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Kodesh E, Navot-Mintzer D, Livshitz L, Shub I, Or T. The effects of a multi-day cross-country mountain bike race on myocardial function, stress, inflammation and cardiac biomarkers in amateur master athletes. Res Sports Med 2024; 32:425-442. [PMID: 36134901 DOI: 10.1080/15438627.2022.2125316] [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: 01/20/2022] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
This study aimed to examine the effects of a multi-day mountain bike race on amateur master athlete cyclists (AMA). AMA (50±5 years) completed 2 stages of a mountain bike race. Six weeks before racing, echocardiography, blood and maximal cardiopulmonary exercise tests (CPET) were performed. One hour after completion of each race stage, echocardiography measurements were taken and blood was sampled for stress, inflammatory and cardiac biomarkers. Main outcomes of the CPET were maximal oxygen consumption (VO2max) 50.7±6.5 ml/kg/min; maximal power 328±45 Watt and ventilatory threshold of 86%VO2max. Participants completed 95.7km with an elevation of 1650m on the first day, and 92.5km with an elevation of 1410m on the second day, with completion times of 357±42 and 390 ±43 minutes, respectively. After racing, increases in Creatine Phosphokinase and C-reactive protein (3-6 fold) (p<0.001), Troponin I (4-fold) (p<0.001) and N-terminal pro-brain natriuretic peptide (NT-Pro BNP) (4-7-fold) (p<0.001) were noted, with a reduction in the myocardial global work index of 17-24% (p<0.001). No correlations were found between Troponin I or NT-Pro BNP and myocardial global work index. Highly aerobically fit AMA participating in demanding endurance events demonstrated elevated stress, inflammatory, muscle damage and cardiac biomarkers. However, these changes did not significantly correlate with altered cardiac function. In addition, consecutive days of demanding prolonged cycling exercise did not have cumulative effects on the measured myocardial parameters.
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Affiliation(s)
- Einat Kodesh
- Physical Therapy department, University of Haifa, Haifa, Israel
| | - Dalya Navot-Mintzer
- The Ribstein Center for Sports Medicine and Research, Wingate Institute, Netanya, Israel
| | - Liora Livshitz
- Cardiology Department, Galilee Medical Center, Nahariya, Israel
| | - Idit Shub
- The Ribstein Center for Sports Medicine and Research, Wingate Institute, Netanya, Israel
| | - Tsafrir Or
- Cardiology Department, Galilee Medical Center, Nahariya, Israel
- Azrieli Faculty of Medicine, Bar Ilan University, Israel
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Li YS, Ao YW, Zhu DY, Zhang L, Yang RJ, Zhao YL, Zha YF. Reduced myocardial strain of interventricular septum among male amateur marathon runners: a cardiac magnetic resonance study. J Sci Med Sport 2023; 26:506-513. [PMID: 37730468 DOI: 10.1016/j.jsams.2023.06.015] [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: 01/17/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVES To analyze the long-term effect of multiple marathons on cardiac structure and function in amateur marathon runners compared with healthy controls. DESIGN Cross-sectional study using male amateur marathon runners (n = 32) and age-matched cohort of male healthy controls (n = 12). METHODS A total of 32 male amateur marathon runners (age 44 ± 7 years) and 12 male healthy controls (age 42 ± 8 years) underwent cardiac magnetic resonance (CMR). The relevant parameters of cardiac structure and function were studied employing feature-tracking strain analysis. RESULTS Amateur marathon runners showed lower heart rates, body mass index and body surface area. The left ventricular (LV) mass index, LV end-diastolic volume index and right ventricular end-systolic volume index were significantly higher in amateur marathon runners compared with healthy controls. Furthermore, walls of interventricular septum (IVS) in amateur marathon runners were thicker than healthy controls. There was no significant difference between two groups in the global myocardial strain (MS) in LV. However, the segmental radial and circumferential strains of the LV were lower in amateur marathon runners compared to healthy controls, specifically in the 8th and 9th segments. Finally, we also found as the total running intensity increased, so did global longitudinal strain. CONCLUSIONS We reported higher wall thickness and lower regional radial and circumferential strain in the IVS region in amateur marathon runners, suggesting that prolonged and high-intensity exercise may cause cardiac remodeling. Further studies are needed to investigate whether this is an adaptive or maladaptive change in amateur marathon runners.
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Affiliation(s)
- Yu-Shuang Li
- Department of Radiology, Renmin Hospital of Wuhan University, Hubei Zhang Road, Wuchang District No. 99 Jiefang Road 238, Wuhan, Hubei 430060, China
| | - Ya-Wen Ao
- Department of Radiology, Renmin Hospital of Wuhan University, Hubei Zhang Road, Wuchang District No. 99 Jiefang Road 238, Wuhan, Hubei 430060, China
| | - Dong-Yong Zhu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, Hubei 430022, China
| | - Liang Zhang
- Department of Radiology, Renmin Hospital of Wuhan University, Hubei Zhang Road, Wuchang District No. 99 Jiefang Road 238, Wuhan, Hubei 430060, China
| | - Ren-Jie Yang
- Department of Radiology, Renmin Hospital of Wuhan University, Hubei Zhang Road, Wuchang District No. 99 Jiefang Road 238, Wuhan, Hubei 430060, China
| | - Yi-Lin Zhao
- Department of Radiology, Renmin Hospital of Wuhan University, Hubei Zhang Road, Wuchang District No. 99 Jiefang Road 238, Wuhan, Hubei 430060, China.
| | - Yun-Fei Zha
- Department of Radiology, Renmin Hospital of Wuhan University, Hubei Zhang Road, Wuchang District No. 99 Jiefang Road 238, Wuhan, Hubei 430060, China.
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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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Hu J, Zhou S, Ryu S, Adams K, Gao Z. Effects of Long-Term Endurance Exercise on Cardiac Morphology, Function, and Injury Indicators among Amateur Marathon Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2600. [PMID: 36767963 PMCID: PMC9916084 DOI: 10.3390/ijerph20032600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/22/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to investigate the effects of long-term endurance exercise on cardiac morphology and function, as well as injury indicators, among amateur marathon runners. We recruited 33 amateur runners who participated in a marathon. Participants were divided into experimental and control groups according to their National Athletic Grade. The experimental group included participants with a National Athletic Grade of 2 or better, and the control group included participants who did not have a National Athletic Grade. Cardiac morphology, function, and injury indicators were assessed before and after the participants' involvement in the Changsha International Marathon. All cardiac morphology and function indicators returned to pre-race levels at 24 h post-race, and left ventricular end-diastolic volume and left ventricular end-systolic volume indicators showed similar trends. Both stroke volume (SV) and percent fractional shortening (%FS) indicators showed similar trends in changes in the measurements before and after the race. SV showed no change between the pre-race and post-race periods. On the other hand, %FS showed a significant increase in the immediate post-race period, followed by restoration of its level at 24 h post-race. Among myocardial injury indicators, serum levels of cardiac troponin I, creatine kinase (CK), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and N-terminal pro-b-type natriuretic peptide (NT-proBNP) measured before the race, immediately after the race, and 24 h after the race displayed similar trends in changes among CK, CK-MB, LDH, and AST, while NT-proBNP levels did not change. We concluded that high-level amateur marathon runners had greater heart volumes, as well as wall and septal thicknesses, than low-level marathon runners, with differences in heart volume being the most pronounced. Long-term high-intensity endurance exercise caused some damage to the hearts of amateur runners. High-level runners showed better myocardial repair ability, and their levels of myocardial injury markers showed greater decreases at 24 h post-race, while low-level runners had poorer myocardial repair ability.
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Affiliation(s)
- Jianzhong Hu
- School of Physical Education, Hengyang Normal University, Hengyang 421002, China
| | - Songqing Zhou
- School of Physical Education, Hengyang Normal University, Hengyang 421002, China
| | - Suryeon Ryu
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kaitlyn Adams
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Zan Gao
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, USA
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Dong X, Zhao Y, Zhao Z, Fang J, Zhang X. The association between marathon running and high-sensitivity cardiac troponin: A systematic review and meta-analysis. J Back Musculoskelet Rehabil 2023; 36:1023-1031. [PMID: 37248881 DOI: 10.3233/bmr-220352] [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] [Indexed: 05/31/2023]
Abstract
BACKGROUND Marathon running is an extreme sport with a distance of about 42 kilometers. Its relationship to high-sensitivity cardiac troponin (hs-cTn) remains controversial. OBJECTIVE As the gold standard for detecting myocardial injury, the trends of hs-cTn before and after a marathon were investigated and analyzed. METHODS A literature search was conducted in PubMed, EMBASE, and Cochrane Library databases by combing the keywords marathon and troponin, and studies regarding high-sensitivity cardiac troponin I (hs-cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) concentrations before and after marathon running (not for half-marathon and ultra-marathon) were included. "Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group" were used to assess the risk of bias. Statistical analysis was performed using Review Manager, presenting data as mean values and 95% confidence intervals (CIs). Sensitivity analysis and subgroup analysis were performed if there was high heterogeneity among studies based on I2 statistic. RESULTS A total of 13 studies involving 824 marathoners were included in this systematic review and meta-analysis. Both hs-cTnI (MD 68.79 ng/L, [95% CI 53.22, 84.37], p< 0.001) and hs-cTnT (MD 42.91 ng/L, [95% CI 30.39, 55.43], p< 0.001) were elevated after running a marathon, but the concentration of hs-cTnT returned to baseline after 72 to 96 h post-race (MD 0.11 ng/L, [95% CI -1.30, 1.52], p= 0.88). The results of subgroup analysis demonstrated that the 99th percentile upper reference limit of hs-cTnT might be the source of heterogeneity. CONCLUSION The concentrations of hs-cTnI and hs-cTnT were increased after marathon running, but the change of hs-cTnT is usually not seen as irreversible myocardial injury.
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Affiliation(s)
- Xueping Dong
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China
- Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Yikun Zhao
- Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Zhen Zhao
- Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Jiajin Fang
- Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Xintao Zhang
- Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
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Costache AD, Leon-Constantin MM, Roca M, Maștaleru A, Anghel RC, Zota IM, Drugescu A, Costache II, Chetran A, Moisă ȘM, Huzum B, Mitu O, Cumpăt C, Honceriu C, Mitu F. Cardiac Biomarkers in Sports Cardiology. J Cardiovasc Dev Dis 2022; 9:453. [PMID: 36547450 PMCID: PMC9781597 DOI: 10.3390/jcdd9120453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Sustained physical activity induces morphological and functional changes in the cardiovascular system. While mostly physiological, they can also become a trigger for major adverse cardiovascular events, the most severe of which are sudden cardiac arrest and sudden cardiac death. Therefore, any novel method which can help more accurately estimate the cardiovascular risk should be considered for further studying and future implementation in the standard protocols. The study of biomarkers is gaining more and more ground as they have already established their utility in diagnosing ischemic cardiac disease or in evaluating cardiac dysfunction in patients with heart failure. Nowadays, they are being implemented in the screening of apparently healthy individuals for the assessment of the cardiovascular risk. The aim of this paper is to gather published data regarding the measurements of cardiac biomarkers in athletes, i.e., troponins, myoglobin, CK-MB, NT-proBNP, and D-Dimers, and their potential use in the field of sports cardiology.
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Affiliation(s)
- Alexandru-Dan Costache
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Maria-Magdalena Leon-Constantin
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Mihai Roca
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Alexandra Maștaleru
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Răzvan-Constantin Anghel
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Ioana-Mădălina Zota
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Andrei Drugescu
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Irina-Iuliana Costache
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiology, ”St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Adriana Chetran
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiology, ”St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Ștefana-Maria Moisă
- Department of Mother and Child Medicine-Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Pediatrics I, “St. Maria” Clinical Emergency Hospital, 700309 Iasi, Romania
| | - Bogdan Huzum
- Department of Morphofunctional Sciences II, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Orthopaedics and Traumatology, “Sf. Spiridon” Emergency Hospital, 700111 Iasi, Romania
| | - Ovidiu Mitu
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiology, ”St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Carmen Cumpăt
- Department of Management, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Cezar Honceriu
- Faculty of Physical Education and Sports, “Alexandru Ioan Cuza” University, 700115 Iasi, Romania
| | - Florin Mitu
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
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Costache AD, Roca M, Honceriu C, Costache II, Leon-Constantin MM, Mitu O, Miftode RȘ, Maștaleru A, Iliescu-Halițchi D, Halițchi-Iliescu CO, Ion A, Duca ȘT, Popa DM, Abălasei B, Mocanu V, Mitu F. Cardiopulmonary Exercise Testing and Cardiac Biomarker Measurements in Young Football Players: A Pilot Study. J Clin Med 2022; 11:2772. [PMID: 35628899 PMCID: PMC9143869 DOI: 10.3390/jcm11102772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/07/2022] [Accepted: 05/12/2022] [Indexed: 02/06/2023] Open
Abstract
Constant and intense physical activity causes physiological adaptive changes in the human body, but it can also become a trigger for adverse events, such as sudden cardiac arrest or sudden cardiac death. Our main objective was to assess the use of combined cardiopulmonary exercise testing (CPET) and cardiac biomarker determinants in young professional athletes. We conducted a study which involved the full examination of 19 football players, all male, aged between 18 and 20 years old. They underwent standard clinical and paraclinical evaluation, a 12-lead electrocardiogram (ECG), and transthoracic echocardiography (TTE). Afterwards, a tailored CPET was performed and peripheral venous blood samples were taken before and 3 h after the test in order to determine five biomarker levels at rest and post-effort. The measured biomarkers were cardiac troponin I (cTnI), myoglobin (Myo), the MB isoenzyme of creatine-kinase (CK-MB), the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and D-dimers. While cTnI and NT-proBNP levels were undetectable both at rest and post-effort in all subjects, the variations in Myo, CK-MB and D-dimers showed significant correlations with CPET parameters. This highlights the potential use of combined CPET and biomarker determinants to evaluate professional athletes, and encourages further research on larger study groups.
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Affiliation(s)
- Alexandru-Dan Costache
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Mihai Roca
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Cezar Honceriu
- Faculty of Physical Education and Sports, “Alexandru Ioan Cuza” University, 700115 Iasi, Romania; (C.H.); (B.A.)
| | - Irina-Iuliana Costache
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Maria-Magdalena Leon-Constantin
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Ovidiu Mitu
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Radu-Ștefan Miftode
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Alexandra Maștaleru
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Dan Iliescu-Halițchi
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiology, Arcadia Hospital, 700620 Iasi, Romania
| | - Codruța-Olimpiada Halițchi-Iliescu
- Department of Mother and Child Medicine-Pediatrics, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
- Department of Pediatrics, Arcadia Hospital, 700620 Iasi, Romania
| | - Adriana Ion
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Ștefania-Teodora Duca
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiology, “St. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Delia-Melania Popa
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
| | - Beatrice Abălasei
- Faculty of Physical Education and Sports, “Alexandru Ioan Cuza” University, 700115 Iasi, Romania; (C.H.); (B.A.)
| | - Veronica Mocanu
- Department of Morphofunctional Sciences II, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Florin Mitu
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (A.-D.C.); (I.-I.C.); (M.-M.L.-C.); (O.M.); (R.-Ș.M.); (A.M.); (D.I.-H.); (A.I.); (Ș.-T.D.); (D.-M.P.); (F.M.)
- Department of Cardiovascular Rehabilitation, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
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Vitolo M, Malavasi VL, Proietti M, Diemberger I, Fauchier L, Marin F, Nabauer M, Potpara TS, Dan GA, Kalarus Z, Tavazzi L, Maggioni AP, Lane DA, Lip GYH, Boriani G. Cardiac troponins and adverse outcomes in European patients with atrial fibrillation: A report from the ESC-EHRA EORP atrial fibrillation general long-term registry. Eur J Intern Med 2022; 99:45-56. [PMID: 35177307 DOI: 10.1016/j.ejim.2022.01.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cardiac troponins (cTn) have been reported to be predictors for adverse outcomes in atrial fibrillation (AF), patients, but their actual use is still unclear. AIM To assess the factors associated with cTn testing in routine practice and evaluate the association with outcomes. METHODS Patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry were stratified into 3 groups according to cTn levels as (i) cTn not tested, (ii) cTn in range (≤99th percentile), (iii) cTn elevated (>99th percentile). The composite outcome of any thromboembolism /any acute coronary syndrome/cardiovascular (CV) death, defined as Major Adverse Cardiovascular Events (MACE) and all-cause death were the main endpoints. RESULTS Among 10 445 AF patients (median age 71 years, 40.3% females) cTn were tested in 2834 (27.1%). cTn was elevated in 904/2834 (31.9%) and in-range in 1930/2834 (68.1%) patients. Female sex, in-hospital enrollment, first-detected AF, CV risk factors, history of coronary artery disease, and atypical AF symptoms were independently associated with cTn testing. Elevated cTn were independently associated with a higher risk for MACE (Model 1, hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.40-2.16, Model 2, HR 1.62, 95% CI 1.28-2.05; Model 3 HR 1.76, 95% CI 1.37-2.26) and all-cause death (Model 1, HR 1.45, 95% CI 1.21-1.74; Model 2, HR 1.36, 95% CI 1.12-1.66; Model 3, HR 1.38, 95% CI 1.12-1.71). CONCLUSIONS Elevated cTn levels were associated with an increased risk of all-cause mortality and adverse CV events. Clinical factors that might enhance the need to rule out CAD were associated with cTn testing.
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Affiliation(s)
- Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo, 71, Modena 41124, Italy; Liverpool Center for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Vincenzo L Malavasi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo, 71, Modena 41124, Italy
| | - Marco Proietti
- Liverpool Center for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Igor Diemberger
- Department of Experimental, Diagnostic and Specialty Medicine, Institute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Laurent Fauchier
- Service de Cardiologie, Center Hospitalier Universitaire Trousseau, Tours, France
| | - Francisco Marin
- Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, CIBERCV, Murcia, Spain
| | - Michael Nabauer
- Department of Cardiology, Ludwig-Maximilians-University, Munich, Germany
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia; Intensive Arrhythmia Care, Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Gheorghe-Andrei Dan
- Carol Davila' University of Medicine, Colentina University Hospital, Bucharest, Romania
| | - Zbigniew Kalarus
- Department of Cardiology, SMDZ in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Katowice, Poland
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy
| | | | - Deirdre A Lane
- Liverpool Center for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Gregory Y H Lip
- Liverpool Center for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo, 71, Modena 41124, Italy.
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9
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Marathon-Induced Cardiac Fatigue: A Review over the Last Decade for the Preservation of the Athletes' Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168676. [PMID: 34444424 PMCID: PMC8391217 DOI: 10.3390/ijerph18168676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 11/17/2022]
Abstract
AIM To provide a state-of-the-art review of the last 10 years focusing on cardiac fatigue following a marathon. METHODS The PubMed, Bookshelf and Medline databases were queried during a time span of 10 years to identify studies that met the inclusion criteria. Twenty-four studies focusing only on the impact of marathons on the cardiac function and factors involved in cardiac fatigue were included in this review. RESULTS Sixteen studies focused on the impact of marathons on several biomarkers (e.g., C-reactive protein, cardiac troponin T). Seven studies focused on the left (LV) or right (RV) ventricular function following a marathon and employed cardiac magnetic resonance, echocardiography, myocardial speckle tracking and heart rate variability to analyze global and regional LV or RV mechanics and the impact of the autonomic nervous system on cardiac function. One study focused on serum profiling and its association with cardiac changes after a marathon. CONCLUSIONS This review reported a negligible impact of marathons on LV and RV systolic and contractile function but a negative impact on LV diastolic function in recreational runners. These impairments are often associated with acute damage to the myocardium. Thus, the advice of the present review to athletes is to adapt their training and have a regular medical monitoring to continue to run marathons while preserving their cardiac health.
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10
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Cavigli L, Zorzi A, Spadotto V, Gismondi A, Sisti N, Valentini F, Anselmi F, Mandoli GE, Spera L, Di Florio A, Baccani B, Cameli M, D'Ascenzi F. The acute effects of an ultramarathon on biventricular function and ventricular arrhythmias in master athletes. Eur Heart J Cardiovasc Imaging 2021; 23:423-430. [PMID: 33544827 DOI: 10.1093/ehjci/jeab017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/19/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS Endurance sports practice has significantly increased over the last decades, with a growing proportion of participants older than 40 years. Although the benefits of moderate regular exercise are well known, concerns exist regarding the potential negative effects induced by extreme endurance sport. The aim of this study was to analyse the acute effects of an ultramarathon race on the electrocardiogram (ECG), biventricular function, and ventricular arrhythmias in a population of master athletes. METHODS AND RESULTS Master athletes participating in an ultramarathon (50 km, 600 m of elevation gain) with no history of heart disease were recruited. A single-lead ECG was recorded continuously from the day before to the end of the race. Echocardiography and 12-lead resting ECG were performed before and at the end of the race. The study sample consisted of 68 healthy non-professional master athletes. Compared with baseline, R-wave amplitude in V1 and QTc duration were higher after the race (P < 0.001). Exercise-induced isolated premature ventricular beats were observed in 7% of athletes; none showed non-sustained ventricular tachycardia before or during the race. Left ventricular ejection fraction, global longitudinal strain (GLS), and twisting did not significantly differ before and after the race. After the race, no significant differences were found in right ventricular inflow and outflow tract dimensions, fractional area change, s', and free wall GLS. CONCLUSION In master endurance athletes running an ultra-marathon, exercise-induced ventricular dysfunction, or relevant ventricular arrhythmias was not detected. These results did not confirm the hypothesis of a detrimental acute effect of strenuous exercise on the heart.
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Affiliation(s)
- Luna Cavigli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic, Vascular and Public Health Sciences, University of Padova, Padova, Italy
| | - Veronica Spadotto
- Ospedale Riabilitativo di Alta Specializzazione, Motta di Livenza (TV), Italy
| | - Annalaura Gismondi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Niccolò Sisti
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Francesca Valentini
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Francesca Anselmi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Giulia Elena Mandoli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Lucia Spera
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Alex Di Florio
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Bernardo Baccani
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Matteo Cameli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
| | - Flavio D'Ascenzi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale M. Bracci, 16, 53100 Siena, Italy
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11
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Yan Z, Zeng N, Li J, Liao T, Ni G. Cardiac Effects of Treadmill Running at Different Intensities in a Rat Model. Front Physiol 2021; 12:774681. [PMID: 34912240 PMCID: PMC8667026 DOI: 10.3389/fphys.2021.774681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/09/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose: In this study, we investigated the effect of treadmill exercise training on cardiac hypertrophy, collagen deposition, echo parameters and serum levels of cardiac troponin I (cTnI) in rats, and how they differ with various exercise intensities, hence exploring potential signal transduction. Methods: Male Sprague-Dawley rats were randomly divided into sedentary (SED), low-intensity running (LIR), medium-intensity running (MIR), and high-intensity running (HIR) groups. Each exercise group had 3 subgroups that were sacrificed for cardiac tissue analyses at 1, 4, and 8 weeks, respectively, and all rats participated in a daily 1 h treadmill routine 5 days per week. Echocardiographic measurements were performed 24 h after the last exercise session. Additionally, myocardium samples and blood were collected for histological and biochemical examinations. Changes in the extracellular signal-regulated kinases 1/2 (ERK1/2) signal pathway were detected by Western blotting. Results: After a week of running, ventricular myocyte size and the phosphorylation of ERK1/2 increased in the HIR group, while left ventricular (LV) diastolic diameter values and LV relative wall thickness increased in the LIR and MIR groups. In addition, we observed heart enlargement, cTnI decrease, and ERK1/2 signal activation in each of the exercise groups after 4 weeks of running. However, the HIR group displayed substantial rupture and increased fibrosis in myocardial tissue. In addition, compared with the LIR and MIR groups, 8 weeks of HIR resulted in structural damage, fiber deposition, and increased cTnI. However, there was no difference in the activation of ERK1/2 signaling between the exercise and SED groups. Conclusion: The effect of running on cardiac hypertrophy was intensity dependent. In contrast to LIR and MIR, the cardiac hypertrophy induced by 8 weeks of HIR was characterized by potential cardiomyocyte injury, which increased the risk of pathological development. Furthermore, the ERK signaling pathway was mainly involved in the compensatory hypertrophy process of the myocardium in the early stage of exercise and was positively correlated with exercise load. However, long-term exercise may attenuate ERK signaling activation.
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Affiliation(s)
- Zhipeng Yan
- Department of Rehabilitation Medicine, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Ni Zeng
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Jieting Li
- Department of Rehabilitation Medicine, Fuzhou Second Affiliated Hospital, Xiamen University, Fuzhou, China
| | - Tao Liao
- Department of Rehabilitation Medicine, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Guoxin Ni
- Department of Rehabilitation Medicine, First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- *Correspondence: Guoxin Ni,
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12
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Halasz G, Piepoli MF. Editor's presentation: Overweight carries a higher risk for developing heart failure in young women. Eur J Prev Cardiol 2020; 27:1123-1125. [PMID: 32646301 DOI: 10.1177/2047487320941362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Geza Halasz
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Italy
| | - Massimo F Piepoli
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Italy.,Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
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13
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Martínez-Navarro I, Sánchez-Gómez J, Sanmiguel D, Collado E, Hernando B, Panizo N, Hernando C. Immediate and 24-h post-marathon cardiac troponin T is associated with relative exercise intensity. Eur J Appl Physiol 2020; 120:1723-1731. [PMID: 32468283 DOI: 10.1007/s00421-020-04403-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/19/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE We aimed at exploring whether cardiopulmonary fitness, echocardiographic measures and relative exercise intensity were associated with high-sensitivity cardiac troponin T (hs-TNT) rise and normalization following a marathon. METHODS Nighty-eight participants (83 men, 15 women; 38.72 ± 3.63 years) were subjected to echocardiographic assessment and a cardiopulmonary exercise test (CPET) before the race. hs-TNT was measured before, immediately after and at 24, 48, 96, 144 and 192 h post-race. Speed and mean heart rate (HR) during the race were relativized to CPET values: peak speed (%VVMAX), peak HR (HR%MAX), speed and HR at the second ventilatory threshold (HR%VT2 and %VVT2). RESULTS Hs-TNT increased from pre- to post-race (5.74 ± 5.29 vs. 50.4 ± 57.04 ng/L; p < 0.001), seeing values above the Upper Reference Limit (URL) in 95% of the participants. At 24 h post-race, 39% of the runners still exceeded the URL (High hs-TNT group). hs-TNT rise was correlated with marathon speed %VVT2 (r = 0.22; p = 0.042), mean HR%VT2 (r = 0.30; p = 0.007), and mean HR%MAX (r = 0.32; p = 0.004). Moreover, the High hs-TNT group performed the marathon at a higher Speed %VVT2 (88.21 ± 6.53 vs. 83.49 ± 6.54%; p = 0.002) and Speed %VVMAX (72 ± 4.25 vs. 69.40 ± 5.53%; p = 0.009). hs-TNT showed no significant associations with cardiopulmonary fitness and echocardiographic measures, except for a slight correlation with left ventricular end systolic diameter (r = 0.26; p = 0.018). CONCLUSION Post-race hs-TNT was above the URL in barely all runners. Magnitude of hs-TNT rise was correlated with exercise mean HR; whereas, its normalization kept relationship with marathon relative speed.
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Affiliation(s)
- Ignacio Martínez-Navarro
- Physical Education and Sports Department, Faculty of Physical Activity and Sport Sciences, University of Valencia, C/Gascó Oliag 3, 46010, Valencia, Spain. .,Sports Health Unit, Vithas 9 de Octubre Hospital, Valencia, Spain.
| | - J Sánchez-Gómez
- Sports Health Unit, Vithas 9 de Octubre Hospital, Valencia, Spain.,Universitary Clinical Hospital of Valencia, Valencia, Spain
| | - D Sanmiguel
- Sports Health Unit, Vithas 9 de Octubre Hospital, Valencia, Spain.,General Hospital of Valencia, Valencia, Spain
| | - E Collado
- Faculty of Health Sciences, Jaume I University, Castellón de la Plana, Castellon, Spain
| | - B Hernando
- Department of Medicine, Jaume I University, Castellón de la Plana, Castellon, Spain
| | - N Panizo
- Faculty of Health Sciences, Jaume I University, Castellón de la Plana, Castellon, Spain.,Universitary Doctor Peset Hospital of Valencia, Valencia, Spain
| | - C Hernando
- Sport Service, Jaume I University, Castellón de la Plana, Castellon, Spain.,Department of Education and Specific Didactics, Jaume I University, Castellón de la Plana, Castellon, Spain
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14
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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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15
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Gajda R, Klisiewicz A, Matsibora V, Piotrowska-Kownacka D, Biernacka EK. Heart of the World's Top Ultramarathon Runner-Not Necessarily Much Different from Normal. Diagnostics (Basel) 2020; 10:diagnostics10020073. [PMID: 32012817 PMCID: PMC7168911 DOI: 10.3390/diagnostics10020073] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 01/25/2020] [Indexed: 12/11/2022] Open
Abstract
The impact of ultramarathon (UM) runs on the organs of competitors, especially elite individuals, is poorly understood. We tested a 36-year-old UM runner before, 1–2 days after, and 10–11 days after winning a 24-h UM as a part of the Polish Championships (258.228 km). During each testing session, we performed an electrocardiogram (ECG), transthoracic echocardiography (TTE), cardiac magnetic resonance imaging (MRI), cardiac 31P magnetic resonance spectroscopy (31P MRS), and blood tests. Initially, increased cholesterol and low-density lipoprotein cholesterol (LDL-C) levels were identified. The day after the UM, increased levels of white blood cells, neutrophils, fibrinogen, alanine aminotransferase, aspartate aminotransferase, creatine kinase, C-reactive protein, and N-terminal type B natriuretic propeptide were observed. Additionally, decreases in hemoglobin, hematocrit, cholesterol, LDL-C, and hyponatremia were observed. On day 10, all measurements returned to normal levels, and cholesterol and LDL-C returned to their baseline abnormal values. ECG, TTE, MRI, and 31P MRS remained within the normal ranges, demonstrating physiological adaptation to exercise. The transient changes in laboratory test results were typical for the extreme efforts of the athlete and most likely reflected transient but massive striated muscle damage, liver cell damage, activation of inflammatory processes, effects on the coagulation system, exercise-associated hyponatremia, and cytoprotective or growth-regulatory effects. These results indicated that many years of intensive endurance training and numerous UMs (including the last 24-h UM) did not have a permanent adverse effect on this world-class UM runner’s body and heart. Transient post-competition anomalies in laboratory test results were typical of those commonly observed after UM efforts.
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Affiliation(s)
- Robert Gajda
- Center for Sports Cardiology at the Gajda-Med Medical Center in Pułtusk, ul. Piotra Skargi 23/29, 06-100 Pułtusk, Poland
- Correspondence: ; Tel.: +48-604286030; Fax: +48-23-6920199
| | - Anna Klisiewicz
- The Cardinal Stefan Wyszyński National Institute of Cardiology, ul. Alpejska 42, 04-628 Warszawa, Poland; (A.K.); (E.K.B.)
| | - Vadym Matsibora
- The 2nd Department of Clinical Radiology, Medical University of Warsaw, ul. Banacha 1A, 02-097 Warsaw, Poland;
| | - Dorota Piotrowska-Kownacka
- The 1st Department of Radiology, Medical University of Warsaw, ul. Żwirki i Wigury 61, 02-091 Warsaw, Poland;
| | - Elżbieta Katarzyna Biernacka
- The Cardinal Stefan Wyszyński National Institute of Cardiology, ul. Alpejska 42, 04-628 Warszawa, Poland; (A.K.); (E.K.B.)
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16
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Faconti L, Parsons I, Farukh B, McNally R, Nesti L, Fang L, Stacey M, Hill N, Woods D, Chowienczyk P. Post-exertional increase in first-phase ejection fraction in recreational marathon runners. JRSM Cardiovasc Dis 2020; 9:2048004020926366. [PMID: 32489656 PMCID: PMC7238440 DOI: 10.1177/2048004020926366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/08/2020] [Accepted: 04/19/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Running a marathon has been equivocally associated with acute changes in cardiac performance. First-phase ejection fraction is a novel integrated echocardiographic measure of left ventricular contractility and systo-diastolic coupling which has never been studied in the context of physical activity. The aim of this study was to assess first-phase ejection fraction following recreational marathon running along with standard echocardiographic indices of systolic and diastolic function.Design and participants: Runners (n = 25, 17 males), age (mean ± standard deviation) 39 ± 9 years, were assessed before and immediately after a marathon race which was completed in 4 h, 10 min ± 47 min. MAIN OUTCOME MEASURES Central hemodynamics were estimated with applanation tonometry; cardiac performance was assessed using standard M-mode two-dimensional Doppler, tissue-doppler imaging and speckle-tracking echocardiography. First-phase ejection fraction was calculated as the percentage change in left ventricular volume from end-diastole to the time of peak aortic blood flow. RESULTS Conventional indices of systolic function and cardiac performance were similar pre- and post-race while aortic systolic blood pressure decreased by 9 ± 8 mmHg (P < 0.001) and first-phase ejection fraction increased by approximately 48% from 16.3 ± 3.9% to 22.9 ± 2.5% (P < 0.001). The ratio of left ventricular transmitral Doppler early velocity (E) to tissue-doppler imaging early annular velocity (e') increased from 5.1 ± 1.8 to 6.2 ± 1.3 (P < 0.01). CONCLUSION In recreational marathon runners, there is a marked increase in first-phase ejection fraction after the race despite no other significant change in cardiac performance or conventional measure of systolic function. More detailed physiological studies are required to elucidate the mechanism of this increase.
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Affiliation(s)
- Luca Faconti
- Department of Clinical Pharmacology, King’s College London,
British Heart Foundation Centre, London, UK
| | - Iain Parsons
- Department of Clinical Pharmacology, King’s College London,
British Heart Foundation Centre, London, UK
- Academic Department of Military Medicine, Research and Clinical
Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - Bushra Farukh
- Department of Clinical Pharmacology, King’s College London,
British Heart Foundation Centre, London, UK
| | - Ryan McNally
- Department of Clinical Pharmacology, King’s College London,
British Heart Foundation Centre, London, UK
| | - Lorenzo Nesti
- Department of Clinical Pharmacology, King’s College London,
British Heart Foundation Centre, London, UK
| | - Lingyun Fang
- Department of Clinical Pharmacology, King’s College London,
British Heart Foundation Centre, London, UK
| | - Michael Stacey
- Department of Diabetes & Endocrinology, Imperial College,
London, UK
| | - Neil Hill
- Academic Department of Military Medicine, Research and Clinical
Innovation, Royal Centre for Defence Medicine, Birmingham, UK
- Department of Diabetes & Endocrinology, Imperial College,
London, UK
| | - David Woods
- Academic Department of Military Medicine, Research and Clinical
Innovation, Royal Centre for Defence Medicine, Birmingham, UK
- Research Institute for Sport, Physical Activity and Leisure,
Leeds Beckett University, Leeds, UK
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King’s College London,
British Heart Foundation Centre, London, UK
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17
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Piepoli MF. Editor's Presentation: 'The forbidden fruits: Fake or reality?'. Eur J Prev Cardiol 2019; 27:3-6. [PMID: 31850821 DOI: 10.1177/2047487319895946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Massimo F Piepoli
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Italy.,Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
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