Comparison of cardiac biomarker dynamics in marathon, semi-marathon and untrained runners: what is the impact on results interpretation?

Abstract

Background: Cardiac biomarkers elevations have been described after running exercise. Objective of our study was to check cardiac biomarker dynamics in well trained athletes and untrained middle aged apparently healthy men and to highlight the impact on the lab results interpretation in emergency department.Methods: Cardiac biomarkers for ischemic condition, cardiac stretch and fibrotic processes were tested in different type of runners before, directly after and 3 hours after running. Markers for inflammation, muscle disease and renal function were also measured.Results: Cardiac biomarker levels between groups were not statistically different in the pre-exercise samples for natriuretic peptides [B-type natriuretic peptide (BNP), N-terminal Pro BNP (NT-ProBNP)] and galectin-3 (Gal-3), only Troponin I levels were higher. Directly after exercise, all cardiac biomarker levels were higher compared to the baseline, Gal-3 and BNP levels decreased 3 hours after completion of the run.Troponin values continued to increase with highest levels 3 hours after exercise. Troponin T, NT-Pro-BNP and Gal-3 also showed significant correlation to markers of inflammation, fibrosis and renal function.Conclusions: Exercises of different intensity can be associated with biochemical abnormalities and longterm consequences are unknown. In chest pain patients presenting to the emergency department possible impact of exercise on test results, especially Troponin, should be checked.

Kinetics of Cardiac Remodeling and Fibrosis Biomarkers During an Extreme Mountain Ultramarathon

“…Contradicting these findings, other studies have shown that increased Gal-3 was associated with biochemical abnormalities during high-intensity endurance exercise, which may reflect adverse consequences on cardiac structure ( 33 ). It is possible that the discordance rise is a consequence of the training status of the athletes, a kind of physiological adaptation, in line with one of our previous studies with marathon runners ( 41 ).…”

Prospective evaluation of cardiac effects of first-time marathon training, running, and recovery in middle-aged men: cohort study rationale and design

“…Prior marathon studies demonstrated several sources of intrinsic bias or were limited to conventional investigative procedures, such as biomarkers, ECG and echocardiography [ 8 – 10 ]. A common source of bias is the inclusion of (highly) experienced runners only, who complete a comprehensive, investigator-led training programme, with evident and/or treated cardiovascular risk factors, leading to strongly selected study populations.…”

“…Several phenomena that point to potentially detrimental cardiac effects of running have been reported, such as elevated biomarkers for myocardial injury (troponin T and I, NT-proBNP) [ 8 , 9 ], and reductions in left and right ventricular systolic and diastolic function directly after marathon completion [ 10 ]. Most studies on cardiac effects of marathon running are cross-sectional or retrospective, do not include state-of-the-art imaging investigations such as cardiovascular magnetic resonance imaging (MRI) coupled with functional assessments, and do not include recovery follow-up.…”

Intense sport practices and cardiac biomarkers

“…Few studies have been conducted on the relationship between Gal-3 and sports. A significant increase in Gal-3 levels has been observed after running 30 km [69] or after a marathon [71] or a 60 km ultra-marathon [72]. These increases did not correlate with an increase in cardiac markers such as troponins (cTn) and NT-proBNP.…”