Race duration and blood pressure are major predictors of exercise-induced cardiac troponin elevation

Kleiven, Øyunn; Omland, Torbjørn; Skadberg, Øyvind; Melberg, Tor; Bjørkavoll-Bergseth, Magnus; Auestad, Bjørn; Bergseth, Rolf; Greve, Ole Jacob; Aakre, Kristin Moberg; Ørn, Stein

doi:10.1016/j.ijcard.2019.02.044

Cited by 38 publications

(34 citation statements)

References 29 publications

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“…Nevertheless, the difference in the percentage of runners (LT: 77%, UT: 57%) with post-race values of hs-TNT above the URL did not reach statistical significance and most of the runners in the two races displayed values below the URL at 24 h post-race (LT: 78%, UT: 87%). This rate of normalization (i.e., percentage of participants with hs-TNT values below the URL at 24 h post-race) is similar to the one previously reported following a road marathon (between 73 and 83%) [ 60 – 62 ] and a 91-km mountain bike race (82%) [ 58 ].…”

Section: Discussionsupporting

confidence: 85%

Effect of mountain ultramarathon distance competition on biochemical variables, respiratory and lower-limb fatigue

Martínez-Navarro

Sánchez-Gómez²,

Aparicio

et al. 2020

PLoS ONE

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The study aimed at assessing the acute physiological effects of running a 65-km vs a 107km mountain ultramarathon. Nineteen athletes (15 males and 4 females) from the shorter race and forty three athletes (26 males and 17 females) from the longer race were enrolled. Body weight, respiratory and lower limb strength were assessed before and after the race. Blood samples were obtained before, after and 24-h post-race. Body weight loss did not differ between races. A decrease in squat jump height (p<0.01; d = 1.4), forced vital capacity (p<0.01; d = 0.5), forced expiratory volume in 1 s (p<0.01; d = 0.6), peak inspiratory flow (p<0.01; d = 0.6) and maximal inspiratory pressure (p<0.01; d = 0.8) was observed after the longer race; while, after the shorter race only maximal inspiratory pressure declined (p<0.01; d = 0.5). Greater post-race concentrations of creatine kinase (p<0.01; d = 0.9) and C-reactive protein (p<0.01; d = 2.3) were observed following the longer race, while high-sensitivity cardiac troponin was higher after the shorter race (p<0.01; d = 0.3). Sodium decreased post-competition only after the shorter race (p = 0.02; d = 0.6), while creatinine increased only following the longer race (p<0.01; d = 1.5). In both groups, glomerular filtration rate declined at post-race (longer race: p<0.01, d = 2.1; shorter race: p = 0.01, d = 1.4) and returned to baseline values at 24 h post-race. In summary, expiratory and lower-limb fatigue, and muscle damage and inflammatory response were greater following the longer race; while a higher release of cardiac troponins was observed after the shorter race. The alteration and restoration of renal function was similar after either race.

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Section: Discussionsupporting

confidence: 85%

Effect of mountain ultramarathon distance competition on biochemical variables, respiratory and lower-limb fatigue

Martínez-Navarro

Sánchez-Gómez²,

Aparicio

et al. 2020

PLoS ONE

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“…Subjects were excluded if they had known CV disease or CV medication, or if they had a resting ECG suggestive of underlying pathology at screening. 9 Study subjects were assessed by electrocardiograms (ECG), clinical assessments, and blood samples at baseline and at 3and 24 hours after the race. Study recruitment is outlined in Figure S1.…”

Section: Methodsmentioning

confidence: 99%

Endurance exercise training volume is not associated with progression of coronary artery calcification

Kleiven

Bjørkavoll-Bergseth

Omland

et al. 2020

Scandinavian Med Sci Sports

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Background:Recent cross-sectional studies have suggested a dose-dependent relationship between lifelong exposure to physical activity and the burden of calcified coronary artery disease (CAD). No longitudinal studies have addressed this concern. Hypothesis: Exercise volume is associated with progression of coronary artery calcium (CAC), defined as ≥10 units increase in CAC score. Methods: Sixty-one recreational athletes who were assessed by coronary computed tomography angiography (CCTA) as part of the NEEDED 2013/14 study were reassessed 4-5 years later, in 2018. Results: Subjects were 45.9 ± 9.6 years old at inclusion, and 46 (74%) were male.Between 2013 and 2018, the participants reported median 5 (range: 0-20, 25th-75th percentile: 4-6) hours of high-intensity exercise per week. None of the included subjects smoked during follow-up. At inclusion, 21 (33%) participants had coronary artery calcifications. On follow-up CCTA in 2018, 15 (25%) subjects had progressive coronary calcification (≥10 Agatston units increase in CAC). These subjects were older (53 ± 9 vs 44 ± 9 years old, P = .002) and had higher levels of low-density lipoprotein

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“…have been reported previously 13 . Blood samples, clinical assessments, blood pressure measurements, and ECGs were obtained the day before (baseline) and at 3 and 24 h following the race.…”

Section: Screening and Patient Inclusion Are Presented In Figure 1 Imentioning

confidence: 84%

“…The current study used CCTA to identify obstructive CAD in a subset of 120 subjects participating in the NEEDED 2014 main study ( N = 1002). 13 All study participants were asymptomatic, recreational cyclists participating in the 91-km North Sea mountain bike race. Screening and patient inclusion are presented in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

“…However, only 13 subjects were assessed by coronary computed tomography angiography (CCTA) in that study. The present study explores the potential diagnostic role of cTn assessment following strenuous exercise in a larger subset of presumably healthy individuals included in the North Sea Race Endurance Exercise Study 2014 13 . The main aim of the present study was to compare the exercise-induced cTn profiles in presumably healthy recreational cyclists with and without coronary artery obstruction identified by CCTA.…”

Section: Introductionmentioning

confidence: 99%

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Occult obstructive coronary artery disease is associated with prolonged cardiac troponin elevation following strenuous exercise

Kleiven

Omland

Skadberg

et al. 2019

Eur J Prev Cardiolog

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Background Sudden cardiac death among middle-aged recreational athletes is predominantly due to myocardial ischaemia. This study examined whether measuring cardiac troponin I and T (cTnI and cTnT) after strenuous exercise could identify occult obstructive coronary artery disease. Design Prospective observational study. Methods Subjects were recruited from 1002 asymptomatic recreational cyclists completing a 91-km mountain bike race (North Sea Race Endurance Exercise Study). No subject had known cardiovascular disease or took cardiovascular medication. Blood samples were collected within 24 h before and 3 h and 24 h after the race. Coronary computed tomography angiography was performed in 80 participants with the highest post-exercise cTnI and in 40 reference subjects with moderately elevated cTnI values. Results Study subjects ( N = 120) were 45 (36–52) years old and 74% were male. There were similar demographics in the High-cTnI group and the Reference group. The cTn concentrations were highest at 3 h post-race: cTnI, 224 (125–304) ng/L; cTnT, 89 (55–124) ng/L. Nine subjects had obstructive coronary artery disease on coronary computed tomography angiography, eight of whom were High-cTnI responders. Two subjects had myocardial bridging, both High-cTnI responders. Troponin concentrations at 24 h post-race were higher in subjects with obstructive coronary artery disease than in the rest of the cohort ( n = 109): cTnI, 151 (72–233) ng/L vs. 24 (19–82) ng/L, p = 0.005; cTnT, 39 (25–55) ng/L vs. 20 (14–31) ng/L, p = 0.002. The areas under the receiver operating characteristic curves for predicting obstructive coronary artery disease were 0.79, p = 0.005 (cTnI) and 0.82, p = 0.002 (cTnT). Conclusion In subjects with occult obstructive coronary artery disease there was a prolonged elevation of cTn following strenuous exercise.

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Race duration and blood pressure are major predictors of exercise-induced cardiac troponin elevation

Abstract: This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Cited by 38 publications

References 29 publications

Effect of mountain ultramarathon distance competition on biochemical variables, respiratory and lower-limb fatigue

Effect of mountain ultramarathon distance competition on biochemical variables, respiratory and lower-limb fatigue

Endurance exercise training volume is not associated with progression of coronary artery calcification

Occult obstructive coronary artery disease is associated with prolonged cardiac troponin elevation following strenuous exercise

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