Effects of Marathon Running on Cardiac Markers and Endothelin-1 in EIH Athletes

Kim, Y. J.; Shin, Young Oh; Lee, Y. H.; Jee, Haemi; Shin, Kyung-A; Goh, Choong-Won; Kim, C. H.; Min, Young‐Ki; Yang, Hye-Won; Lee, J. B.

doi:10.1055/s-0032-1331257

Cited by 22 publications

(16 citation statements)

References 43 publications

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“…However, cTnI and NT-proBNP were recently reported to be increased in runners with exercise-induced hypertension in marathons and ultramarathons. 16,17 These data, in combination with the results shown in the present study, support the following hypothesis: middle-aged marathon runners with potential ischemic cardiovascular disease and excessive increases in BP may undergo increased myocardial ischemia caused by increased oxygen demand of the myocardia, which, in turn, induces cardiac events such as arrhythmia. In this study, 13 (32.5%) of 40 runners exhibited exercise-induced hypertension.…”

Section: Discussionsupporting

confidence: 88%

“…The induction of cardiac troponin after excessive exercise has been reported to be primarily affected by exercise intensity, whereas the induction of N-terminal pro-B-type natriuretic peptide (NT-proBNP) is related to exercise duration. 14,15 According to recent reports, cardiac troponin I (cTnI), NT-proBNP, and endothelin-1 (ET-1) are induced to higher levels in marathon runners with exercise-induced high BP, 16 whereas NT-proBNP, creatine kinase (CK), and high-sensitivity Creactive protein (hs-CRP) are induced to higher levels in 100-km ultramarathon runners with exercise-induced high BP. 17 Previous studies were conducted with only a small number of cases and lack of variability of exerciseinduced hypertension.…”

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confidence: 99%

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Correlation of Cardiac Markers and Biomarkers With Blood Pressure of Middle‐Aged Marathon Runners

Kim

Ahn

Shin

et al. 2015

J of Clinical Hypertension

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Runners with exercise-induced high blood pressure have recently been reported to exhibit higher levels of cardiac markers, vasoconstrictors, and inflammation. The authors attempted to identify correlations between exercise-related personal characteristics and the levels of biochemical/cardiac markers in marathon runners in this study. Forty healthy runners were enrolled. Blood samples were taken both before and after finishing a full marathon. The change in each cardiac/biochemical marker over the course of the marathon was determined. All markers were significantly (P<.001) increased immediately after the marathon (creatine kinase-MB [CK-MB]: 7.9 ± 2.7 ng/mL, cardiac troponin I (cTnI): 0.06 ± 0.10 ng/mL, N-terminal pro-B-type natriuretic peptide (NT-proBNP): 95.7 ± 76.4, endothelin-1: 2.7 ± 1.16, high-sensitivity C-reactive protein [hs-CRP]: 0.1 ± 0.09, creatine kinase [CK]: 315.7 ± 94.0, lactate dehydrogenase [LDH]: 552.8 ± 130.3) compared with their premarathon values (CK-MB: 4.3 ± 1.3, cTnI: 0.01 ± 0.003, NT-proBNP: 27.6 ± 31.1, endothelin-1: 1.11 ± 0.5, hs-CRP: 0.06 ± 0.07, CK: 149.2 ± 66.0, LDH: 399 ± 75.1). In middle-aged marathon runners, factors related to increased blood pressure were correlated with marathon-induced increases in cTnI, NT-proBNP, endothelin-1, and hs-CRP. These correlations were observed independent of running history, records of finishing, and peak oxygen uptake.

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Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 99%

Correlation of Cardiac Markers and Biomarkers With Blood Pressure of Middle‐Aged Marathon Runners

Kim

Ahn

Shin

et al. 2015

J of Clinical Hypertension

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“…3 ). Levels of cTnI can be increased by extreme exercise such as a marathon or a 100-km ultramarathon [ 1 , 12 , 24 , 25 ]. They can even exceed the URL.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, it has been reported that expression levels of cardiac markers in exercise-induced hypertension (EIH) runners are higher than those in ultramarathon runners with normal response [ 11 ]. EIH runners have been reported to have higher myocardial load and increased skeletal muscle damage during marathon [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Long-Distance Running on Cardiac Markers and Biomarkers in Exercise-Induced Hypertension Runners: An Observational Study

et al. 2018

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ObjectiveTo investigate changes of cardiac and muscle damage markers in exercise-induced hypertension (EIH) runners before running (pre-race), immediately after completing a 100-km ultramarathon race, and during the recovery period (24, 72, and 120 hours post-race).MethodsIn this observational study, volunteers were divided into EIH group (n=11) whose maximum systolic blood pressure was ≥210 mmHg in graded exercise testing and normal exercise blood pressure response (NEBPR) group (n=11). Their blood samples were collected at pre-race, immediately after race, and at 24, 72, and 120 hours post-race.ResultsCreatine kinase (CK) and cardiac troponin I (cTnI) levels were significantly higher in EIH group than those in the NEBPR group immediately after race and at 24 hours post-race (all p<0.05). However, lactate dehydrogenase (LDH), creatine kinase-myocardial band (CKMB), or CKMB/CK levels did not show any significant differences between the two groups in each period. N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were significantly higher in EIH group than those in NEBPR group immediately after race and at 24 and 72 hours post-race (all p<0.05). A high sensitivity C-reactive protein (hs-CRP) level was significantly higher in EIH group than that in NEBPR group at 24 hours post-race (p<0.05).ConclusionThe phenomenon of higher inflammatory and cardiac marker levels in EIH group may exaggerate cardiac volume pressure and blood flow restrictions which in turn can result in cardiac muscle damage. Further prospective studies are needed to investigate the chronic effect of such phenomenon on the cardiovascular system in EIH runners.

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“…Recent reports show that the incidence of exercise-induced hypertension (EIH) is high [ 7 ] among long-distance runners and that runners with EIH show a greater elevation of cardiac troponin I, a marker for myocardial injury, and N-terminal fragment of the prohormone brain-type natriuretic peptide, a marker for myocardial volume-pressure, than normal runners during a marathon or ultramarathon, [ 8 , 9 ] raising concerns for the risk of cardiac events during exercise. EIH is defined as a normal resting blood pressure (BP) of <140/80 mm Hg with a maximum systolic BP (SBP) ≥210 mm Hg.…”

Section: Introductionmentioning

confidence: 99%

Exercise-induced hypertension is associated with angiotensin II activity and total nitric oxide

et al. 2020

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Angiotensin II mediates exercise-induced hypertension (EIH), which adversely impacts future cardiovascular health. There is paucity of data on the association between EIH and angiotensin II in well-trained middle-aged marathoners. Therefore, we investigated the renin-angiotensin-aldosterone-system and total nitric oxide activity in middle-aged marathoners with EIH. Seventy middle-aged marathoners were divided into 3 groups: normal blood pressure ([NBPG] [n = 21]), EIH group ([EIHG] [n = 35]), and complex hypertension group ([CHG] [n = 14]). We defined NBPG as resting systolic BP/diastolic BP (SBP/DBP) of ≤140/90 mm Hg and maximal exercise SBP of ≤210 mm Hg, EIHG as resting SBP/DBP ≤140/90 mm Hg and maximal exercise SBP of ≥210 mm Hg, and CHG as resting SBP/DBP ≥140/90 mm Hg and maximal exercise SBP of ≥210 mm Hg. Renin-angiotensin-aldosterone-system and NO levels were measured before and 30 minutes after the graded exercise test. Renin level was elevated while angiotensin level was reduced after 30 minutes of graded exercise test. There was no change in angiotensin I and angiotensin converting enzyme levels. Comparing the groups, renin level was only elevated in the CHG during recovery, while aldosterone level was higher than the baseline level in the recovery phase in all groups. Angiotensin I level remained unchanged in all groups. Angiotensin II level reduced significantly in the NBPG group but remained at the baseline in the EIHG and CHG groups. NO level was unchanged in the NBPG group but reduced in the EIHG and CHG groups after exercise. At 3 minutes of recovery, SBP was the highest in the NBPG group, followed by the EIHG and CHG groups ( P < .05). In conclusion, angiotensin II activity and reduced NO level are associated with EIH in middle-aged long-distance runners. Angiotensin II inhibitors may; therefore, be the more appropriate antihypertensive medication for runners with EIH.

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Effects of Marathon Running on Cardiac Markers and Endothelin-1 in EIH Athletes

Cited by 22 publications

References 43 publications

Correlation of Cardiac Markers and Biomarkers With Blood Pressure of Middle‐Aged Marathon Runners

Correlation of Cardiac Markers and Biomarkers With Blood Pressure of Middle‐Aged Marathon Runners

Effects of Long-Distance Running on Cardiac Markers and Biomarkers in Exercise-Induced Hypertension Runners: An Observational Study

Exercise-induced hypertension is associated with angiotensin II activity and total nitric oxide

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