Cardiac Troponin T Release Is Stimulated by Endurance Exercise in Healthy Humans

Middleton, Natalie; George, Keith; Whyte, Greg; Gaze, David; Collinson, Paul; Shave, Rob

doi:10.1016/j.jacc.2008.03.069

Cited by 152 publications

(136 citation statements)

References 9 publications

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“…intensity and level of training), but also to blood sample timing [52]. Moreover, the method used to measure the troponin levels can affect results [25]: due to the low circulating levels of cTnI and cTnT in healthy subjects, only highly sensitive methods allow the accurate evaluation of biomarker variations in the majority of subjects tested, especially when pre-and post-exercise values are both below the 99th URL [8,25].…”

Section: Physical Exercisementioning

confidence: 99%

“…Moreover, the method used to measure the troponin levels can affect results [25]: due to the low circulating levels of cTnI and cTnT in healthy subjects, only highly sensitive methods allow the accurate evaluation of biomarker variations in the majority of subjects tested, especially when pre-and post-exercise values are both below the 99th URL [8,25]. Importantly, almost 100% of subjects demonstrated a significant increase in circulating levels after exercise, especially when highly sensitive methods were employed [25,[52][53][54][55][56].…”

Section: Physical Exercisementioning

confidence: 99%

“…From a clinical viewpoint, some studies reported that increased troponin levels can be detected not only during or few minutes after the exercise, but also hours after strenuous physical effort [25,52]. Therefore it is important to check whether each subject/patient has performed intense physical activity before cTn measurement.…”

Section: Physical Exercisementioning

confidence: 99%

“…The kinetic profile of cTnI and cTnT circulating levels after strenuous exercise in apparently healthy subjects [25,40,[52][53][54][55][56][77][78][79][80][81][82][83][84][85][86][87][88][89][90] is different from that usually observed in patients with AMI. It is well known that circulating levels of cTnI and cTnT in patients with uncomplicated type 1 AMI usually peak between 12 and 36 h from beginning of thoracic pain, gradually returning to below the 99th URL value within 5-7 days [1,3,40,76].…”

Section: Mechanisms Of Troponin Release In Cardiac Patients and Healtmentioning

confidence: 99%

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The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

Clerico

Zaninotto

Ripoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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According to recent international guidelines, including the 2012 Third Universal Definiton of Myocardial Infarction by the Joint ESC/ACCF/AHA/WHF Task Force, an increase in cardiac troponin (cTn) levels over the 99th percentile upper reference limit (99th URL) should be considered clinically relevant, this cut-off being measured with an imprecision ≤10 CV%. In theory 99th URL values strongly depend not only on demographic and physiological variables (i.e. criteria for considering the reference population "healthy"), but also on the analytical performance of cTn methods and mathematical algorithms used for the calculation. The aim of the present article was therefore to review the methodological and pathophysiological factors affecting the evaluation and calculation of the 99th URL for cTn assay. The critical analysis made showed that no uniform procedure is followed, and nor have experts or regulatory bodies provided uniform guidelines for researchers or cTn assays manufacturers as an aid in "their quest to define normality". In particular, little attention has been paid to the way in which a healthy reference population is to be selected, or the criteria for calculating the 99th URL value for cTn assays, thus highlighting the need for international recommendations not only for demographic and physiological variables criteria for defining a healthy reference population, but also for calculating mathematical algorithms for establishing/ calculating clinical decision values. An expert consensus group, comprising laboratory and clinical scientists, biomedical statisticians, industrial and regulatory representatives, should be responsible for drawing up these guidelines.

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Section: Physical Exercisementioning

confidence: 99%

Section: Physical Exercisementioning

confidence: 99%

Section: Physical Exercisementioning

confidence: 99%

Section: Mechanisms Of Troponin Release In Cardiac Patients and Healtmentioning

confidence: 99%

See 2 more Smart Citations

The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

Clerico

Zaninotto

Ripoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…The underlying pathophysiological mechanism of cTn release in endurance exercise seems to be rather complex, since recent results from an ultra-marathon suggest that individual factors influence the extent and time course in cTn release of individual runners (18). In another study with marathon runners it was observed that runners developed a second peak of cTn release several hours after the end of a marathon run and after cTn had already decreased to baseline levels (19). In analogy to myocardial infarction this observation may be explained by a remodelling process including cell necrosis and/or apoptosis.…”

Section: Pathophysiology Of Troponin Releasementioning

confidence: 99%

Diagnostic and Prognostic Information Provided by a High Sensitivity Assay for Cardiac Troponin T

Jarausch¹

2010

Journal of Medical Biochemistry

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Kratak sadr`aj: Sr~ani troponini (cTns) preporu~uju se kao biomarkeri za dijagnozu akutnog infarkta miokarda, pro cenu rizika i prognoze, kao i za odre|ivanje antitrombotske terapije i strategije revaskularizacije kod pacijenata sa akutnim koronarnim sindromima. Implementacija visoko osetljivih testova za cTn u klini~koj praksi je pove}ala broj pacijenata kod kojih je dijagnostikovan infarkt miokarda. Pored toga, pove}an je i broj pacijenata sa povi{e -nim nivo ima cTn koji se ne mogu pripisati akutnom ishemijskom o{te }enju, {to je prime}eno kod pacijenata sa hro ni~nim sr~anim bolestima i drugim neishemijskim sr~a -nim o{te}e njima ili kod pacijenata sa o{te}enom renalnom funkcijom. Nova definicija infarkta miokarda podr`ava tuma ~enje povi{enih cTn izmerenih pomo}u visokoosetljivih testova za cTn kod pacijenata kod kojih se sumnja na akutni koro narni sindrom. Ovde se prikazuju kli ni~ke studije sa nedavno uvedenim visokoosetljivim testom za cTnT (TnT hs) uz uop{teni osvrt na iskustva sa viso ko osetljivim cTn testovima.Klju~ne re~i: sr~ani troponin, visokoosetljivi test za sr~ani troponin, akutni infarkt miokarda

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Normalization of elevated cardiac, kidney, and hemolysis plasma markers within 48 h in Mexican Tarahumara runners following a 78 km race at moderate altitude

Christensen

Espino

Infante-Ramírez

et al. 2014

American J Hum Biol

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Objectives: The aim of this study was to examine to what extent extreme endurance exercise results in changes of plasma markers associated with cardiac and renal damage, as well as hemolysis in male, Mexican Tarahumara runners.Methods: Ten Tarahumara runners (mean (sd) age of 38 (12) years) participated in a 78 km race in Chihuahua, Mexico at 2,400 m above sea level. Cardiac, kidney, and hematology plasma markers were measured pre-race and <5 min, 1 h, 3 h, 6 h, 24 h, and 48 h post-race. Anthropometry, blood pressure, pulse rate, electrocardiography, HbA1c, hemoglobin and VO 2max (estimated from heart rate following step test) were assessed pre-race, while physical activity energy expenditure and intensity were estimated during the race, and oxygen partial pressure saturation (SpO 2 ) <30 min post-race.Results: Estimated mean VO 2max was 48 (9) mLO 2 min 21 kg 21 and relative intensity during the race was 68 (11)%VO 2 max. Mean SpO 2 was 92 (3)% <30 min post-race. Plasma concentrations of especially total creatine kinase, creatine kinase-MB isoform, and haptoglobin changed significantly from pre-race values (P < 0.001) up to 24 h postrace, but had returned to pre-race values after 48 h. The plasma concentrations of mid-regional proatrial natiuretic peptide and copeptin returned to pre-race concentrations after 1 and 6 h, respectively.Conclusions: Altered cardiac, renal, and hemolysis plasma markers were normalized after 48 h following 78 km of running, suggesting that the impact of exercise-induced cardiac and kidney damage as well as hemolysis in the Mexican Tarahumara is low. Am. J. Hum. Biol. 26:836-843, 2014.

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Cardiac Troponin T Release Is Stimulated by Endurance Exercise in Healthy Humans

Cited by 152 publications

References 9 publications

The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

Diagnostic and Prognostic Information Provided by a High Sensitivity Assay for Cardiac Troponin T

Normalization of elevated cardiac, kidney, and hemolysis plasma markers within 48 h in Mexican Tarahumara runners following a 78 km race at moderate altitude

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