Int J Sports Med 2012; 33(05): 333-337
DOI: 10.1055/s-0031-1301322
Physiology & Biochemistry
© Georg Thieme Verlag KG Stuttgart · New York

Post-Exercise Cardiac Troponin Release is Related to Exercise Training History

R. Mehta
1   Queen Mary University of London, Centre for Sports and Exercise Medicine, London, United Kingdom
,
D. Gaze
2   St. George’s Healthcare NHS Trust, Department of Chemical Pathology, Clinical Blood Sciences, London, United Kingdom
,
S. Mohan
1   Queen Mary University of London, Centre for Sports and Exercise Medicine, London, United Kingdom
,
K. L. Williams
3   Liverpool John Moores University, Research Institute of Sport & Exercise Sciences, Liverpool, United Kingdom
,
V. Sprung
3   Liverpool John Moores University, Research Institute of Sport & Exercise Sciences, Liverpool, United Kingdom
,
K. George
3   Liverpool John Moores University, Research Institute of Sport & Exercise Sciences, Liverpool, United Kingdom
,
R. Jeffries
4   Brunel University, Centre for Sports Medicine and Human Performance, Uxbridge, United Kingdom
,
Z. Hudson
1   Queen Mary University of London, Centre for Sports and Exercise Medicine, London, United Kingdom
,
M. Perry
1   Queen Mary University of London, Centre for Sports and Exercise Medicine, London, United Kingdom
,
R. Shave
4   Brunel University, Centre for Sports Medicine and Human Performance, Uxbridge, United Kingdom
› Author Affiliations
Further Information

Publication History



accepted after revision 15 December 2011

Publication Date:
29 February 2012 (online)

Abstract

Marathon running can increase circulating cardiac troponin above the diagnostic criteria for myocardial infarction. We determined whether prior-exercise experience (training history) might be related to the magnitude of immediate post-race troponin release following completion of the London Marathon in a group of non-elite runners. Using a prospective study design, 52 runners were recruited into either HIGH T-E (trained-experience) (n=27) or LOW T-E (n=25) groups. Cardiac troponin I (cTnI) release following race completion was compared between these 2 groups. To examine relationships between cTnI release and participant demographic and indices of prior training experience an additional 52 runners who did not meet the criteria for either the HIGH T-E or LOW T-E groups were also recruited. The combined data from all 104 runners was analysed using multivariate linear regression analysis. The results revealed a significant difference in post marathon circulating cTnI between LOW T-E runners (median: 0.11 µg/L; interquartile range [IQR]: 0.03–0.18 µg/L) and HIGH T-E runners (median: 0.03 µg/L; IQR 0.02–0.057 µg/L) (p<0.05). Average miles run per week in the last 3 years, a marker of total training experience, encompassing training volume and duration, was negatively associated with post-marathon cTnI release (p<0.001).

In conclusion, exercise-induced cTnI release is strongly related to previous training experience.

 
  • References

  • 1 Collison PO, Clifford-Mobley O, Gaze D, Boa F, Senior R. Assay imprecision and 99th-percentile reference value of a high-sensitivity cardiac troponin I assay. Clin Chem 2009; 1433-1434
  • 2 Collison PO, Stubbs PJ, Kessler AC. Multicentre evaluation of the diagnostic value of cardiac troponin T, CK-MB mass, and myoglobin for assessing patients with suspected acute coronary syndromes in routine clinical practice. Heart 2003; 89: 280-286
  • 3 Ebbeling CB, Clarkson PM. Exercise induced muscle damage and adaptation. Sports Med 1989; 7: 207-234
  • 4 Fortescue EB, Shin AY, Greenes DS, Mannix RC, Agarwal S, Feldman BJ, Shah MI, Rifai N, Landzberg MJ, Newburger JW, Almond CS. Cardiac troponin increases among runners in the Boston Marathon. Ann Emerg Med 2007; 49: 137-143
  • 5 Frassl W, Kowoll R, Katz N, Speth M, Stangl A, Brechtel L, Joscht B, Boldt LH, Meier-Buttermilch R, Schlemmer M, Roecker L, Gunga HC. Cardiac markers (BNP, NT-pro-BNP, Troponin I, Troponin T, in female amateur runners before and up until three days after a marathon. Clin Lab 2008; 54: 81-87
  • 6 George K, Whyte G, Stephenson C, Shave R, Dawson E, Edwards B, Gaze D, Collinson P. Post exercise left ventricular function and cTnT in recreational marathon runners. Med Sci Sports Exerc 2004; 36: 1709-1715
  • 7 Goette A, Bukowska A, Dobrev D, Pfeiffenberger J, Morawietz H, Strugala D, Wiswedel I, Röhl FW, Wolke C, Bergmann S, Bramlage P, Ravens U, Lendeckel U. Acute atrial tachyarrythmia induces angiotensin II type 1 receptor-mediated oxidative stress and microvascular flow abnormalities in the ventricles. Eur Heart J 2009; 30: 1411-1420
  • 8 Harriss DJ, Atkinson G. Update – Ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
  • 9 Herrmann M, Scharhag J, Miclea M, Urhausen A, Herrmann W, Kindermann W. Post-race kinetics of cardiac troponin T and I and N-terminal pro-brain natriuretic peptide in marathon runners. Clin Chem 2003; 49: 831-834
  • 10 Hessel MH, Atsma DE, van der Valk EJ, Bax WH, Schalij MJ, van der Laarse A. Release of cardiac troponin I from viable cardiomyocytes is mediated by integrin stimulation. Pflugers Arch 2008; 455: 979-986
  • 11 Hickman PE, Potter JM, Aroney C, Koerbin G, Southcott E, Wu AH, Roberts MS. Cardiac troponin may be released by ischemia alone, without necrosis. Clin Chim Acta 2010; 411: 318-323
  • 12 Hubble KM, Fatovich DM, Grasko JM, Vasikaran JD. Cardiac troponin increases among marathon runners in the Perth Marathon: the Troponin in Marathons (TRIM) study. Med J Aust 2009; 190: 91-93
  • 13 Hultman E, Sahlin K. Acid-base balance during exercise. Exerc Sport Sci Rev 1990; 8: 41-128
  • 14 Jassal DS, Moffat D, Krahn J, Ahmadie R, Fang T, Eschun G, Sharma S. Cardiac injury markers in non-elite marathon runners. Int J Sports Med 2009; 30: 75-79
  • 15 Katus HA, Remppis A, Scheffold T, Diederich KW, Kuebler W. Intracellular compartmentation of cardiac troponin T and its release kinetics in patients with reperfused and nonreperfused myocardial infarction. Am J Cardiol 1991; 67: 1360-1367
  • 16 Koller A, Schobersberger W. Post-exercise release of cardiac troponins. J Am Coll Cardiol 2009; 53: 1341
  • 17 Leers MP, Schepers R, Baumgarten R. Effects of a long-distance run on cardiac markers in healthy athletes. Clin Chem Lab Med 2006; 44: 999-1003
  • 18 Legaz-Arrese A, George K, Carranza-Garcia LE, Munguia-Izquierdo D, Moros-Garcia T, Serrano-Ostariz E. The impact of exercise intensity on the release of cardiac biomarkers in marathon runners. Eur J Appl Physiol 2011; [epub ahead of print]
  • 19 Leon AS, Connett J, Jacobs DR, Rauramaa R. Leisure-time physical activity levels and risk of coronary heart disease and death. The Muliple Risk Factor Intervention Trial. JAMA 1987; 258: 2388-2395
  • 20 Lippi G, Banfi G. Exercise-related increase of cardiac troponin release in sports: An apparent paradox finally elucidated?. Clin Chim Acta 2010; 411: 610-611
  • 21 London Marathon Ltd (2008), viewed on 30/11/08 http://www.london-marathon.co.uk
  • 22 Mair J, Schobersberger W, Koller A, Bialk P, Villiger B, Frey W, Puschendorf B. Risk for exercise-induced myocardial injury for athletes performing prolonged strenuous endurance exercise. Am J Cardiol 1997; 80: 543-544
  • 23 McNeil PL, Khakee R. Disruptions of muscle fiber plasma membranes. Role in exercise-induced damage. Am J Pathol 1992; 140: 1097-1109
  • 24 Michielsen EC, Wodzig WK, Van Dieijen-Visser MP. Cardiac troponin T release after prolonged strenuous exercise. Sports Med 2008; 38: 425-435
  • 25 Middleton N, George K, Whyte G, Gaze D, Collison P, Shave R. Cardiac troponin T release is stimulated by endurance exercise in healthy humans. J Am Coll Cardiol 2008; 52: 1813-1814
  • 26 Mingels A, Jacobs L, Michielsen E, Swaanenburg J, Wodzig W, van Dieijen-Visser M. Reference population and Marathon runner sera assessed by highly sensitive cardiac troponin T and commercial cardiac troponin T and I assays. Clin Chem 2009; 55: 101-108
  • 27 Neilan TG, Januzzi JL, Lee-Lewandrowski E, Ton-Nu TT, Yoerger DM, Jassal DS, Lewandrowski KB, Siegel AJ, Marshall JE, Douglas PS, Lawlor D, Picard MH, Wood MJ. Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon. Circulation 2006; 114: 2325-2333
  • 28 Neumayer G, Pfister R, Mitterbauer G, Eibl G, Hoertnagl H. Effect of competitive marathon cycling on plasma N-terminal pro-brain natriuretic peptide and cardiac troponin T in healthy recreational cyclists. Am J Cardiol 2005; 96: 732-735
  • 29 Scharhag J, Herrmann M, Urhausen A, Haschke M, Herrmann W, Kindermann W. Independent elevations of N-terminal pro-brain natriuretic peptide and cardiac troponins in endurance athletes after prolonged strenuous exercise. Am Heart J. 2005; 150: 1128-1134
  • 30 Scherr J, Braun S, Schuster T, Hartmann C, Moehlenkamp S, Wolfarth S, Pressler A, Halle M. 72-h kinetics of high-sensitive troponin T and inflammatory markers after marathon. Med Sci Sports Exerc 2011; [Epub ahead of print]
  • 31 Serrano-Ostariz E, Terreros-Blanco JL, Legaz-Arrese A, George K, Shave R, Bocos-Terraz P, Izquierdo-Alvarez S, Bancalero JL, Echavarri JM, Quilez J, Aragones MT, Carranza-Garcia LE. The impact of exercise duration and intensity on the release of cardiac biomarkers. Scand J Med Sci Sports 2011; 21: 244-249
  • 32 Shave R, Baggish A, George K, Wood M, Scharhag J, Whyte G, Gaze D, Thompson PD. Exercise-induced cardiac troponin elevation: Evidence, mechanisms and implications. J Am Coll Cardiol 2010; 56: 169-176
  • 33 Shave R, George KP, Atkinson G, Hart E, Middleton N, Whyte G, Gaze D, Collinson PO. Exercise-induced cardiac troponin T release: A meta-analysis. Med Sci Sports Exerc 2007; 39: 2099-2106
  • 34 Siegel AJ, Lewandrowski EL, Chun KY, Sholar MB, Fischman AJ, Lewandrowski KB. Changes in cardiac markers including B-natriuretic peptide in runners after the Boston marathon. Am J Cardiol 2001; 88: 920-923
  • 35 Thompson PD, Franklin BA, Balady GJ, Blair SN, Corrado D, Estes 3rd NA, Fulton JE, Gordon NF, Haskell WL, Link MS, Maron BJ, Mittleman MA, Pelliccia A, Wenger NK, Willich SN, Costa F. Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council of Nutrition, Physical Activity and Metabolism and the Council on Clinical Cardiology. Circulation 2007; 115: 2358-2368