Cardiac Biomarker Release After Exercise in Healthy Children and Adolescents: A Systematic Review and Meta-Analysis

Abstract

Purpose:The authors evaluated the impact of acute exercise and 24-hour recovery on serum concentration of cardiac troponins T and I (cTnT and cTnI) and N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP) in healthy children and adolescents. The authors also determined the proportion of participants exceeding the upper reference limits and acute myocardial infarction cutoff for each assay.Method:Web of Science, SPORTDiscus, MEDLINE, ScienceDirect, and Scopus databases were systematically searched up to November 2017. Studies were screened and quality-assessed; the data was systematically extracted and analyzed.Results:From 751 studies initially identified, 14 met the inclusion criteria for data extraction. All 3 biomarkers were increased significantly after exercise. A decrease from postexercise to 24 hours was noted in cTnT and cTnI, although this decrease was only statistically significant for cTnT. The upper reference limit was exceeded by 76% of participants for cTnT, a 51% for cTnI, and a 13% for NT-proBNP. Furthermore, the cutoff value for acute myocardial infarction was exceeded by 39% for cTnT and a 11% for cTnI. Postexercise peak values of cTnT were associated with duration and intensity (Q(3) = 28.3,P < .001) while NT-proBNP peak values were associated with duration (Q(2) = 11.9,P = .003).Conclusion:Exercise results in the appearance of elevated levels of cTnT, cTnI, and NT-proBNP in children and adolescents. Postexercise elevations of cTnT and NT-proBNP are associated with exercise duration and intensity.

Cardiac Troponin T Release after Football 7 in Healthy Children and Adults

“…As previously noticed in other studies [3,4], participants had normal ECG and reported no history of personal nor familiar cardiovascular disease. However, the overall rate of positive detection was substantial (25/36, 69.44%), and similar to that in a recent meta-analysis including studies with participants under the age of 18 (166/219, 75.8%, χ 2 = 0.37, p = 0.54) [6]. These findings reinforce the hypothesis that transient elevations of cTn after practicing sport might be a physiological acute response to exercise rather than a pathological sign of cardiovascular disease.…”

“…Blood samples were taken from an antecubital vein before exercise (pre) and at 3 h after exercise (post). The election of these sampling times was based on previous research reporting an approximate time-to-peak for cTnT of between 2 and 5 h after exercise [6]. Blood samples were quickly centrifuged and stored at −80 • C for further analysis.…”

“…Whilst some previous studies reported higher peak cTn values in adolescents when compared with the adults [5], others found no age differences [3,4]. Despite this, studies focusing on this phenomenon in younger populations are still scarce [6]. It has been hypothesized that, the higher elevations of cTn in young athletes might be related to maturation, since the immature myocardium might be more vulnerable to injury in clinical situations [3,5].…”

The validity and reliability of the Healthy Lifestyle Screening Tool

“…Exercise has been reported as a very important factor in the maintenance of good health [31][32][33]. Todde et al [33] has suggested that high-intensity exercise and functional exercises can improve functional mobility and muscle endurance among those who are above the age of 65.…”

Interpretation of elevated high-sensitivity cardiac troponin I in elite soccer players previously infected by severe acute respiratory syndrome coronavirus 2

“…Additionally in the acute phase, troponins, when elevated, do track with inflammatory and coagulation markers, suggesting non-specific cytokine-mediated cardiotoxicity [ 8 ]. On the other hand, in athletes, hs-troponins can be elevated even in absence of overt myocardial disease or injury, due to repeated exercise, especially in the young subjects [ 9 , 10 ].…”