Impact of an endurance training program on exercise-induced cardiac biomarker release

Abstract

We evaluated the influence of a 14-wk endurance running program on the exercise-induced release of high-sensitivity cardiac troponin T (hs-cTnT) and NH2-terminal pro-brain natriuretic peptide (NT-proBNP). Fifty-eight untrained participants were randomized to supervised endurance exercise (14 wk, 3-4 days/wk, 120-240 min/wk, 65-85% of maximum heart rate) or a control group. At baseline and after the training program, hs-cTnT and NT-proBNP were assessed before and 5 min, 1 h, 3 h, 6 h, 12 h, and 24 h after a 60-min maximal running test. Before training, hs-cTnT was significantly elevated in both groups with acute exercise (P < 0.0001) with no between-group differences. There was considerable heterogeneity in peak hs-cTnT concentration with the upper reference limit exceeded in 71% of the exercise tests. After training, both baseline and postexercise hs-cTnT were significantly higher compared with pretraining and the response of the control group (P = 0.008). Acute exercise led to a small but significant increase in NT-proBNP, but this was not mediated by training (P = 0.121). In summary, a controlled endurance training intervention resulted in higher pre- and postexercise values of hs-cTnT with no changes in NT-proBNP.

Individual variability of high-sensitivity cardiac troponin levels after aerobic exercise is not mediated by exercise mode

“…Furthermore, the increases in hscTnT in response to swimming, running, and cycling tests were moderately-highly correlated (r = 0.495-0.802). The magnitudes of these associations were similar to those recently observed after two identical bouts of prolonged exercise (Legaz-Arrese et al, 2015;Tian et al, 2014). This would suggest that the small differences in exercise HR, pacing, etc.…”

“…At odds with most field work but confirming three recent controlled studies (Legaz-Arrese et al, 2015;Middleton et al, 2008;Tian et al, 2012), the present data suggest that cTn was elevated in all subjects after exercise. It is important to consider that the magnitude of cTn response across past work has been highly variable (Eijsvogels et al, 2015;Serrano-Ostáriz et al, 2009;Tian et al, 2012).…”

“…One element of the work by Shave et al (2007;2010b) and others (Legaz-Arrese et al, 2015;Tian et al, 2012) is that the individual cTn response to exercise is quite disparate. The percentage of participants whose post-exercise cTn exceeds the upper reference limit (URL) varies significantly between studies (Middleton et al, 2008;Shave et al, 2007).…”

“…The "kinetics" of cTn appearance and clearance after exercise has been limited to a small number of recent studies Legaz-Arrese et al, 2015;Middleton et al, 2008;Tian et al, 2012). Of these studies only Legaz-Arrese et al (2015) and Tian et al (2012) assessed hs-cTnT over a 24 h period post-exercise.…”

“…Of these studies only Legaz-Arrese et al (2015) and Tian et al (2012) assessed hs-cTnT over a 24 h period post-exercise. Whilst this data demonstrated a consistent time to peak hs-cTnT after 60-90 min, there was evidence of heterogeneity in peak responses with the URL exceeded in 71-88% of participants.…”