Sex differences in release of cardiac troponin T after endurance exercise

Abstract

Post-exercise cardiac troponin release has been extensively described in athletic groups but little attention has been given to any role of sex in mediating this phenomenon. OBJECTIVE: We compared the release of cardiac troponin T (cTnT) after endurance running in training-experience, biological-age and maturity-matched young male and female runners. MATERIALS AND METHODS: Nineteen male (training history: 2.3±1.0 yr; mean age: 16.1±1.2 yr; Tanner stage: 3.7±0.6) and 19 female (training history: 2.2±1.0 yr; mean age: 15.9±1.4 yr; Tanner stage: 4.0±0.4) runners performed a 21 km run with "all-out" effort. Serum cTnT levels were assessed at pre-exercise (Pre-ex) and at 4 h post-exercise (Post-ex). RESULTS: At Pre-ex, cTnT concentrations were below the 99th percentile value (10 ng.l-1) in 32/38 runners. Postex cTnT increased in all subjects but the response was substantially higher (P<0.05) in males [median (range): 210 (20-1360) ng.l-1 ] than females [median (range): 80 (10-550) ng.l-1 ]. At Post-ex, 95% (95% confidence interval: 75-99%) of males and 63% (95% confidence interval: 41-81%) of females (P<0.05) had cTnT concentrations above the cutoff for acute myocardial infarction. CONCLUSIONS: The present data suggest that post-exercise cTnT elevation occurs in all runners but is augmented in young male compared to female athletes.

Cardiac Biomarker Release after Endurance Exercise in Male and Female Adults and Adolescents

“…Using the hs-cTnT assay, higher baseline values in male than in female subjects have been previously reported in adults 30 and adolescents. 31 Others researchers have speculated a role for sex hormones to explain the sex differences in resting hs-cTnT concentration 15,31 where as we have speculated a role for sex differences in heart size. 5,6,32,33 This is an area that requires further research and insight to fully explain the mechanism(s) at play behind sex-based differences in the hs-cTnT response to exercise.…”

“…These results partially agree with those recently observed in male and female adolescent runners. 15 The authors reported that the response of cTnT after endurance exercise was substantially higher in male than female subjects, but at pre-exercise cTnT data were not different between 2 groups. In this study, exercise intensity was not controlled, and, therefore, we cannot rule out this factor as a contaminator variable.…”

“…There is limited information on the influence of sex on exercise-induced cardiac biomarker release. 11,15,16 Traiperm et al 11 noted similar increases in male and female adolescent marathon runners, but data were limited by assay precision, the number of sampling times postexercise, and the lack of control of the duration/intensity of exercise and pubertal status. In contrast, in a recent study, although limited by assay precision and by the number of sampling times postexercise, it was observed that after a half-marathon cTnT elevation occurred in all runners but is higher in young male compared with female athletes.…”

“…In contrast, in a recent study, although limited by assay precision and by the number of sampling times postexercise, it was observed that after a half-marathon cTnT elevation occurred in all runners but is higher in young male compared with female athletes. 15 No studies in adolescents have evaluated the influence of sex on NT-proBNP values.…”

Impact of high‐intensity interval training and moderate‐intensity continuous training on resting and postexercise cardiac troponin T concentration

“…This assay has a range from 3 to 10,000 ng l −1 , with a lower limit of detection of 3 ng l −1 . Serum cTnT concentrations that were below the limit of detection are reported as 1.5 ng l −1 (Kong et al., ; Tian et al., ). The coefficient of variation at a mean cTnT concentration of 13.5 ng l −1 is 5.2%.…”