Influence of maturational status in the exercise-induced release of cardiac troponin T in healthy young swimmers

Cirer-Sastre, Rafel; Legaz-Arrese, Alejandro; Corbi, Francisco; López-Laval, Isaac; George, Keith; Reverter-Masià, Joaquín

doi:10.1016/j.jsams.2020.06.019

Cited by 12 publications

(21 citation statements)

References 36 publications

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“…This is contrary to our expectations, since previous authors suggested that the less mature myocardium in the younger might be more susceptible to exercise-induced elevations of cTn [8,9]. Interestingly though, a recent study reported higher exercise-induced elevations of cTnT in late puberty, suggesting that this might be explained by the higher relative intensities during exercise achieved in this group [13]. In line with this study, our adolescents group also achieved higher cardiac intensities during the test.…”

Section: Discussioncontrasting

confidence: 88%

“…Almost one-half of the participants in this study (44%) exceeded the upper reference limit for cTnT in the third blood extraction. Previous studies involving similar assessments and exercise exposures also found high rates of positive detection in both young and adult trained participants [4,[6][7][8]13]. This is particularly relevant for the triage of athletes who develop chest pain that mimics cardiac injury after exercise, and who might have serum cTn drawn in the EDs.…”

Section: Discussionmentioning

confidence: 68%

“…The main limitations in this study, by contrast, have been mentioned in the above paragraphs. We could not perform an exhaustive cardiac screening including echocardiography, additional biochemical analyses, or assessments of maturational status, as has been done or mentioned in some previous studies [6,12,13]. Additionally, we did not perform cTnT measurements beyond the 3 h post exercise.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Exercise-Induced Release of Cardiac Troponins in Adolescent vs. Adult Swimmers

Cirer-Sastre

Corbi

López-Laval

et al. 2021

IJERPH

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To examine the exercise-induced release of cardiac troponin T (cTnT) in adolescent and adult swimmers. Thirty-two trained male (18 adolescents, 14 adults) swam at maximal pace in a 45 min distance trial, and blood samples were drawn before, immediately and 3 h after exercise for subsequent cTnT analysis and comparison. Having comparable training experience and baseline values of cTnT (p = 0.78 and p = 0.13), adults exercised at lower absolute and relative intensity (p < 0.001 and p < 0.001, respectively), but presented higher immediate cTnT after exercise than adolescents (p < 0.001). Despite that, peak concentrations were observed at 3 h post exercise and peak elevations were comparable between groups (p = 0.074). Fourteen (44%) apparently healthy subjects exceeded the cutoff value for myocardial infarction (MI). Adolescents presented a delayed elevation of cTnT compared with adults, but achieved similar peak values.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Exercise-Induced Release of Cardiac Troponins in Adolescent vs. Adult Swimmers

Cirer-Sastre

Corbi

López-Laval

et al. 2021

IJERPH

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“…Although no prior study has investigated the effect of puberty on Troponin levels, studies by Cirer-Sastre et al and Legaz-Arrese et al have assessed the effect of exercise-induced release of cardiac markers at different stages of puberty [ 34 , 35 ]. We could demonstrate that hsTnT levels in boys rise from pubertal stage 2 onward and that in all pubertal stages, girls have consistently lower levels than boys, with an increasing effect during puberty.…”

Section: Discussionmentioning

confidence: 99%

Age-Dependent Reference Values for hs-Troponin T and NT-proBNP and Determining Factors in a Cohort of Healthy Children (The LIFE Child Study)

et al. 2022

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This study aimed to provide reliable pediatric reference values for N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitive Troponin T (hsTnT) obtained from a population of well children and investigate for associations with sex, pubertal status, body mass index (BMI), and serum lipid levels. We analyzed hsTnT and NT-proBNP values obtained from 4826 samples provided by 2522 children aged 0.25–18 years participating in a prospective longitudinal population-based cohort study, “LIFE child” in Leipzig, Germany (Poulain et al., Eur J Epidemiol 32:145–158, 2017). NT-proBNP values decreased throughout childhood from values over 400 ng/L at 3 months to 138 ng/L in females and 65 ng/L in males by 18 years of age. Values dropped rapidly with advancing pubertal stage. We found a strong association between lower NT-proBNP values and higher BMI or elevated serum lipids, the latter effect being more pronounced in males. For hsTnT levels, approximately half of the measurements were below the detection limit. However, 76% of those aged 3 months and 21% of those aged 6 months had values exceeding the adult cut-off limit. Females had slightly higher levels in the first 2 years of life but this was reversed during puberty. In males, there was an upward trend from pubertal stage 2 onward. We identified a positive association between hsTnT and BMI but a negative association with low-density lipoprotein (LDL) cholesterol and triglyceride levels in boys but not in girls. Based on a large number of healthy children, we have established reliable reference values for NT-proBNP and hsTnT for use in everyday clinical practice. We have also identified important associations between certain metabolic and cardiac markers.Clinical Trial Registration ClinicalTrial.gov (NCT02550236).

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“…In order to understand the underlying mechanisms and related clinical implications, several studies have identified potential moderators of exercise-induced cTn elevation. Overall, hs-cTn concentrations was impacted: by exercise duration (Kleiven et al, 2019), intensity (Richardson et al, 2018;Martínez-Navarro et al, 2020) and workload (Cirer-Sastre et al, 2019); maturational status (Martínez-Navarro et al, 2020;Cirer-Sastre et al, 2021); training experience (Tian et al, 2012); gender (Kong et al, 2017;Legaz-Arrese et al, 2017); basal level of cTn (Legaz-Arrese et al, 2015a,c); as well as environment (Li et al, 2016). The possibility of interaction of the moderators needs further investigation.…”

Section: Introductionmentioning

confidence: 99%

Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis

Hopkins

Wang

et al. 2021

Front. Physiol.

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Background: Kinetics, moderators and reference limits for exercise-induced cardiac troponin T (cTnT) elevations are still unclear.Methods: A systematic review of published literature was conducted adhering to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies reporting high-sensitivity cardiac troponin T (hs-cTnT) concentrations before and after a bout of exercise in athletes were included and analyzed. The final dataset consisted of 62 estimates from 16 bouts in 13 studies of 5–1,002 athletes (1,421 in total). Meta-analysis was performed using general linear mixed modeling and Bayesian inferences about effect magnitudes. Modifying fixed-effect moderators of gender, age, baseline level, exercise duration, intensity and modalities were investigated. Simulation was used to derive 99th percentile with 95% limits of upper reference ranges for hs-cTnT of athletic populations.Results: The mean and upper reference limits of hs-cTnT before exercise were 4.4 and 19 ng.L−1. Clear increases in hs-cTnT ranging from large to very large (factor changes of 2.1–7.5, 90% compatibility limits, ×/÷1.3) were evident from 0.7 through 25 h, peaking at 2.9 h after the midpoint of a 2.5-h bout of running, when the mean and upper reference limit for hs-cTnT were 33 and 390 ng L−1. A four-fold increase in exercise duration produced a large clear increase (2.4, ×/÷1.7) in post-exercise hs-cTnT. Rowing exercise demonstrated an extremely large clear reduction (0.1 ×/÷2.4).Conclusions: The kinetics of cTnT elevation following exercise, the positive effect of exercise duration, the impact of exercise modality and 99th upper reference limits for athletic populations were reasonably well defined by this meta-analysis.

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Influence of maturational status in the exercise-induced release of cardiac troponin T in healthy young swimmers

Abstract: Influence of maturational status in the exercise-induced release of cardiac troponin T in healthy young swimmers.

Cited by 12 publications

References 36 publications

Exercise-Induced Release of Cardiac Troponins in Adolescent vs. Adult Swimmers

Exercise-Induced Release of Cardiac Troponins in Adolescent vs. Adult Swimmers

Age-Dependent Reference Values for hs-Troponin T and NT-proBNP and Determining Factors in a Cohort of Healthy Children (The LIFE Child Study)

Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis

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