Myocardial Injury and Overload among Amateur Marathoners as Indicated by Changes in Concentrations of Cardiovascular Biomarkers

Abstract

Marathons continue to grow in popularity among amateurs. However, the impact of intensive exercise on the amateur’s cardiovascular system has not yet been studied. Analysis of the influence of the marathon on kinetics of biomarkers reflecting cardiac injury and overload may bring new insights into this issue. We investigated the effect of running a marathon on the concentrations of high sensitivity cardiac troponin I (hs-cTnI), heart-type fatty acid binding protein (H-FABP), N-terminal proatrial natriuretic peptide (NT-proANP), B-type natriuretic peptide (BNP), growth differentiation factor 15 (GDF-15) and galectin 3 (Gal-3) in the population of male amateur runners. The study included 35 amateur marathoners and followed 3 stages: S1—two weeks prior to the marathon, S2—at the finish line and S3—two weeks after. Blood samples were collected at each stage and analyzed for biomarkers and laboratory parameters. Concentrations of all studied biomarkers were significantly higher at S2, whereas at S3 did not differ significantly compared to S1. Running a marathon by an amateur causes an acute rise in biomarkers of cardiac injury and stress. Whether repetitive bouts of intensive exercise elicit long-term adverse cardiovascular effects in amateur marathoners needs further research.

Inflammatory response to a marathon run in amateur athletes

“…After the finishing the marathon run, we asked the participants to suspend high-intensity training as well as participation in any upcoming competitions. The characteristics of a study group were described previously [7].…”

“…Fasting blood samples at Stage 1 and Stage 3 were collected at the cardiology department. Serum was prepared immediately after collection by centrifugation at 2000 rpm at room temperature for 12 minutes and then stored in -80˚C for the further analysis [7].…”

“…The data was analyzed using Statistica 12 software (StatSoft). A p value < 0.05 was considered statistically significant [7].…”

Diagnosis, Investigation and Management of Patients with Acute and Chronic Myocardial Injury

“…Myocardial injury has also been documented as a transient phenomenon after high-intensity exercise [ 52 , 53 ]. Troponin concentrations are higher after short intense periods of exercise than following prolonged exercise at lower intensity, and in healthy persons levels return to pre-exercise levels within 24 h. Elevation in both troponin I and T has been documented in athletes and non-athletes after major endurance events, with up to 43% of non-athletes having concentrations above the 99th percentile [ 54 , 55 , 56 ]. Historically, rhabdomyolysis, which can occur after intense exercise or muscle injury, has been positively correlated with elevated cardiac troponins [ 57 ].…”

Altered GDF15 and FGF21 Levels in Response to Strenuous Exercise: A Study in Marathon Runners

“…Although the rise in GDF15 may be related to changes in cardiac hemodynamic volume and pressure overload immediately after the marathon, it has been proposed that GDF15 does not appear as reliable to track specifically cardiorespiratory fitness in acute exercise, possibly because of the contribution of other noncardiac processes to the GDF15 rise in exercise (Kaleta-Duss et al, 2020). Nonetheless, some authors found GDF15 levels to be associated with impairment in exercise capacity in patients with the heart failure syndrome (Stahrenberg et al, 2010) whereas others do not consider GDF15 as a reliable biomarker of exercise capacity in heart failure patients (Fudim et al, 2020).…”