The impact of an ultra-trail on the dynamic of cardiac, inflammatory, renal and oxidative stress biological markers correlated with electrocardiogram and echocardiogram

Goff, Caroline Le; Kaux, J F; Seidel, Laurence; Pincemaïl, Joël; Cavalier, Étienne; Mélon, Pierre

doi:10.1080/00015385.2020.1778871

Cited by 6 publications

(7 citation statements)

References 44 publications

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“…In this study, 16 runners met the criteria at the first race; the subsequent race caused less increase in SCR concentration and decrement in estimated glomerular filtration rate than the first race. This pattern confirms that usually, runners recover from the increase in SCR after some days [11,13,39,40] A comparison between multi-stage races and single-stage races shows that multistage races may help runners to recover from the efforts [15,39] reducing the number of episodes diagnosed in these kinds of ultra-trail races; this result may be due to the slower pace that runners use to cover higher distances [40] One of the reasons behind EAH development in long-distance runners is a poorly planned hydration strategy [41]. Not only does this directly affects EAH, but it has also been described in cases of kidney damage and even ER, due to myoglobin released into the bloodstream following sarcolemma rupture [42,43].…”

Section: Discussionsupporting

confidence: 84%

“…AKI includes structural damage such as a decreased kidney function [10], which could be associated with a significant increase in morbidity and mortality both in the short term and the long [9]. The incidence of AKI episodes found in ultra-trail races is very heterogeneous, varying between 0% [11][12][13][14] and 76% [15]. This wide range of results is due to the different criteria and biomarkers developed to diagnose this illness.…”

Section: Introductionmentioning

confidence: 99%

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Extreme Ultra-Trail Race Induces Muscular Damage, Risk for Acute Kidney Injury and Hyponatremia: A Case Report

Lecina

López

Otín

et al. 2021

IJERPH

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A case study involving a healthy trained male athlete who completed a 786 km multi-stage ultra-trail race. Several markers were analyzed in blood and urine samples: creatinine (SCR) for kidney damage, sodium ([Na+]) for hyponatremia, creatine kinase (CK) for exertional rhabdomyolysis, as well as other hematological values. Samples were taken before and after the race and during the recovery period (days 2 and 9 after the race). Results showed: SCR = 1.13 mg/dl, [Na+] =139 mmol/l and CK = 1.099 UI/l. Criteria for the determination of acute kidney damage were not met, and [Na+] concentration was above 135 mEq/L, indicating the absence of hyponatremia. Exertional rhabdomyolysis was suffered by the athlete (baseline CK increased fivefold), though this situation was reverted after 9 days of recovery. Ultra-trail races cause biochemical changes in athletes, which should be known about by healthcare professionals.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Extreme Ultra-Trail Race Induces Muscular Damage, Risk for Acute Kidney Injury and Hyponatremia: A Case Report

Lecina

López

Otín

et al. 2021

IJERPH

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“…These selected articles were fully reviewed and evaluated to verify whether they met the inclusion criteria. A total of 28 articles were accepted for final review, 13 of which focused on AKI ( Table 1 ) [ 28 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ] and the remaining 15 on EAH ( Table 2 ) [ 24 , 27 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ]. Nine of the studies reported combined results of AKI and EAH [ 24 , 27 , 28 , 44 , 45 , 49 , 51 , 52 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

“…AKI cases were classified according to severity using the AKIN, KDIGO or RIFLE criteria [ 31 , 33 ]. AKI cases were distributed as follows: 392 subjects met the risk-stage criteria (35.22%) [ 16 , 44 , 45 , 46 , 47 , 49 , 50 , 52 , 54 ], 75 subjects suffered AKI in the injury stage (6.73%) [ 24 , 28 , 42 , 46 , 48 , 53 ] and only one subject met the criteria for failure (0.01%), but he did not require renal replacement therapy. This case occurred in a 95-mile ultra-trail [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

Acute Kidney Injury and Hyponatremia in Ultra-Trail Racing: A Systematic Review

et al. 2022

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Background and objectives: Ultra-trail races can cause episodes of acute kidney injury (AKI) and exercise-associated hyponatremia (EAH) in healthy subjects without previous renal pathology. This systematic review aims to review the incidence of these two syndromes together and separately taking into account the length and elevation of the ultra-trail race examined. Materials and Methods: A systematic review was conducted through electronic search in four electronic databases (PubMed, EBSCO, Web of Science and Alcorze). Results: A total of 1127 articles published between January 2006 and December 31, 2021 were included, 28 of which met the inclusion criteria. The studies were categorized according to the length and stages of the race in four categories: medium (42 to 69 km), long (70 to 99 km), extra (>100 km) and multi-stage if they included various stages. A total of 2950 runners (666 females and 2284 males) were extracted from 28 publications. The AKI incidence found was 42.04% (468 cases of 1113), and 195 of 2065 were diagnosed with EAH, accounting for 9.11%. The concurrence of both pathologies together reached 11.84% (27 individuals) from a total of 228 runners with AKI and EAH simultaneously analyzed. Sorted by race category, the AKI+EAH cases were distributed as follows: 18 of 27 in the extra (13.63% and n = 132), 4 in the large (5.79% and n = 69) and 5 in the medium category (18.15% and n = 27). Conclusions: According to these results, extra and medium races showed a similar incidence of AKI+EAH. These findings underline the importance of the duration and intensity of the race and may make them responsible for the etiology of these medical conditions. Due to their variable incidence, EAH and AKI are often underdiagnosed, leading to poorer prognosis, increased condition seriousness and hindered treatment. The results of this review urge participants, coaches and race organizers to take measures to improve the early diagnosis and urgent treatment of possible EAH and AKI cases.

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“…Sometimes it is diagnosed on a variable reference value of CK (1000 to 10,000 U·L −1 ) [ 16 , 17 ], while other authors agree that CK elevation 5 times the upper limit of normal is the defining biochemical abnormality for this condition [ 16 , 18 , 19 , 20 ]. Due to this variety in the diagnostic criteria of ER from CK [ 18 , 19 ], other markers such as lactate dehydrogenase (LDH) [ 21 ], aspartate transaminase (AST) and alanine aminotransferase (ALT) [ 14 , 22 ] are analyzed to assess its severity. These markers present a linear relation with both CK and MB increasing when comparing basal with post-race values [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

768-km Multi-Stage Ultra-Trail Case Study-Muscle Damage, Biochemical Alterations and Strength Loss on Lower Limbs

Lecina

Otín

Fuente

et al. 2022

IJERPH

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A series of case studies aimed to evaluate muscular fatigue in running a 768-km ultra-trail race in 11 days. Four non-professional athletes (four males) were enrolled. Muscle damage blood biomarkers (creatine kinase (CK), lactodeshydrogenase (LDH), aspartate transaminase (AST) and alanine aminotransferase (ALT) and lower limb strength were evaluated by using Bosco jumps test; squat jump (SJ), countermovement jump (CMJ) and Abalakov jump (ABA) were assessed before (pre), after the race (post) and for two and nine days during the recovery period (rec2 and rec9), respectively. Results showed: pre-post SJ = −28%, CMJ = −36% and ABA = −21%. Values returned to basal during rec9: SJ = −1%, CMJ = −2% or even exceeded pre-values ABA = +3%. On the contrary, muscle damage blood biomarkers values increased at post; CK = +888%, LDH = +172%, AST = +167% and ALT = +159% and the values returned gradually to baseline at rec9 except for AST = +226% and ALT = +103% which remained higher. Nonparametric bivariate Spearman’s test showed strong correlations (Rs ≥ 0.8) between some jumps and muscle damage biomarkers at post (SJ-LDH Rs = 0.80, SJ-AST Rs = 0.8, ABA-LD H Rs = 0.80 and ABA-AST Rs = 0.80), at rec2 (SJ-CK Rs = 0.80 and SJ-ALT Rs = 0.80) and even during rec9 (ABA-CK). Similarly, some parameters such as accumulated elevation and training volume showed a strong correlation with LDH values after finishing the ultra-trail race. The alteration induced by completing an ultra-trail event in the muscle affects lower limb strength and may in some circumstances result in serious medical conditions including post- exertional rhabdomyolysis.

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The impact of an ultra-trail on the dynamic of cardiac, inflammatory, renal and oxidative stress biological markers correlated with electrocardiogram and echocardiogram

Cited by 6 publications

References 44 publications

Extreme Ultra-Trail Race Induces Muscular Damage, Risk for Acute Kidney Injury and Hyponatremia: A Case Report

Extreme Ultra-Trail Race Induces Muscular Damage, Risk for Acute Kidney Injury and Hyponatremia: A Case Report

Acute Kidney Injury and Hyponatremia in Ultra-Trail Racing: A Systematic Review

768-km Multi-Stage Ultra-Trail Case Study-Muscle Damage, Biochemical Alterations and Strength Loss on Lower Limbs

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