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Tsai IH, Kao WF, How CK, Li LH, Lin YK, Kung LC, Chiu YH, Chien DK, Chang WH. Cardiac autonomic regulation following a 246-km mountain ultra-marathon: An observational study. Medicine (Baltimore) 2024; 103:e38756. [PMID: 38968488 PMCID: PMC11224880 DOI: 10.1097/md.0000000000038756] [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: 03/08/2024] [Accepted: 06/07/2024] [Indexed: 07/07/2024] Open
Abstract
Physical exercise requires integrated autonomic and cardiovascular adjustments to maintain homeostasis. We aimed to observe acute posture-related changes in blood pressure, and apply a portable noninvasive monitor to measure the heart index for detecting arrhythmia among elite participants of a 246-km mountain ultra-marathon. Nine experienced ultra-marathoners (8 males and 1 female) participating in the Run Across Taiwan Ultra-marathon in 2018 were enrolled. The runners' Heart Spectrum Blood Pressure Monitor measurements were obtained in the standing and supine positions before and immediately after the race. Their high-sensitivity troponin T and N-terminal proB-type natriuretic peptide levels were analyzed 1 week before and immediately after the event. Heart rate was differed significantly in the immediate postrace assessment compared to the prerace assessment, in both the standing (P = .011; d = 1.19) and supine positions (P = .008; d = 1.35). Postural hypotension occurred in 4 (44.4%) individuals immediately postrace. In 3 out of 9 (33.3%) recruited finishers, the occurrence of premature ventricular complex signals in the standing position was detected; premature ventricular complex signal effect was observed in the supine position postrace in only 1 participant (11.1%). Premature ventricular complex signal was positively correlated with running speed (P = .037). Of the 6 individuals who completed the biochemical tests postrace, 2 (33.3%) had high-sensitivity troponin T and 6 (100%) had N-terminal proB-type natriuretic peptide values above the reference interval. A statistically significant increase was observed in both the high-sensitivity troponin T (P = .028; d = 1.97), and N-terminal proB-type natriuretic peptide (P = .028; d = 2.91) levels postrace compared to prerace. In conclusion, significant alterations in blood pressure and heart rate were observed in the standing position, and postexercise (postural) hypotension occurred among ultra-marathoners. The incidence of premature ventricular complexes was higher after the race than before.
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Affiliation(s)
- I-Hsun Tsai
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Puzih City, Chiayi County, Taiwan
| | - Wei-Fong Kao
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chorng-Kuang How
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Emergency Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Hua Li
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Program of Medical Biotechnology, Taipei Medical University, Taipei, Taiwan
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Lu-Chih Kung
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Yu-Hui Chiu
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Ding-Kuo Chien
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Wen-Han Chang
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
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Burger AL, Wegberger C, Tscharre M, Kaufmann CC, Muthspiel M, Pogran E, Freynhofer MK, Szalay A, Huber K, Jäger B. Impact of an Ultra-Endurance Marathon on Cardiac Function in Association with Cardiovascular Biomarkers. SPORTS MEDICINE - OPEN 2024; 10:67. [PMID: 38851665 PMCID: PMC11162405 DOI: 10.1186/s40798-024-00737-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Participation in ultra-endurance races may lead to a transient decline in cardiac function and increased cardiovascular biomarkers. This study aims to assess alterations in biventricular function immediately and five days after the competition in relation to elevation of high-sensitivity cardiac Troponin I (hs-cTnI) and N-terminal-pro-brain-natriuretic-peptide (NT-proBNP). METHODS AND RESULTS Fifteen participants of an ultramarathon (UM) with a running distance of 130 km were included. Transthoracic echocardiography and quantification of biomarkers was performed before, immediately after and five days after the race. A significant reduction in right ventricular fractional area change (FAC) was observed after the race (48.0 ± 4.6% vs. 46.7 ± 3.8%, p = 0.011) that persisted five days later (48.0 ± 4.6% vs. 46.3 ± 3.9%, p = 0.027). No difference in left ventricular ejection fraction (LVEF) was found (p = 0.510). Upon stratification according to biomarkers, participants with NT-proBNP above the median had a significantly reduced LVEF directly (60.8 ± 3.6% vs. 56.9 ± 4.8%, p = 0.030) and five days after the race (60.8 ± 3.6% vs. 55.3 ± 4.5%, p = 0.007) compared to baseline values. FAC was significantly reduced five days after the race (48.4 ± 5.1 vs. 44.3 ± 3.9, p = 0.044). Athletes with hs-cTnI above the median had a significantly reduced FAC directly after the race (48.1 ± 4.6 vs. 46.5 ± 4.4, p = 0.038), while no difference in LVEF was observed. No alteration in cardiac function was observed if hs-cTnI or NT-proBNP was below the median. CONCLUSION A slight decline in cardiac function after prolonged strenuous exercise was observed in athletes with an elevation of hs-cTnI and NT-proBNP above the median but not below.
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Affiliation(s)
- Achim Leo Burger
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria.
- Medical School, Sigmund Freud University, Vienna, Austria.
| | - Claudia Wegberger
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
| | - Maximilian Tscharre
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
| | - Christoph C Kaufmann
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
- Medical School, Sigmund Freud University, Vienna, Austria
| | - Marie Muthspiel
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
| | - Edita Pogran
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
| | - Matthias K Freynhofer
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
| | - Alexander Szalay
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
| | - Kurt Huber
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
- Medical School, Sigmund Freud University, Vienna, Austria
| | - Bernhard Jäger
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring, Montleartstrasse 37, 1160, Vienna, Austria
- Medical School, Sigmund Freud University, Vienna, Austria
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Burtscher J, Vanderriele PE, Legrand M, Predel HG, Niebauer J, O’Keefe JH, Millet GP, Burtscher M. Could Repeated Cardio-Renal Injury Trigger Late Cardiovascular Sequelae in Extreme Endurance Athletes? Sports Med 2022; 52:2821-2836. [DOI: 10.1007/s40279-022-01734-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2022] [Indexed: 12/17/2022]
Abstract
AbstractRegular exercise confers multifaceted and well-established health benefits. Yet, transient and asymptomatic increases in markers of cardio-renal injury are commonly observed in ultra-endurance athletes during and after competition. This has raised concerns that chronic recurring insults could cause long-term cardiac and/or renal damage. Indeed, extreme endurance exercise (EEE) over decades has sometimes been linked with untoward cardiac effects, but a causal relation with acute injury markers has not yet been established. Here, we summarize the current knowledge on markers of cardiac and/or renal injury in EEE athletes, outline the possible interplay between cardiac and kidney damage, and explore the roles of various factors in the development of potential exercise-related cardiac damage, including underlying diseases, medication, sex, training, competition, regeneration, mitochondrial dysfunction, oxidative stress, and inflammation. In conclusion, despite the undisputed health benefits of regular exercise, we speculate, based on the intimate link between heart and kidney diseases, that in rare cases excessive endurance sport may induce adverse cardio-renal interactions that under specific, hitherto undefined conditions could result in persistent cardiac damage. We highlight future research priorities and provide decision support for athletes and clinical consultants who are seeking safe strategies for participation in EEE training and competition.
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Abstract
Research among non-industrial societies suggests that body kinematics adopted during running vary between groups according to the cultural importance of running. Among groups in which running is common and an important part of cultural identity, runners tend to adopt what exercise scientists and coaches consider to be good technique for avoiding injury and maximising performance. In contrast, among groups in which running is not particularly culturally important, people tend to adopt suboptimal technique. This paper begins by describing key elements of good running technique, including landing with a forefoot or midfoot strike pattern and leg oriented roughly vertically. Next, we review evidence from non-industrial societies that cultural attitudes about running associate with variation in running techniques. Then, we present new data from Tsimane forager–horticulturalists in Bolivia. Our findings suggest that running is neither a common activity among the Tsimane nor is it considered an important part of cultural identity. We also demonstrate that when Tsimane do run, they tend to use suboptimal technique, specifically landing with a rearfoot strike pattern and leg protracted ahead of the knee (called overstriding). Finally, we discuss processes by which culture might influence variation in running techniques among non-industrial societies, including self-optimisation and social learning. New evidence from the Tsimane underscores that running techniques vary between societies according to the cultural importance of running
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Calleja-Romero A, Vicente-Rodríguez G, Garatachea N. Acute effects of long-distance races on heart rate variability and arterial stiffness: A systematic review and meta-analysis. J Sports Sci 2021; 40:248-270. [PMID: 34720045 DOI: 10.1080/02640414.2021.1986276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study systematically reviewed and quantified the effects of running a long-distance race (LDR) on heart rate variability (HRV) and arterial stiffness (AS). All types of races of a distance equal to or greater than a marathon (≥42.2 km) were included. A total of 2,220 articles were identified, 52 were included in the qualitative analysis, and 48 were meta-analysed. The standardised mean difference pre- and post-race of various time-domain and frequency-domain indices of HRV, mean arterial blood pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP) and carotid-femoral pulse wave velocity (cfPWV) was calculated. Regarding HRV, there was a significant decrease in most of the variables considered as markers of parasympathetic activity, indicating a shift of autonomic balance towards a reduced vagal tone. Regarding vascular variables, there was a significant drop in blood pressure and reduced AS. In conclusion, running an LDR seems to have a considerable acute effect on the autonomic nervous system, haemodynamics, and vascular properties. The observed effects could be categorised within the expected acute responses to long-lasting, strenuous exercise.
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Affiliation(s)
- Alberto Calleja-Romero
- Faculty of Health and Sport Science (Fcsd, Ronda Misericordia 5, 22001-Huesca, Spain), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain
| | - Germán Vicente-Rodríguez
- Faculty of Health and Sport Science (Fcsd, Ronda Misericordia 5, 22001-Huesca, Spain), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Growth, Exercise, Nutrition and Development Group and IIS-Aragon, Spain.,Centro De Investigación Biomédica En Red De Fisiopatología De La Obesidad Y Nutrición (Ciber-obn), Madrid, Spain.,Instituto Agroalimentario De Aragón -ia2- (Cita-universidad De Zaragoza), Zaragoza, Spain
| | - Nuria Garatachea
- Faculty of Health and Sport Science (Fcsd, Ronda Misericordia 5, 22001-Huesca, Spain), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Growth, Exercise, Nutrition and Development Group and IIS-Aragon, Spain.,Centro De Investigación Biomédica En Red De Fisiopatología De La Obesidad Y Nutrición (Ciber-obn), Madrid, Spain.,Instituto Agroalimentario De Aragón -ia2- (Cita-universidad De Zaragoza), Zaragoza, Spain
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6
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Tiller NB, Stewart GM, Illidi CR, Levine BD. Exercise Is Medicine? The Cardiorespiratory Implications of Ultra-marathon. Curr Sports Med Rep 2021; 19:290-297. [PMID: 32769665 DOI: 10.1249/jsr.0000000000000738] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Regular physical activity decreases the risk of cardiovascular disease, type II diabetes, obesity, certain cancers, and all-cause mortality. Nevertheless, there is mounting evidence that extreme exercise behaviors may be detrimental to human health. This review collates several decades of literature on the physiology and pathophysiology of ultra-marathon running, with emphasis on the cardiorespiratory implications. Herein, we discuss the prevalence and clinical significance of postrace decreases in lung function and diffusing capacity, respiratory muscle fatigue, pulmonary edema, biomarkers of cardiac injury, left/right ventricular dysfunction, and chronic myocardial remodeling. The aim of this article is to inform risk stratification for ultra-marathon and to edify best practice for personnel overseeing the events (i.e., race directors and medics).
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Affiliation(s)
- Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA
| | - Glenn M Stewart
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Camilla R Illidi
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, UNITED KINGDOM
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, and University of Texas Southwestern Medical Center, Dallas, TX
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7
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Peruzzi M. Heart and endurance sports: excesses are often unhealthy. Minerva Cardioangiol 2020; 68:302-304. [PMID: 33094569 DOI: 10.23736/s0026-4725.20.05414-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Mariangela Peruzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy - .,Mediterranea Cardiocentro, Naples, Italy -
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Skottrup PD, Kallemose T, Espino D, Infante-Ramirez R, Brage S, Terzic D, Goetze JP, Kjaergaard J, Christensen DL. Plasma marker for systemic inflammation is increased in Mexican Tarahumara following ultra-distance running. Am J Hum Biol 2020; 33:e23501. [PMID: 32902062 DOI: 10.1002/ajhb.23501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Previous studies have suggested that acute exercise-induced cardiac and kidney damage following ultra-distance running is low in Mexican Tarahumara even though C-reactive protein (CRP) remained elevated 24 hours post-race. We aimed to study if the plasma biomarker, soluble urokinase-type plasminogen activator receptor (suPAR), could replace or complement CRP as a systemic inflammation biomarker in Tarahumara men and women following ultra-distance running. METHODS Plasma samples were collected pre-race and at three to six different time points post-race in Mexican Tarahumara competing in three independent ultramarathons; men running 78 km (GroupI, n = 9), women running 52 km (GroupII, n = 3), and men running 63 km (GroupIII, n = 10). Baseline anthropometry, blood pressure, glycated hemoglobin, and hemoglobin were measured, aerobic fitness was estimated by submaximal step test, absolute and relative running intensity assessed using combined heart rate and accelerometry. Plasma was collected pre- and post-race to analyze concentrations of suPAR, and-for women only-a panel of inflammatory, cardiac and kidney plasma biomarkers. Mixed-effect models were used to evaluate the effect of ultramarathon running on plasma suPAR concentrations. RESULTS Compared to pre-race values, suPAR was significantly elevated in plasma <5 minutes after the three ultramarathon races (70%-109% increase of the mean for the three groups). Furthermore, plasma suPAR remained significantly elevated up to 6 hours post-race for all three groups of runners independent of running intensity. CONCLUSIONS The results suggest that suPAR can complement, but not replace CRP following ultra-distance running in Tarahumara men and women.
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Affiliation(s)
- Peter Durand Skottrup
- Department of Clinical Biochemistry, Copenhagen University Hospital, Hvidovre, Denmark.,Novo Nordisk A/S, Global Research Technologies, Research Bioanalysis, Måløv, Denmark
| | - Thomas Kallemose
- Clinical Research Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Diana Espino
- Faculty of Physical Education and Sport Sciences, Autonomous University of Chihuahua, Chihuahua, Mexico
| | | | - Soren Brage
- MRC-Epidemiology Unit, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Dijana Terzic
- Department of Clinical Biochemistry, Centre of Diagnostics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jens Peter Goetze
- Department of Clinical Biochemistry, Centre of Diagnostics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jesper Kjaergaard
- Department of Cardiology, Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Dirk Lund Christensen
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Giovanelli N, Lazzer S, Cauci S. Muscle damage and inflammatory status biomarkers after a 3-stage trail running race. J Sports Med Phys Fitness 2020; 60:1486-1492. [PMID: 32586083 DOI: 10.23736/s0022-4707.20.10997-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Participants in ultramarathon and multi-stage races are continuously increasing. A detailed knowledge of the time-course of the restoration in muscular, cardiac, and inflammatory biomarkers after a multi-stage race may help the design of training schedules focused to avoid adverse outcomes of repetitive high-intensity endurance exercise and athlete exhaustion. Thus, the aim of the study was to evaluate blood parameters and serum biomarkers associated to muscle damage and inflammation in athletes participating in a 3-stage competition. METHODS Ten runners concluded the race "Magraid" consisting of 3 stages of 22, 48 and 20 km. Before (PRE), immediately after the end of the third stage (POST) and five days after the last stage (R5d), we collected blood samples. RESULTS Among others, at POST mean white blood cell (+57±42%; P=0.006), blood urea nitrogen (+68±39%; P<0.001), creatinine (+17±12%, P=0.005), alanine aminotransferase (ALT, +104±69%; P=0.002), lactate dehydrogenase (LDH, +116±64%; P<0.001), creatine kinase (CK, +2044±1433%; P=0.011), CK-MBm (+1544±1007%; P=0.004), cardiac troponin I (cTnI, +85±129%; P=0.015), C-reactive protein (hsCRP, +2137±1660%; P=0.015) were higher than PRE. At R5d, ALT (+72±53%; P=0.010), LDH (+32±25%; P=0.006) and hsCRP (+252±234%; P=0.021) were still different compared with PRE. CONCLUSIONS A 3-stage trail running race induces an inflammatory status and muscle damage and functional consequences on some physiological systems that may not be completely recovered within a short period.
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11
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Le Goff C, Farré Segura J, Dufour P, Kaux JF, Cavalier E. Intense sport practices and cardiac biomarkers. Clin Biochem 2020; 79:1-8. [PMID: 32097617 DOI: 10.1016/j.clinbiochem.2020.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/05/2020] [Accepted: 02/17/2020] [Indexed: 12/13/2022]
Abstract
Biomarkers are well established for the diagnosis of myocardial infarction, heart failure and cardiac fibrosis. Different papers on cardiac biomarker evolution during exercise have been published in the literature and generally show mild to moderate elevations. However, the mechanism responsible for these elevations, reflecting physiological or even pathophysiological changes, still has to be clearly elucidated. There are also indications of higher cardiac risk in poorly trained athletes than in well-trained athletes. Whether regular repetition of intensive exercise might lead, in the longer term, to fibrosis and heart failure remains to be determined. In this review, we summarized the main research about the effects of intense exercise (in particular, running) on cardiac biomarkers (including troponins, natriuretic peptides, etc.). We found that cardiac fibrosis biomarkers seemed to be the most informative regarding the biological impact of intense physical activity.
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Affiliation(s)
- C Le Goff
- Department of Clinical Chemistry, University Hospital of Liege, Belgium.
| | - J Farré Segura
- Department of Clinical Chemistry, University Hospital of Liege, Belgium
| | - P Dufour
- Department of Clinical Chemistry, University Hospital of Liege, Belgium
| | - J F Kaux
- Department of Clinical Chemistry, University Hospital of Liege, Belgium
| | - E Cavalier
- Department of Clinical Chemistry, University Hospital of Liege, Belgium
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Rivera-Morales J, Sotuyo S, Vargas-Guadarrama LA, De Santiago S, Pasquet P. Physical Activity and Cardiorespiratory Fitness in Tarahumara and Mestizo Adolescents from Sierra Tarahumara, Mexico. Am J Hum Biol 2020; 32:e23396. [PMID: 32022399 DOI: 10.1002/ajhb.23396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 12/30/2019] [Accepted: 01/19/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Our purpose was to explore the levels of cardiorespiratory fitness (CRF) and the relationship between CRF, physical activity, and other physical traits in traditional and nontraditional Tarahumara, and Mestizo adolescents from Sierra Tarahumara, Mexico. METHODS A sample of 87 adolescents aged 16.9 ± 1.2 years (mean ± SD) performed the Margaria step test to quantify CRF. Physical activity was estimated using the International Physical Activity Questionnaire. Blood pressure (BP) and anthropometric measures were taken to estimate body composition and other physical characteristics. RESULTS Traditional Tarahumara showed higher levels of CRF than nontraditional Tarahumara and Mestizo adolescents (F = 5.5, p = .006). The time allotted to sedentary activities was higher in the Mestizo and nontraditional Tarahumara (χ2 = 10.17, p = .006). In nontraditional Tarahumara, adiposity was associated with CRF reduction (r2 = -.63, p = .00), while vigorous physical activities were positively associated with CRF (r2 = .43, p = .03) and negatively associated with the z-score of body fat (r2 = -.42 p = .03). Finally, CRF was negatively associated with fat percentage (r2 = -.27, p = .00) and systolic blood pressure (r2 = -.09, p = .04) in the Mestizo. In this group, walking activities (r2 = -.25, p = .003) and total physical activity score (r2 = -.11, p = .03) had a positive association with the CRF, while moderate activities had a negative association with the body mass index (r2 = .09, p = .04), and vigorous activities were negatively associated with body weight (r2 = .11, p = .03). CONCLUSIONS In the sampled nontraditional Tarahumara and Mestizo adolescents, moderate and vigorous physical activities were important factors in determining levels in CRF, fat percentage, and other health parameters.
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Affiliation(s)
- Javier Rivera-Morales
- Laboratorio de Genética, Escuela Nacional de Antropología e Historia (ENAH), Mexico City, Mexico
| | - Solange Sotuyo
- Instituto de Biología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Luis A Vargas-Guadarrama
- Instituto de Investigaciones Antropológicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Patrick Pasquet
- Centre National de la Recherche Scientifique, UMR 7206, Paris, France
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13
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Roeh A, Schuster T, Jung P, Schneider J, Halle M, Scherr J. Two dimensional and real-time three dimensional ultrasound measurements of left ventricular diastolic function after marathon running: results from a substudy of the BeMaGIC trial. Int J Cardiovasc Imaging 2019; 35:1861-1869. [PMID: 31154595 DOI: 10.1007/s10554-019-01634-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 05/24/2019] [Indexed: 01/13/2023]
Abstract
Strenuous exercise results in transient but minor alterations in left ventricular diastolic function (LVDF). The aim of this study is to describe and interpret the kinetics of the well-established 2D parameters of diastolic function and the novel and very sensitive 3D parameters before/after a marathon race. LVDF was evaluated by transthoracic echocardiography (TEE) in 212 healthy male [aged 42 (36-49) years)] marathon runners (all Be-MaGIC-study) in the week prior to (V1), immediately after (V2), 24 h after (V3) and 72 h after (V4) a marathon race. Real time three-dimensional echocardiography (RT3DE) included maximal and minimal left atrium (LA) volume, total LA ejection fraction (Total-EF), total LA stroke volume (Total-SV), true ejection fraction (True-EF) and atrial stroke volume (ASV). After adjustment for possible confounders (heart rate and systolic blood pressure), 2D Parameters of left ventricular inflow (E/A-ratio) decreased from pre- to immediately post-race (- 0.3 ± 0.06, p < 0.001) and returned to baseline within 24 h. [Formula: see text]-ratio remained unchanged directly post-race, but was significantly increased during follow-up of 24 and 72 h. 3D LA Vmin was increased immediately postrace and in the 24 h follow-up, LA Vmax was increased immediately post-race and in the follow-up of 24 and 72 h. During follow-up of 72 h, but not immediately postrace, TrueEF and ASV were significantly increased. Both techniques revealed acute and prolonged alterations of diastolic LV function. Considering all parameters, the recovery of diastolic LV after a marathon seems to take longer than previously assumed.Trial registration ClinicalTrials.gov ID: NCT00933218.
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Affiliation(s)
- Astrid Roeh
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universitaet Muenchen, Munich, Germany.
| | - Tibor Schuster
- Department for Medical Statistics and Epidemiology, Klinikum Rechts Der Isar, Technische Universitaet Muenchen, Munich, Germany
| | - Philip Jung
- Medizinische Klinik und Poliklinik I, Klinikum der Universitaet Muenchen, Munich, Germany
| | - Jens Schneider
- Universitäts Herz-Zentrum Freiburg - Bad Krozingen, Klinik für Kardiologie Und Angiologie II, Bad Krozingen, Germany
| | - Martin Halle
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universitaet Muenchen, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, 80802, Munich, Germany
| | - Johannes Scherr
- Department of Prevention, Rehabilitation and Sports Medicine, Technische Universitaet Muenchen, Munich, Germany
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Danielsson T, Schreyer H, Woksepp H, Johansson T, Bergman P, Månsson A, Carlsson J. Two-peaked increase of serum myosin heavy chain-α after triathlon suggests heart muscle cell death. BMJ Open Sport Exerc Med 2019; 5:e000486. [PMID: 30740234 PMCID: PMC6347893 DOI: 10.1136/bmjsem-2018-000486] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 11/03/2022] Open
Abstract
Objective It has been suggested that the mechanism behind cardiac troponin elevation after strenuous exercise is passage through a cell membrane with changed permeability rather than myocardial cell death. We hypothesised that an increase of cardiac specific myosin heavy chain-alpha (MHC-α; 224 kDa compared with cardiac troponin T's (cTnT) 37 kDa) could hardly be explained by passage through a cell membrane. Methods Blood samples were collected from 56 athletes (15 female, age 42.5±9.7, range 24-70 years) before, directly after and on days 1-8 after an Ironman. Biomarkers (C reactive protein (CRP), cTnT, creatine kinase (CK), MHC-α, myoglobin (MG), creatinine (C) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) were measured. Results The course of MHC-α concentration (µg/L) was 1.33±0.53 (before), 2.57±0.78 (directly after), 1.51±0.53 (day 1), 2.74±0.55 (day 4) and 1.83±0.76 (day 6). Other biomarkers showed a one-peaked increase with maximal values either directly after the race or at day 1: cTnT 76 ± 80 ng/L (12-440; reference<15), NT-proBNP 776±684 ng/L (92-4700; ref.<300), CK 68±55 µkat/L (5-280; ref.<1.9), MG 2088±2350 µg/L (130-17 000; ref.<72) and creatinine 100±20 µmol/L (74-161; ref.<100), CRP 49±23 mg/L (15-119; ref.<5). Conclusion MHC-α exhibited a two-peaked increase which could represent a first release from the cytosolic pool and later from cell necrosis. This is the first investigation of MHC-α plasma concentration after exercise.
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Affiliation(s)
- Tom Danielsson
- Department of Sport Sciences, Linnæus University, Kalmar, Sweden
| | - Hendrik Schreyer
- Department of Internal Medicine, Section of Cardiology, Kalmar County Hospital, Kalmar, Sweden
| | - Hanna Woksepp
- Department of Clinical Microbiology and Research Section Development and Public Health Unit, Kalmar County Hospital, Kalmar, Sweden
| | - Therese Johansson
- Department of Internal Medicine, Section of Cardiology, Kalmar County Hospital, Kalmar, Sweden
| | - Patrick Bergman
- Department of Sport Sciences, Linnæus University, Kalmar, Sweden
| | - Alf Månsson
- Department of Chemistry and Biomedical Sciences, Linnæus University, Kalmar, Sweden
| | - Jörg Carlsson
- Department of Internal Medicine, Section of Cardiology, Kalmar County Hospital, Kalmar, Sweden.,Department of Health and Caring Sciences, Linnæus University, Kalmar, Sweden
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Acute Responses of Novel Cardiac Biomarkers to a 24-h Ultra-Marathon. J Clin Med 2019; 8:jcm8010057. [PMID: 30625976 PMCID: PMC6351937 DOI: 10.3390/jcm8010057] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 12/31/2018] [Accepted: 01/01/2019] [Indexed: 12/24/2022] Open
Abstract
The aim of the present study was to examine the acute effect of an ultra-endurance performance on N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac specific troponin T (cTnT), creatinine kinase-myocardial band (CK-MB), high sensitive C-reactive protein (hsCRP), ischemia modified albumin (IMA), heart-type fatty acid binding protein (H-FABP) and cardiovascular function. Cardiac biomarkers were evaluated in 14 male ultra-marathoners (age 40 ± 12 years) during a 24 h ultra-marathon at five points (i.e., Pre-race; Marathon, 12-h run, 24-h run, and 48-h post-race). All subjects underwent baseline echocardiography assessment at least 10 days prior to the ultra-marathon and 48 h post-race. The average distance covered during the race was 149.4 ± 33.0 km. Running the ultra-marathon led to a progressive increase in hsCRP and H-FABP concentrations (p < 0.001). CK-MB and cTnT levels were higher after a 24-h run compared to pre-race (p < 0.05). Diastolic function was altered post-race characterized by a reduction in peak early to late diastolic filling (p < 0.01). Running an ultra-marathon significantly stimulates specific cardiac biomarkers; however, the dynamic of secretion of biomarkers linked to myocardium ischemia were differentially regulated during the ultra-marathon race. It is suggested that both exercise duration and intensity play a crucial role in cardiovascular adaptive mechanisms and cause risk of cardiac stress in ultra-marathoners.
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Nikolaidis PT, Knechtle B. Russians are the fastest and the youngest in the "Comrades Marathon". J Sports Sci 2018; 37:1387-1392. [PMID: 30583710 DOI: 10.1080/02640414.2018.1559979] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The present retrospective study intended to determine age, performance, the role of nationality and participation trends across calendar years in runners competing in "Comrades Marathon", the ultra-marathon with the longest tradition and the highest number of finishers worldwide. We analysed 235,467 finishers (40,211 women and 195,256 men) competing between 1994 and 2017. In women and men, Russians were the fastest (12.55 ± 2.03 km/h and 12.24 ± 2.93 km/h, respectively) and Indians the slowest (7.87 ± 0.64 km/h and 7.91 ± 0.60 km/h) (p < 0.001, η2 = 0.053 and η2 = 0.010, small effect size, ES). Also, Russians were the youngest (33.9 ± 4.6 and 36.3 ± 5.9 years, respectively) and Japanese the oldest (49.3 ± 9.6 and 51.4 ± 12.3 years, respectively) (p < 0.001, η2 = 0.011, small ES). Performance improved (r = 0.90 in women and r = 0.92 in men), age of finishers (r = 0.91 in women and r = 0.97 in men), participation (r = 0.92 in women and r = 0.87 in men) and sex difference in age increased (r = 0.71), whereas men-to-women ratio (r = -0.91) and sex difference in performance (r = -0.68) decreased across calendar years (p < 0.001). In summary, runners from Russia were the fastest and the youngest in both sexes. The knowledge of the relationship of nationality with performance, age and participation trends of finishers, and changes across calendar years are of practical importance for ultra-runners and coaches working with them.
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Affiliation(s)
| | - Beat Knechtle
- b Medbase St. Gallen Am Vadianplatz , St. Gallen , Switzerland
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Knechtle B, Nikolaidis PT. Physiology and Pathophysiology in Ultra-Marathon Running. Front Physiol 2018; 9:634. [PMID: 29910741 PMCID: PMC5992463 DOI: 10.3389/fphys.2018.00634] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/11/2018] [Indexed: 12/31/2022] Open
Abstract
In this overview, we summarize the findings of the literature with regards to physiology and pathophysiology of ultra-marathon running. The number of ultra-marathon races and the number of official finishers considerably increased in the last decades especially due to the increased number of female and age-group runners. A typical ultra-marathoner is male, married, well-educated, and ~45 years old. Female ultra-marathoners account for ~20% of the total number of finishers. Ultra-marathoners are older and have a larger weekly training volume, but run more slowly during training compared to marathoners. Previous experience (e.g., number of finishes in ultra-marathon races and personal best marathon time) is the most important predictor variable for a successful ultra-marathon performance followed by specific anthropometric (e.g., low body mass index, BMI, and low body fat) and training (e.g., high volume and running speed during training) characteristics. Women are slower than men, but the sex difference in performance decreased in recent years to ~10–20% depending upon the length of the ultra-marathon. The fastest ultra-marathon race times are generally achieved at the age of 35–45 years or older for both women and men, and the age of peak performance increases with increasing race distance or duration. An ultra-marathon leads to an energy deficit resulting in a reduction of both body fat and skeletal muscle mass. An ultra-marathon in combination with other risk factors, such as extreme weather conditions (either heat or cold) or the country where the race is held, can lead to exercise-associated hyponatremia. An ultra-marathon can also lead to changes in biomarkers indicating a pathological process in specific organs or organ systems such as skeletal muscles, heart, liver, kidney, immune and endocrine system. These changes are usually temporary, depending on intensity and duration of the performance, and usually normalize after the race. In longer ultra-marathons, ~50–60% of the participants experience musculoskeletal problems. The most common injuries in ultra-marathoners involve the lower limb, such as the ankle and the knee. An ultra-marathon can lead to an increase in creatine-kinase to values of 100,000–200,000 U/l depending upon the fitness level of the athlete and the length of the race. Furthermore, an ultra-marathon can lead to changes in the heart as shown by changes in cardiac biomarkers, electro- and echocardiography. Ultra-marathoners often suffer from digestive problems and gastrointestinal bleeding after an ultra-marathon is not uncommon. Liver enzymes can also considerably increase during an ultra-marathon. An ultra-marathon often leads to a temporary reduction in renal function. Ultra-marathoners often suffer from upper respiratory infections after an ultra-marathon. Considering the increased number of participants in ultra-marathons, the findings of the present review would have practical applications for a large number of sports scientists and sports medicine practitioners working in this field.
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Affiliation(s)
- Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
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