Magnitude, Reproducibility, and Association With Baseline Cardiac Function of Cardiac Biomarker Release in Long-Distance Runners Aged ≥55 Years

Sahlén, Anders; Winter, Reidar; Lind, Britta; Jacobsen, Per; Ståhlberg, Marcus; Marklund, Tony; Fux, Thomas; Svensson, Jan; Braunschweig, Frieder

doi:10.1016/j.amjcard.2008.03.042

Cited by 23 publications

(34 citation statements)

References 19 publications

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“…Our athletes completed the marathon in less time (average 202 min) than those in the above-mentioned studies (range average 209-256 min). This study demonstrated, as have others (Sahlén et al 2008;Serrano-Ostáriz et al 2011), that athletes' postexercise NT-proBNP is strongly associated with their respective baseline levels. Baseline values for NT-proBNP for our athletes (average 15 ng L -1 ) were clearly less than those found in some previous studies (Herrmann et al 2003;Neilan et al 2006;Scharhag et al 2005;Trivax et al 2010;Wilson et al 2010) in marathon runners (range average 37-63 ng L -1 ) which could also explain the lower exercise response in the current study.…”

Section: Discussionsupporting

confidence: 85%

“…Baseline values for NT-proBNP for our athletes (average 15 ng L -1 ) were clearly less than those found in some previous studies (Herrmann et al 2003;Neilan et al 2006;Scharhag et al 2005;Trivax et al 2010;Wilson et al 2010) in marathon runners (range average 37-63 ng L -1 ) which could also explain the lower exercise response in the current study. Given that the resting NT-proBNP data demonstrated high reproducibility even after a 3-year period (Sahlén et al 2008), these results suggest a more complex interaction of baseline, prior exercise and exercise-related factors that mediate cardiac biomarker responses to prolonged exercise. In the general population, the baseline NT-proBNP value is influenced by age, sex, obesity, malnutrition, volume overload, pulse rate, blood pressure, and prior heart failure (Chen et al 2008).…”

Section: Discussionmentioning

confidence: 81%

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The impact of exercise intensity on the release of cardiac biomarkers in marathon runners

et al. 2011

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We sought to determine the influence of exercise intensity on the release of cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in amateur marathon runners. Fourteen runners completed three exercise trials of the same duration but at exercise intensities corresponding to: (a) a competitive marathon [mean ± SD: heart rate 159 ± 7 beat min(-1), finish time 202 ± 14 min]; (b) 95% of individual anaerobic threshold [heart rate 144 ± 6 beat min(-1)] and; (c) 85% of individual anaerobic threshold [heart rate 129 ± 5 beat min(-1)]. cTnI and NT-proBNP were assayed from blood samples collected before, 30 min and 3 h post-exercise for each trial. cTnI and NT-proBNP were not different at baseline before each trial. After exercise at 85% of individual anaerobic threshold cTnI was not significantly elevated. Conversely, cTnI was elevated after exercise at 95% of individual anaerobic threshold (0.016 μg L(-1)) and to an even greater extent after exercise at competition intensity (0.054 μg L(-1)). Peak post-exercise values of NT-proBNP were elevated to a similar extent after all exercise trials (P < 0.05). The upper reference limit for cTnI (0.04 μg L(-1)) was exceeded in six subjects at competition intensity. No data for NT-proBNP surpassed its upper reference limit. Peak post-exercise values for cTnI and NT-proBNP were correlated with their respective baseline values. These data suggest exercise intensity influences the release of cTnI, but not NT-proBNP, and that competitive marathon running intensity is required for cTnI to be elevated over its upper reference limit.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 81%

The impact of exercise intensity on the release of cardiac biomarkers in marathon runners

et al. 2011

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“…The study-to-study differences are most likely due to methodological issues such as assay precision and environmental and exercise control as well as more frequent sampling. The high reproducibility in peak postexercise values of NT-proBNP also confirms previous work (23,26). Ongoing work should determine the causes of the high-between subject variability in quantitative cTn and NT-proBNP release.…”

Section: Discussionsupporting

confidence: 82%

“…Individual variability in the response to exercise of NTproBNP was strongly related to the variability in preexercise values (11,12,23,31). Despite this, the present study observed a high degree of within-subject consistency in peak postexercise hs-cTnT release in both groups over their two trials, suggesting that hs-cTnT release is quite a robust phenomenon within any participant and that persists even after a training intervention that may alter the actual peak value of hs-cTnT.…”

Section: Discussioncontrasting

confidence: 59%

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

Legaz-Arrese

López-Laval

George

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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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.

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Altered ventriculo-arterial coupling during exercise in athletes releasing biomarkers after endurance running

et al. 2012

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Exercise can lead to release of biomarkers such as cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP), a poorly understood phenomenon proposed to especially occur with high-intensity exercise in less trained subjects. We hypothesised that haemodynamic perturbations during exercise are larger in athletes with cTnT release, and studied athletes with detectable cTnT levels after an endurance event (HIGH; n = 16; 46 ± 9 years) against matched controls whose levels were undetectable (LOW; n = 11; 44 ± 7 years). Echocardiography was performed at rest and at peak supine bicycle exercise stress. Left ventricular (LV) end-systolic elastance (E (LV) a load-independent measure of LV contractility), effective arterial elastance (E (A) a lumped index of arterial load) and end-systolic meridional wall stress were calculated from cardiac dimensions and brachial blood pressure. Efficiency of cardiac work was judged from the ventriculo-arterial coupling ratio (E (A)/E (LV): optimal range 0.5-1.0). While subgroups had similar values at rest, we found ventriculo-arterial mismatch during exercise in HIGH subjects [0.47 (0.39-0.58) vs. LOW: 0.73 (0.62-0.83); p < 0.01] due to unopposed increase in E (LV) (p < 0.05). In LOW subjects, a greater increase occurred in E (A) during exercise (+81 ± 67 % vs. HIGH: +39 ± 32 %; p = 0.02) which contributed to a maintained coupling ratio. Subjects with higher baseline NT-proBNP had greater systolic wall stress during exercise (R (2) = 0.39; p < 0.01) despite no correlation at rest (p = ns). In conclusion, athletes with exercise-induced biomarker release exhibit ventriculo-arterial mismatch during exercise, suggesting non-optimal cardiac work may contribute to this phenomenon.

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Magnitude, Reproducibility, and Association With Baseline Cardiac Function of Cardiac Biomarker Release in Long-Distance Runners Aged ≥55 Years

Cited by 23 publications

References 19 publications

The impact of exercise intensity on the release of cardiac biomarkers in marathon runners

The impact of exercise intensity on the release of cardiac biomarkers in marathon runners

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

Altered ventriculo-arterial coupling during exercise in athletes releasing biomarkers after endurance running

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