Cardiac Troponin-T Release After Sport and Differences by Age, Sex, Training Type, Volume, and Intensity: A Critical Review

Cantinotti, Massimiliano; Clerico, Aldo; Giordano, Raffaele; Assanta, Nadia; Franchi, Eliana; Köestenberger, Martin; Marchese, Pietro; Storti, Simona; D’Ascenzi, Flavio

doi:10.1097/jsm.0000000000000940

Cited by 12 publications

(6 citation statements)

References 87 publications

(992 reference statements)

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“…We did, however, observe a difference in Troponin T values between athletes and controls where three of the athletes and none of the controls exceeded the upper reference limit for Troponin T for our laboratory. Athletes were not detrained prior to investigation, hence this could be explained by post exercise rise in cardiac troponins which is a well-known and usually physiologic phenomenon 40 . Although being asymptomatic, this could alternatively be a sign of sub-clinical cardiac disease in these athletes.…”

Section: Discussionmentioning

confidence: 99%

No adverse association between exercise exposure and diffuse myocardial fibrosis in male endurance athletes

Andresen,

Klæboe,

Lie

et al. 2024

Sci Rep

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The potential association between endurance exercise and myocardial fibrosis is controversial. Data on exercise exposure and diffuse myocardial fibrosis in endurance athletes are scarce and conflicting. We aimed to investigate the association between exercise exposure and markers of diffuse myocardial fibrosis by cardiovascular magnetic resonance imaging (CMR) in endurance athletes. We examined 27 healthy adult male competitive endurance athletes aged 41 ± 9 years and 16 healthy controls in a cross sectional study using 3 Tesla CMR including late gadolinium enhancement and T1 mapping. Athletes reported detailed exercise history from 12 years of age. Left ventricular total mass, cellular mass and extracellular mass were higher in athletes than controls (86 vs. 58 g/m2, 67 vs. 44 g/m2 and 19 vs. 13 g/m2, all p < 0.01). Extracellular volume (ECV) was lower (21.5% vs. 23.8%, p = 0.03) and native T1 time was shorter (1214 ms vs. 1268 ms, p < 0.01) in the athletes. Increasing exercise dose was independently associated with shorter native T1 time (regression coefficient − 24.1, p < 0.05), but expressed no association with ECV. Our results indicate that diffuse myocardial fibrosis has a low prevalence in healthy male endurance athletes and do not indicate an adverse dose–response relationship between exercise and diffuse myocardial fibrosis in healthy athletes.

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Section: Discussionmentioning

confidence: 99%

No adverse association between exercise exposure and diffuse myocardial fibrosis in male endurance athletes

Andresen,

Klæboe,

Lie

et al. 2024

Sci Rep

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“…It is well established that prolonged strenuous exercise may lead to an elevation of cardiovascular biomarkers such as hs-cTnI and NT-proBNP [ 6 , 14 – 16 ]. Zebrowska et al demonstrated in participants of a 24-h ultramarathon that cTnI and NT-proBNP were significantly elevated directly and one day after the race [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of an Ultra-Endurance Marathon on Cardiac Function in Association with Cardiovascular Biomarkers

Burger,

Wegberger,

Tscharre

et al. 2024

Sports Med - Open

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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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“…In summary, the postexercise release of cTn rarely underlies a subclinical cardiac disease and can be considered a physiological phenomenon observed in athletes of all ages. Future studies are needed to establish the influence of confounders (such as age, sex, sport type, intensity and duration) and individualized ranges of normality of post-exercise cTn levels in athletes [ 61 ].…”

Section: Acute Effectsmentioning

confidence: 99%

May Strenuous Endurance Sports Activity Damage the Cardiovascular System of Healthy Athletes? A Narrative Review

Graziano

Juhász

Brunetti

et al. 2022

JCDD

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The positive effects of physical activity are countless, not only on the cardiovascular system but on health in general. However, some studies suggest a U-shape relationship between exercise volume and effects on the cardiovascular system. On the basis of this perspective, moderate-dose exercise would be beneficial compared to a sedentary lifestyle, while very high-dose physical activity would paradoxically be detrimental. We reviewed the available evidence on the potential adverse effects of very intense, prolonged exercise on the cardiovascular system, both acute and chronic, in healthy athletes without pre-existing cardiovascular conditions. We found that endurance sports activities may cause reversible electrocardiographic changes, ventricular dysfunction, and troponin elevation with complete recovery within a few days. The theory that repeated bouts of acute stress on the heart may lead to chronic myocardial damage remains to be demonstrated. However, male veteran athletes with a long sports career show an increased prevalence of cardiovascular abnormalities such as electrical conduction delay, atrial fibrillation, myocardial fibrosis, and coronary calcifications compared to non-athletes. It must be underlined that the cause–effect relationship between such abnormalities and the exercise and, most importantly, the prognostic relevance of such findings remains to be established.

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Cardiac Troponin-T Release After Sport and Differences by Age, Sex, Training Type, Volume, and Intensity: A Critical Review

Cited by 12 publications

References 87 publications

No adverse association between exercise exposure and diffuse myocardial fibrosis in male endurance athletes

No adverse association between exercise exposure and diffuse myocardial fibrosis in male endurance athletes

Impact of an Ultra-Endurance Marathon on Cardiac Function in Association with Cardiovascular Biomarkers

May Strenuous Endurance Sports Activity Damage the Cardiovascular System of Healthy Athletes? A Narrative Review

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