Highly increased Troponin I levels following high-intensity endurance cycling may detect subclinical coronary artery disease in presumably healthy leisure sport cyclists: The North Sea Race Endurance Exercise Study (NEEDED) 2013

Skadberg, Øyvind; Kleiven, Øyunn; Bjørkavoll-Bergseth, Magnus; Melberg, Tor; Bergseth, Rolf; Selvåg, Jone; Auestad, Bjørn; Greve, Ole Jacob; Dickstein, Kenneth; Aarsland, Torbjørn; Ørn, Stein

doi:10.1177/2047487317693130

Cited by 39 publications

(62 citation statements)

References 155 publications

(299 reference statements)

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“…We report the individual variation of peak cTnI in 26% of subjects with only one individual having a cTnI value greater than the URL. However, this value is much lower than the reported percentages for other game exercises, such as for the long run marathon [28] or cycling [29]. Our findings confirm the diversity of cTnI release in peak time, and at that specific time the analysis suggests some degree of variance in "kinetics" of the cTnI appearance.…”

Section: Discussionsupporting

confidence: 71%

Cardiac Biomarker Levels After a Football Match in Professional Versus Amateur Lithuanian Football Players

Aldujeli¹,

Briedis

Aldujeili

et al. 2019

Medical Research Journal

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Background: There are very limited scientific data available on cardiac troponin I release after intermittent exercise. To know the different factors that mediate cTnI release after exercise is of concern for scientists. In this regard, our study is based on two major goals: 1) to evaluate the cTnI release in individuals during a sports match; and 2) to understand the impact of the status of the athlete (biological) on the release of individual cTnI. Methods: A total of 44 players, including "22 adult professional [PFP]: 24.2±4.5 years, 22 adult amateur [AFP]: 26.5±3.6 years" were involved in a match simulated as real. Successive observations of cTnI release were obtained at different settings such as at rest, pre-exercise, and instant-post-exercise at regular intervals of 3, 6, and then 24 h post-exercise. Results: From the obtained results it was observed that the individual highest values were vastly varied, with higher levels of cTnI release baseline and post-exercise for PFP players as compared to those of AFP (all p < 0.05). Moreover, the cTnI levels were increased (peak post: 0.024 [0.004-0.244] μg/L; p < 0.05). Additionally, the cTnI peak values surpassed the upper limit of reference in 77.3% of PFP (17 PFP). Conclusions: Our study data results affirm that the cTnI release is highly affected by the status of athletes. The cTnI release is enhanced by intermittent exercise.

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Section: Discussionsupporting

confidence: 71%

Cardiac Biomarker Levels After a Football Match in Professional Versus Amateur Lithuanian Football Players

Aldujeli¹,

Briedis

Aldujeili

et al. 2019

Medical Research Journal

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“…Strenuous exercise results in mainly reversible changes of cardiac morphology and function and a transient increase of serum markers of myocardial injury. [1][2][3] However, a portion of athletes reveal myocardial fibrosis on contrast-enhanced cardiac magnetic resonance (CMR), which represents an irreversible myocardial injury. [4][5][6][7] One explanation for myocardial fibrosis in athletes could be repetitive exercise-related myocardial injuries triggered by hypoxia, inflammation or hypertensive overload.…”

Section: Introductionmentioning

confidence: 99%

Acute impact of an endurance race on cardiac function and biomarkers of myocardial injury in triathletes with and without myocardial fibrosis

Tahir

Scherz

Starekova

et al. 2019

Eur J Prev Cardiolog

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Aims The aim of this study was to investigate the occurrence of myocardial injury and cardiac dysfunction after an endurance race by biomarkers and cardiac magnetic resonance in triathletes with and without myocardial fibrosis. Methods and results Thirty asymptomatic male triathletes (45 ± 10 years) with over 10 training hours per week and 55 ± 8 ml/kg per minute maximal oxygen uptake during exercise testing were studied before (baseline) and 2.4 ± 1.1 hours post-race. Baseline cardiac magnetic resonance included cine, T1/T2, late gadolinium enhancement (LGE) and extracellular volume imaging. Post-race non-contrast cardiac magnetic resonance included cine and T1/T2 mapping. Non-ischaemic myocardial fibrosis was present in 10 triathletes (LGE+) whereas 20 had no fibrosis (LGE–). At baseline, LGE + triathletes had higher peak exercise systolic blood pressure with 222 ± 21 mmHg compared to LGE– triathletes (192 ± 30 mmHg, P < 0.01). Post-race troponin T and creatine kinase MB were similarly increased in both groups, but there was no change in T2 and T1 from baseline to post-race with 54 ± 3 ms versus 53 ± 3 ms ( P = 0.797) and 989 ± 21 ms versus 989 ± 28 ms ( P = 0.926), respectively. However, post-race left atrial ejection fraction was significantly lower in LGE + triathletes compared to LGE– triathletes (53 ± 6% vs. 59 ± 6%, P < 0.05). Furthermore, baseline atrial peak filling rates were lower in LGE – triathletes (121 ± 30 ml/s/m2) compared to LGE + triathletes (161 ± 34 ml/s/m2, P < 0.01). Post-race atrial peak filling rates increased in LGE– triathletes to 163 ± 46 ml/s/m2, P < 0.001), but not in LGE + triathletes (169 ± 50ml/s/m2, P = 0.747). Conclusion Despite post-race troponin T release, we did not find detectable myocardial oedema by cardiac magnetic resonance. However, the unfavourable blood pressure response during exercise testing seemed to be associated with post-race cardiac dysfunction, which could explain the occurrence of myocardial fibrosis in triathletes.

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“…often exceeds the upper reference limit following exercise (Vilela et al, 2014;Gresslien and Agewall, 2016). Although strongly needed, there are no agreed thresholds for acute changes in cardiac troponin associated with substantial increased risk of morbidity or mortality in athletes, as the clinical relevance of exercise-induced cardiac troponin is still under debate (Skadberg et al, 2017;Nie, 2018). It has been argued previously that cardiac troponin is not randomly elevated after vigorous exercise but increases in certain "susceptible" individuals (Nie et al, 2011;Tian et al, 2014;Legaz-Arrese et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

Effects of Matched Intermittent and Continuous Exercise on Changes of Cardiac Biomarkers in Endurance Runners

Nie

Zhang

et al. 2020

Front. Physiol.

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Exercise Physiology, a section of the journal Frontiers in PhysiologyPurpose: Endurance runners training with high-intensity intermittent exercise might experience damage to cardiac muscle. We have therefore compared changes of cardiac biomarkers after workload-matched intermittent and continuous exercise.Methods: Twelve endurance runners [11 males, 1 female; means ± SDVO 2max , 62.4 ± 5.4 ml kg −1 min −1 ; velocity ofVO 2max (vVO 2max ), 17.1 ± 1.4 km h −1 ] completed an intermittent and continuous exercise trial in random order. Intermittent exercise consisted of running at 90% vVO 2max for 2 min followed by 50% vVO 2max for 2 min, repeated for 92 min. Continuous exercise was performed at 70% vVO 2max for 92 min. Blood samples were drawn before and 0, 2, 4, 24, and 48 h after exercise for assay of various cardiac biomarkers. Changes in concentration of biomarkers were averaged for the comparison of intermittent with continuous exercise after adjustment for baseline concentration and exercise intensity expressed as percent of heart-rate reserve (%HRR); magnitudes were assessed by standardization.Results: There were moderate and large increases in high-sensitivity cardiac troponin-I and -T respectively following exercise. The differences between the increases adjusted to the mean intensity of 78 %HRR were trivial, but at 85 %HRR the increases for cardiac troponin-I and -T were moderately higher for intermittent compared with continuous exercise (factor difference, ×/÷90% confidence limits: 3.4, ×/÷1.9 and 2.1, ×/÷1.8 respectively). Differences in the changes in other cardiac biomarkers were trivial.Conclusion: Prolonged intermittent exercise is potentially more damaging to cardiac muscle than continuous exercise of the same average running speed at higher average heart rates in endurance runners.

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Highly increased Troponin I levels following high-intensity endurance cycling may detect subclinical coronary artery disease in presumably healthy leisure sport cyclists: The North Sea Race Endurance Exercise Study (NEEDED) 2013

Cited by 39 publications

References 155 publications

Cardiac Biomarker Levels After a Football Match in Professional Versus Amateur Lithuanian Football Players

Cardiac Biomarker Levels After a Football Match in Professional Versus Amateur Lithuanian Football Players

Acute impact of an endurance race on cardiac function and biomarkers of myocardial injury in triathletes with and without myocardial fibrosis

Effects of Matched Intermittent and Continuous Exercise on Changes of Cardiac Biomarkers in Endurance Runners

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