JF, Farre Segura J, Stojkovic V, Ancion A, Seidel L, Lancellotti P, Cavalier E. Evolution of the slopes of ST2 and galectin-3 during marathon and ultratrail running compared to a control group. Clin Chem Lab Med 2020; 58:314-321. [PMID: 31622239 DOI: 10.1515/cclm-2019-0555] [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: 06/05/2019] [Accepted: 09/16/2019] [Indexed: 11/15/2022]
Abstract
Background Previous studies have suggested that exercising may induce cardiac damage. Galectin-3 (Gal-3) and soluble suppression of tumorigenicity 2 (ST2) are very interesting biomarkers for heart failure and myocardial fibrosis. We aimed to compare the kinetics of emerging fibrosis cardiac biomarkers as Gal-3 and ST-2 in endurance runners, and recreational runners before and after a running event represented by a marathon and an ultratrail event. Methods Blood samples were taken from 19 healthy non-elite marathon runners (42 km), 27 ultratour runners (67 km), and 14 recreational runners who represented the control group (10 km) just before the run (T0), just after (T1) and 3 h after (T2), in order to analyze Gal-3, ST2, hsTnT, NT-proBNP, CKMB and hsCRP. We compared the percentage of evolution and the slopes obtained from T0 to T1 (pT0T1) and from T1 to T2 (pT1T2), between the different groups of runners participating in three different races. Results Plasma cardiac biomarker concentrations increased significantly from baseline to immediately post-exercise and most of the time decreased over the subsequent 3-h period. For pT0T1 and pT1T2, the markers Gal-3 and ST2 showed a significant difference between types of run (p < 0.05 and p < 0.0001, respectively). During the recovery time, Gal-3 returned to the baseline values but not ST2 which continued to increase. Conclusions Gal-3 and ST2 are considered as a reflection of cardiac fibrosis and remodeling. The evolution of both was different, particularly after the recovery time. ST2 values exceeding cutoff values at any time.
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Affiliation(s)
- Caroline Le Goff
- Department of Clinical Chemistry, University Hospital of Liège, CHU Sart-Tilman, Liège, Belgium, Phone: +32 4 366 88 21, Fax: +32 4 366 88 23
| | - Jean-François Kaux
- Department of Physical Medicine and Sport Traumatology, University of Liège, Liège, Belgium
| | - Jordi Farre Segura
- Department of Clinical Chemistry, University Hospital of Liège, Liège, Belgium
| | - Violeta Stojkovic
- Department of Clinical Chemistry, University Hospital of Liège, Liège, Belgium
| | - Arnaud Ancion
- Department of Cardiology, University Hospital of Liège, Liège, Belgium
| | - Laurence Seidel
- Biostatistics Department, University Hospital of Liège, Liège, Belgium
| | | | - Etienne Cavalier
- Department of Clinical Chemistry, University Hospital of Liège, Liège, Belgium
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23
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Tesema G, George M, Mondal S, Mathivana D. Effects of one week different intensity endurance exercise on cardiorespiratory and cardiometabolic markers in junior young athletes. BMJ Open Sport Exerc Med 2019; 5:e000644. [PMID: 31673409 PMCID: PMC6797352 DOI: 10.1136/bmjsem-2019-000644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2019] [Indexed: 11/29/2022] Open
Abstract
Background Endurance training in varied intensity zones are more likely to show different adaptive responses. However, it is still unclear the intensity level of endurance exercise in junior young athletes that may promote increased markers for cardiorespiratory and cardiometabolic response. Therefore, we aimed to investigate the effect of 1 week different intensity endurance training on markers of cardiorespiratory and cardiometabolic response in young athletes. Methods Thirty apparently healthy male young athletes averaging 19.4±1.3 years of age were recruited and randomly assigned to two different intensity endurance training groups. The first group trained at 60% to 70% maximum heart rate (HRmax) for 45 min per session and the second group trained at 70% to 80% HRmax for 30 min per session for a period of 1 week three sessions per week. A pre-training and post-training, marker of cardiorespiratory and cardiometabolic response was assessed for both groups. Results Both intensity training had no significant effect on markers of cardiorespiratory response within and between training groups (p>0.05). Whereas, cardiometabolic markers lactate dehydrogenase (p=0.001), cardiac troponin I (p=0.001) and creatine
kinase myocardial band (p=0.001) significantly increased at the end of 1 week within the group in both training groups (p≤0. 05). In the comparative analysis between groups, there was no significant difference in markers of cardiometabolic response (p>0.05). Conclusion 1 week 60% to 70% HRmax and 70% to 80% HRmax intensity zones induces similar acute effects on markers for cardiometabolic and cardiorespiratory responses between groups and significant elevations of cardiometabolic markers within the groups in moderately trained young athletes.
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Affiliation(s)
- Gashaw Tesema
- Department of Sport Science, College of Natural and Computational science, Mizan-Tepi University, Tepi, Ethiopia.,Department of Sport Science, College of Natural and Computational Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mala George
- Department of Biochemistry, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Soumitra Mondal
- Department of Sport science, College of Natural and Computational Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - D Mathivana
- Department of Sport science, College of Natural and Computational Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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24
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Tesema G, George M, Mondal S, Mathivana D. Serum cardiac markers are inversely associated with VO 2max of amateur athletes in response to endurance training adaptations. BMJ Open Sport Exerc Med 2019; 5:e000537. [PMID: 31191977 PMCID: PMC6539158 DOI: 10.1136/bmjsem-2019-000537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2019] [Indexed: 11/24/2022] Open
Abstract
Background The influence of endurance training intensity and adaptation on serum cardiac markers is poorly understood and controversial; however, no enough data observed the association of serum cardiac markers with VO2max. Therefore, we aimed to investigate whether serum cardiac markers are associated with maximum oxygen consumption (VO2max) in response to 12-week endurance training on amateur athletes. Methods 15 apparently healthy male amateur athletes with 19.47 ± 1.30 years of age were recruited and participated in endurance training with 70%–80% maximal heart rate intensity for 35 min per session for the first week and 2 min increments each week from the second to the last week for a period of 12 weeks. VO2max and serum cardiac markers (lactate dehydrogenase [LDH], creatine kinase myocardial band (CK-MB) and cardiac troponin I [CTnI]) were assessed at the beginning of the training and after 12-week endurance training. Results The result of CTnI indicated significantly (p < 0.01) and inversely (r = − 0.466) correlated with VO2max and CK-MB indicated significantly (p < 0.01) and inversely associated with VO2max (r = − 0.536) with moderate relationship. However, we did not find a significant association on LDH (p > 0.05) with VO2max in response to endurance training adaptation. Conclusion Our finding confirms our hypothesis that serum cardiac markers are inversely associated with estimated VO2max in response to endurance training adaptation.
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Affiliation(s)
- Gashaw Tesema
- Department of Sport Science, College of Natural and Computational Science, Mizan-Tepi University, Mizan, Ethiopia
- Department of Sport Science, College of Natural and Computetional Science, Mekelle University, Mekelle, Ethiopia
| | - Mala George
- Department of Biochemistry, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Soumitra Mondal
- Department of Sport Science, College of Natural and Computational Science, Mekelle University, Mekelle, Ethiopia
| | - D Mathivana
- Department of Sport Science, College of Natural and Computational Science, Mekelle University, Mekelle, Ethiopia
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25
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Cardiac Biomarker Release After Exercise in Healthy Children and Adolescents: A Systematic Review and Meta-Analysis. Pediatr Exerc Sci 2019; 31:28-36. [PMID: 30269651 DOI: 10.1123/pes.2018-0058] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The authors evaluated the impact of acute exercise and 24-hour recovery on serum concentration of cardiac troponins T and I (cTnT and cTnI) and N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP) in healthy children and adolescents. The authors also determined the proportion of participants exceeding the upper reference limits and acute myocardial infarction cutoff for each assay. METHOD Web of Science, SPORTDiscus, MEDLINE, ScienceDirect, and Scopus databases were systematically searched up to November 2017. Studies were screened and quality-assessed; the data was systematically extracted and analyzed. RESULTS From 751 studies initially identified, 14 met the inclusion criteria for data extraction. All 3 biomarkers were increased significantly after exercise. A decrease from postexercise to 24 hours was noted in cTnT and cTnI, although this decrease was only statistically significant for cTnT. The upper reference limit was exceeded by 76% of participants for cTnT, a 51% for cTnI, and a 13% for NT-proBNP. Furthermore, the cutoff value for acute myocardial infarction was exceeded by 39% for cTnT and a 11% for cTnI. Postexercise peak values of cTnT were associated with duration and intensity (Q(3) = 28.3, P < .001) while NT-proBNP peak values were associated with duration (Q(2) = 11.9, P = .003). CONCLUSION Exercise results in the appearance of elevated levels of cTnT, cTnI, and NT-proBNP in children and adolescents. Postexercise elevations of cTnT and NT-proBNP are associated with exercise duration and intensity.
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26
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Zhang H, Nie J, Kong Z, Cao W, Zhu X, Zheng Z, George K. The cTnT response to acute exercise at the onset of an endurance training program: evidence of exercise preconditioning? Eur J Appl Physiol 2019; 119:847-855. [PMID: 30627826 DOI: 10.1007/s00421-019-04074-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 01/04/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Exercise induces a cardioprotective effect referred to as "preconditioning". Whether the preconditioning impacts upon the cardiac troponin T (cTnT) response to subsequent exercise bouts is unclear. This study investigated the effects of an initial exercise bout, a second exercise bout 48 h later, as well as subsequent exercise every 48 h for 4 days or a single identical exercise bout after 8 days of inactivity gap on cTnT response to acute exercise. METHODS Twenty-eight sedentary overweight young women were randomly assigned to either six bouts of exercise each separated by 48 h or three bouts of exercise with 48 h between the first two bouts and 8 days between the second and third bouts. All exercise bouts were identical (60% [Formula: see text], 200 kJ) and the total testing period (10 days) was the same for both groups. cTnT was assessed before and after the 1st, 2nd, and final exercise bouts. RESULTS cTnT increased (129%, P < 0.05) after the first bout of exercise in both groups (peak post-exercise cTnT, median [range], ng l-1: 3.43[< 3.00-27.26]) with no between-group differences in the response. The second exercise bout had no significant (P > 0.05) effect on post-exercise cTnT (< 3.00[< 3.00-21.96]). The final exercise bout resulted in an increase (190%, P < 0.05) in cTnT (4.35[< 3.00-13.05]) in both groups. CONCLUSIONS A single bout exercise resulted in a temporary blunting of cTnT response to acute exercise 48 h later. The effect of exercise preconditioning was not preserved, regardless of whether followed by repeated exercise every 48 h or a cessation of exercise for 8 days.
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Affiliation(s)
- Haifeng Zhang
- Physical Education College, Hebei Normal University, Shijiazhuang, Hebei, China.,Provincial Key Lab of Measurement and Evaluation in Human Movement and Bio-Information, Shijiazhuang, Hebei, China
| | - Jinlei Nie
- School of Physical Education and Sports, Macao Polytechnic Institute, Rua de Luis Gonzaga Gomes, Macao, China.
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Macao, China
| | - Wenling Cao
- Physical Education College, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Xiangui Zhu
- Physical Education College, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Ziwei Zheng
- Physical Education College, Hebei Normal University, Shijiazhuang, Hebei, China
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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27
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High-sensitivity cardiac troponin T increases after stress echocardiography. Clin Biochem 2019; 63:18-23. [DOI: 10.1016/j.clinbiochem.2018.11.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/24/2018] [Accepted: 11/28/2018] [Indexed: 11/21/2022]
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Nie J, Zhang H, He Y, Cao W, Liu Y, Kong Z, George K. The impact of high-intensity interval training on the cTnT response to acute exercise in sedentary obese young women. Scand J Med Sci Sports 2018; 29:160-170. [PMID: 30474147 DOI: 10.1111/sms.13344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/23/2018] [Indexed: 01/08/2023]
Abstract
AIMS This study characterized (a) the cardiac troponin T (cTnT) response to three forms of acute high-intensity interval exercise (HIE), and (b) the impact of 12 weeks of HIE training on the cTnT response to acute exercise in sedentary obese young women. METHODS Thirty-six sedentary women were randomized to traditional HIE training (repeated 4-minute cycling at 90% V ˙ O2max interspersed with 3-minute rest, 200 kJ/session), work-equivalent sprint interval exercise (SIE) training (repeated 1-minute cycling at 120% V ˙ O2max interspersed with 1.5-minute rest) or repeated-sprint exercise (RSE) training (40 × 6-second all-out sprints interspersed with 9-second rest) group. cTnT was assessed using a high-sensitivity assay before and immediately, 3 and 4 hours after the 1st (PRE), 6th (EARLY), 20th (MID), and 44th (END) training session, respectively. RESULTS cTnT was elevated (P < 0.05) after all forms of acute interval exercise at the PRE and EARLY assessment with cTnT response higher (P < 0.05) after HIE (307%) and SIE (318%) than RSE (142%) at the PRE assessment. All forms of acute interval exercise at MID and END had no effect on the cohort cTnT concentration post-exercise (all P > 0.05). CONCLUSION For sedentary obese young women, both HIE and SIE, matched for total work, induced a similar elevation in cTnT after acute exercise with a smaller rise observed after RSE. By the 44th training session, almost no post-exercise cTnT elevation was observed in all three groups. Such information is relevant for clinicians as it could improve medical decisionmaking.
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Affiliation(s)
- Jinlei Nie
- School of Physical Education and Sports, Macao Polytechnic Institute, Macao, Macao
| | - Haifeng Zhang
- Physical Education College, Hebei Normal University, Shijiazhuang, China.,Provincial Key Lab of Measurement and Evaluation in Human Movement and Bio-Information, Shijiazhuang, China
| | - Yuxiu He
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Wenling Cao
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Yang Liu
- Physical Education College, Hebei Normal University, Shijiazhuang, China
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Macao, Macao
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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de Gonzalo-Calvo D, Dávalos A, Fernández-Sanjurjo M, Amado-Rodríguez L, Díaz-Coto S, Tomás-Zapico C, Montero A, García-González Á, Llorente-Cortés V, Heras ME, Boraita Pérez A, Díaz-Martínez ÁE, Úbeda N, Iglesias-Gutiérrez E. Circulating microRNAs as emerging cardiac biomarkers responsive to acute exercise. Int J Cardiol 2018; 264:130-136. [DOI: 10.1016/j.ijcard.2018.02.092] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 01/27/2018] [Accepted: 02/22/2018] [Indexed: 02/07/2023]
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30
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Nie J, Zhang H, Kong Z, George K, Little JP, Tong TK, Li F, Shi Q. Impact of high-intensity interval training and moderate-intensity continuous training on resting and postexercise cardiac troponin T concentration. Exp Physiol 2018; 103:370-380. [PMID: 29247498 DOI: 10.1113/ep086767] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/13/2017] [Indexed: 12/17/2022]
Abstract
NEW FINDINGS What is the central question of this study? Does exercise training impact resting and postexercise cardiac troponin T (cTnT) concentration? What is the main finding and its importance? This randomized controlled intervention study demonstrated that 12 weeks of either high-intensity interval training or moderate-intensity continuous training largely abolished the exercise-induced elevation in cTnT when exercise was performed at the same absolute intensity. There was no impact of training on resting cTnT or postexercise appearance of cTnT when exercise was performed at the same relative intensity. These findings provide new information that might help clinicians with decision-making in relationship to basal and postexercise values of cTnT in individuals with different training status. ABSTRACT We evaluated the influence of 12 weeks of high-intensity interval training [HIIT; repeated 4 min cycling at 90% of maximal oxygen uptake (V̇O2max) interspersed with 3 min rest, 200-300 kJ per session, 3 or 4 days each week] and work-equivalent moderate-intensity continuous training (MICT; continuous cycling at 60% V̇O2max) on resting cardiac troponin T (cTnT) and the appearance of exercise-induced cTnT. Forty-eight sedentary obese young women were randomly assigned to HIIT, MICT or a control group. The V̇O2max and body composition were measured before and after training. At baseline, cTnT was assessed using a high-sensitivity assay at rest and immediately, 2 and 4 h after 45 min cycling at 60% V̇O2max. After a 12 week training period, cTnT was assessed before and after 45 min cycling at the same relative and absolute intensities as before training. Training led to higher V̇O2max and lower fat mass in both HIIT and MICT groups (all P < 0.05). Before training, cTnT was significantly elevated in all three groups (by 35-118%, all P < 0.05) with acute exercise. After training, both resting and postexercise cTnT concentrations (same relative intensity) were similar to pretraining values. In contrast, postexercise cTnT (same absolute intensity, which represented a smaller exercise stimulus) was not elevated from rest in both HIIT and MICT groups. In conclusion, 12 weeks of either HIIT or MICT largely abolished the postexercise elevation of cTnT concentration when exercise was performed at the same absolute intensity. There was, however, no impact of training on resting cTnT or postexercise appearance of cTnT for exercise performed at the same relative intensity.
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Affiliation(s)
- Jinlei Nie
- School of Physical Education and Sports, Macao Polytechnic Institute, Macao, China
| | - Haifeng Zhang
- College of Physical Education, Hebei Normal University, Hebei, China
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Macao, China
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jonathan P Little
- School of Health and Exercise Science, University of British Columbia, Kelowna, BC, Canada
| | - Tomas K Tong
- Dr Stephen Hui Research Centre for Physical Recreation and Wellness, Department of Physical Education, Hong Kong Baptist University, Hong Kong, China
| | - Feifei Li
- College of Physical Education, Hebei Normal University, Hebei, China
| | - Qingde Shi
- School of Physical Education and Sports, Macao Polytechnic Institute, Macao, China
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Legaz-Arrese A, Carranza-García LE, Navarro-Orocio R, Valadez-Lira A, Mayolas-Pi C, Munguía-Izquierdo D, Reverter-Masía J, George K. Cardiac Biomarker Release after Endurance Exercise in Male and Female Adults and Adolescents. J Pediatr 2017; 191:96-102. [PMID: 29173327 DOI: 10.1016/j.jpeds.2017.08.061] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/18/2017] [Accepted: 08/22/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To compare the responses of high-sensitivity cardiac troponin T (hs-cTnT) and NH2-terminal probrain natriuretic peptide (NT-proBNP) after 60 minutes of swimming in male and female adults and adolescents with different pubertal status. STUDY DESIGN Adolescent swimmers (25 male and 25 female) and adult swimmers (7 male and 9 female) participated in a 60-minute maximal swimming test with serial assessment of hs-cTnT and NT-proBNP at rest, immediately postexercise, and at 1, 3, 6, 12, and 24 hours postexercise. Adolescents were classified according to pubertal status: Tanner stages 3 (n = 14), 4 (n = 22), and 5 (n = 14). RESULTS Exercise resulted in an increase in both biomarkers. hs-cTnT responses to exercise were similar in adolescents with different pubertal status and adults, although there was substantial individual variability in peak hs-cTnT, with the upper reference limit exceeding in 62% of the participants. Postexercise kinetics for hs-cTnT were largely consistent across all groups with a return to near baseline levels 24 hours postexercise. The male participants showed higher values of hs-cTnT at baseline and postexercise. All groups had similar NT-proBNP responses to acute exercise and recovery. One swimmer exceeded the upper reference limit for NT-proBNP. CONCLUSIONS An exercise-associated increase in hs-cTnT and NT-proBNP occurred in response to a 60-minute maximal swimming test that was independent of pubertal status/adolescent vs adults. The present data also suggests that baseline and postexercise hs-cTnT values are higher in male compared with female, with no sex differences in NT-proBNP values.
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Affiliation(s)
| | | | | | - Alberto Valadez-Lira
- School of Biological Sciences, Autonomous University of Nuevo Leon, Monterrey, Mexico
| | - Carmen Mayolas-Pi
- Section of Physical Education and Sports, University of Zaragoza, Zaragoza, Spain
| | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, Universidad Pablo de Olavide, Sevilla, Spain
| | | | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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Nie J. Cardiac troponins: Potential biomarkers for the detection of subclinical coronary artery disease in athletes participating in endurance sports. Eur J Prev Cardiol 2017; 25:110-111. [PMID: 28569552 DOI: 10.1177/2047487317711744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Jinlei Nie
- School of Physical Education and Sports, Macao Polytechnic Institute, Macao, China
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Klinkenberg LJJ, Luyten P, van der Linden N, Urgel K, Snijders DPC, Knackstedt C, Dennert R, Kietselaer BLJH, Mingels AMA, Cardinaels EPM, Peeters FECM, van Suijlen JDE, Ten Kate J, Marsch E, Theelen TL, Sluimer JC, Wouters K, Bekers O, Bekkers SCAM, van Loon LJC, van Dieijen-Visser MP, Meex SJR. Cardiac Troponin T and I Release After a 30-km Run. Am J Cardiol 2016; 118:281-7. [PMID: 27282835 DOI: 10.1016/j.amjcard.2016.04.030] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/20/2016] [Accepted: 04/20/2016] [Indexed: 11/15/2022]
Abstract
Prolonged endurance-type exercise is associated with elevated cardiac troponin (cTn) levels in asymptomatic recreational athletes. It is unclear whether exercise-induced cTn release mirrors a physiological or pathological underlying process. The aim of this study was to provide a direct comparison of the release kinetics of high-sensitivity cTnI (hs-cTnI) and T (hs-cTnT) after endurance-type exercise. In addition, the effect of remote ischemic preconditioning (RIPC), a cardioprotective strategy that limits ischemia-reperfusion injury, was investigated in a randomized controlled crossover manner. Twenty-five healthy volunteers completed an outdoor 30-km running trial preceded by RIPC (4 × 5 min 220 mm Hg unilateral occlusion) or control intervention. hs-cTnT, hs-cTnI, and sensitive cTnI (s-cTnI) concentrations were examined before, immediately after, 2 and 5 hours after the trial. The completion of a 30-km run resulted in a significant increase in circulating cTn (time: all p <0.001), with maximum hs-cTnT, hs-cTnI, and s-cTnI levels of 47 ± 27, 69 ± 62, and 82 ± 64 ng/L (mean ± SD), respectively. Maximum hs-cTnT concentrations were measured in 60% of the participants at 2 hours after exercise, compared with maximum hs-cTnI and s-cTnI concentrations at 5 hours in 84% and 80% of the participants. Application of an RIPC stimulus did not reduce exercise-induced cTn release (time × trial: all p >0.5). In conclusion, in contrast to acute myocardial infarction, maximum hs-cTnT levels after exercise precede maximum hs-cTnI levels. Distinct release kinetics of hs-cTnT and hs-cTnI and the absence of an effect of RIPC favors the concept that exercise-induced cTn release may be mechanistically distinct from cTn release in acute myocardial infarction.
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Affiliation(s)
- Lieke J J Klinkenberg
- Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Peter Luyten
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Noreen van der Linden
- Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Kim Urgel
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Daniëlle P C Snijders
- Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Christian Knackstedt
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Robert Dennert
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Alma M A Mingels
- Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Eline P M Cardinaels
- Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Frederique E C M Peeters
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jeroen D E van Suijlen
- Department of Clinical Chemistry and Laboratory Hematology, Gelre ziekenhuizen, Apeldoorn/Zutphen, the Netherlands
| | - Joop Ten Kate
- Department of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard-Geleen, the Netherlands
| | - Elke Marsch
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Pathology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Thomas L Theelen
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Pathology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Judith C Sluimer
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Pathology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Kristiaan Wouters
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Internal Medicine, Laboratory for Metabolism and Vascular Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Otto Bekers
- Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sebastiaan C A M Bekkers
- Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Luc J C van Loon
- Department of Human Movement Sciences, School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Marja P van Dieijen-Visser
- Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Steven J R Meex
- Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
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van der Linden N, Klinkenberg LJJ, Leenders M, Tieland M, Verdijk LB, Niens M, van Suijlen JDE, de Groot LCPGM, Bekers O, van Loon LJC, van Dieijen-Visser MP, Meex SJR. The effect of exercise training on the course of cardiac troponin T and I levels: three independent training studies. Sci Rep 2015; 5:18320. [PMID: 26671282 PMCID: PMC4680870 DOI: 10.1038/srep18320] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/16/2015] [Indexed: 12/22/2022] Open
Abstract
With the introduction of high-sensitive assays, cardiac troponins became potential biomarkers for risk stratification and prognostic medicine. Observational studies have reported an inverse association between physical activity and basal cardiac troponin levels. However, causality has never been demonstrated. This study investigated whether basal cardiac troponin concentrations are receptive to lifestyle interventions such as exercise training. Basal high-sensitive cardiac troponin T (cTnT ) and I (cTnI) were monitored in two resistance-type exercise training programs (12-week (study 1) and 24-week (study 2)) in older adults (≥65 years). In addition, a retrospective analysis for high sensitive troponin I in a 24-week exercise controlled trial in (pre)frail older adults was performed (study 3). In total, 91 subjects were included in the final data analyses. There were no significant changes in cardiac troponin levels over time in study 1 and 2 (study 1: cTnT −0.13 (−0.33–+0.08) ng/L/12-weeks, cTnI −0.10 (−0.33–+0.12) ng/L/12-weeks; study 2: cTnT −1.99 (−4.79–+0.81) ng/L/24-weeks, cTnI −1.59 (−5.70–+2.51) ng/L/24-weeks). Neither was there a significant interaction between training and the course of cardiac troponin in study 3 (p = 0.27). In conclusion, this study provides no evidence that prolonged resistance-type exercise training can modulate basal cardiac troponin levels.
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Affiliation(s)
- Noreen van der Linden
- Department of Clinical Chemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Lieke J J Klinkenberg
- Department of Clinical Chemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Marika Leenders
- Department of Human Movement Sciences, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands.,Top Institute Food and Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Michael Tieland
- Top Institute Food and Nutrition, Wageningen University, Wageningen, The Netherlands.,Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Lex B Verdijk
- Department of Human Movement Sciences, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands.,Top Institute Food and Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Marijke Niens
- Department of Clinical Chemistry, Gelre Ziekenhuizen, Apeldoorn, The Netherlands
| | | | - Lisette C P G M de Groot
- Top Institute Food and Nutrition, Wageningen University, Wageningen, The Netherlands.,Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Otto Bekers
- Department of Clinical Chemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Luc J C van Loon
- Department of Human Movement Sciences, School for Nutrition, Toxicology and Metabolism (NUTRIM), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands.,Top Institute Food and Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Marja P van Dieijen-Visser
- Department of Clinical Chemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Steven J R Meex
- Department of Clinical Chemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
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Sanchis-Gomar F, Alis R, Rampinini E, Bosio A, Romagnoli M, Lombardi G, Lippi G. Hs-cTnT levels in professional soccer players throughout a season: No evidence of sustained cardiac damage. Int J Cardiol 2015; 197:292-3. [PMID: 26142978 DOI: 10.1016/j.ijcard.2015.06.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 06/26/2015] [Indexed: 11/19/2022]
Affiliation(s)
| | - Rafael Alis
- Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain; School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | | | - Andrea Bosio
- Human Performance Laboratory, MAPEI Sport Research Center, Italy
| | - Marco Romagnoli
- Research Institute of the Hospital 12 de Octubre ("i+12"), Madrid, Spain; Department of Physical Education and Sports, University of Valencia, Valencia, Spain
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry & Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milano, Italy
| | - Giuseppe Lippi
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
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Legaz-Arrese A, López-Laval I, George K, Puente-Lanzarote JJ, Moliner-Urdiales D, Ayala-Tajuelo VJ, Mayolas-Pi C, Reverter-Masià J. Individual variability in cardiac biomarker release after 30 min of high-intensity rowing in elite and amateur athletes. Appl Physiol Nutr Metab 2015; 40:951-8. [DOI: 10.1139/apnm-2015-0055] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This study had two objectives: (i) to examine individual variation in the pattern of cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) release in response to high-intensity rowing exercise, and (ii) to establish whether individual heterogeneity in biomarker appearance was influenced by athletic status (elite vs. amateur). We examined cTnI and NT-proBNP in 18 elite and 14 amateur rowers before and 5 min, 1, 3, 6, 12, and 24 h after a 30-min maximal rowing test. Compared with pre-exercise levels, peak postexercise cTnI (pre: 0.014 ± 0.030 μg·L–1; peak post: 0.058 ± 0.091 μg·L–1; p = 0.000) and NT-proBNP (pre: 15 ± 11 ng·L–1; peak post: 31 ± 19 ng·L–1; p = 0.000) were elevated. Substantial individual heterogeneity in peak and time-course data was noted for cTnI. Peak cTnI exceeded the upper reference limit (URL) in 9 elite and 3 amateur rowers. No rower exceeded the URL for NT-proBNP. Elite rowers had higher baseline (0.019 ± 0.038 vs. 0.008 ± 0.015 μg·L–1; p = 0.003) and peak postexercise cTnI (0.080 ± 0.115 vs. 0.030 ± 0.029 μg·L–1; p = 0.022) than amateur rowers, but the change with exercise was similar between groups. There were no significant differences in baseline and peak postexercise NT-proBNP between groups. In summary, marked individuality in the cTnI response to a short but high-intensity rowing bout was observed. Athletic status did not seem to affect the change in cardiac biomarkers in response to high-intensity exercise.
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Affiliation(s)
- Alejandro Legaz-Arrese
- Section of Physical Education and Sports, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Isaac López-Laval
- Section of Physical Education and Sports, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Keith George
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK
| | | | - Diego Moliner-Urdiales
- Department of Education, University Jaume I, Avenida Sos Baynat s/n, 12071 Castellón, Spain
| | | | - Carmen Mayolas-Pi
- Section of Physical Education and Sports, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain
| | - Joaquín Reverter-Masià
- Research Group Human Movement, University of Lleida, C/Partida Caparrella s/n, 25192 Lleida, Spain
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Legaz-Arrese A, López-Laval I, George K, José Puente-Lanzarote J, Castellar-Otín C, Reverter-Masià J, Munguía-Izquierdo D. Individual variability of high-sensitivity cardiac troponin levels after aerobic exercise is not mediated by exercise mode. Biomarkers 2015; 20:219-24. [DOI: 10.3109/1354750x.2015.1068851] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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38
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Elevation of cardiac troponins measured after recreational resistance training. Clin Biochem 2015; 48:803-6. [PMID: 26116764 DOI: 10.1016/j.clinbiochem.2015.06.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 06/16/2015] [Accepted: 06/23/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Whereas elevated cardiac troponin (cTn) concentrations i.e. above the 99th percentile of healthy reference population (recommended cutoff for the diagnosis of myocardial infarction) are well-documented in healthy individuals after prolonged and/or intensive exercises such as marathons, data on less-strenuous sports are scarce. Therefore, our aim was to investigate cTnI and cTnT release in response to recreational resistance training, here a single-bout of 1-h kettlebell workout. METHODS Serum samples were collected from 11 apparently healthy volunteers the previous day (pre-exercise), three hours after the kettlebell class (post-exercise), the next day and three days later. The aliquoted samples were analyzed with Abbott Laboratories' Architect high-sensitivity (hs)-cTnI assay (limit of detection, LoD = 2 ng/L), our 3+1-type cTnI assay free from cTn-specific autoantibody interference (LoD = 3 ng/L) and Roche Diagnostics' hs-cTnT assay (LoD = 5 ng/L). RESULTS The post-exercise cTn concentrations were significantly higher than the pre-exercise values (median 5.5-9.6 ng/L vs. <LoD, P<0.05 for all) and they correlated strongly between the three assays (Spearman r = 0.881-0.960, P<0.001 for all). Furthermore, a few post-exercise concentrations even exceeded the 99th percentile of Architect hs-cTnI (>26 ng/L, n = 2) and/or hs-cTnT (>14 ng/L, n = 4). The cTn concentrations returned to baseline during the three days of follow-up. CONCLUSIONS Our study demonstrates abnormally elevated cTns with well-validated sensitive cTn assays after resistance training. This confirms that different kinds of recreational physical activity are yet another confounder that may affect the determination and use of 99th percentile reference values. Therefore, exercise-associated changes should be carefully addressed as part of the evaluation what is "normal cTn".
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