Abstract
Abstract Elderly population often is encouraged to practice sports in preventing cardiovascular diseases. However, evidences exist that intense physical efforts are related with a higher risk for acute myocardial infarction and sudden death. Biological markers for myocardial injury was analyzed in a group of 15 elderly athletes without a history of coronary artery disease, who participated in the 77th International Sao Silvestre race (15,000 m) in Sao Paulo City. A statistical difference was observed between total CPK activity levels before the run, immediately after the run, and some time later. Similar results were observed in the concentration of CK-MB mass. The cardiac troponin I (TnI-c) levels remained unchanged and within normal limits during the same time periods. The results of the present study showed no evidence of myocardial injury in elderly subjects without a history of coronary artery disease after participating in long-distance runs, as confirmed by the analysis of TnI-c levels. The increase in total CPK activity levels and the concentration of CK-MB mass do not represent myocardial injury in these subjects.
Highlights
The detection, by serologic markers, of myocardial ischemic injuries in patients subjected to intense physical exertion presents some limitations due to the elevation in serum levels of creatine phosphokinase MB-isoenzyme (CK-MB) [15] due to an increase in its level in the skeletal musculature [2, 17]
We found a few articles in the literature showing increases in the cardiac troponin levels of young subjects after highly intensive sports activities such as marathons, ultra marathons, and Ironman-type triathlons, some of them performed at high altitudes [3, 5, 9, 11, 13, 14]
In the search to analyze this risk in elderly patients, the only article investigating the specific behavior of enzymatic changes was the study by Lucía et al [10], who found no changes in cardiac troponin I levels during the Madrid Marathon
Summary
The benefit resulting from the practice of physical exercises is not exempt from risks [1, 7, 12, 16] and an increase in the risk for acute myocardial infarction and sudden death while exercising or within the subsequent hour.The detection, by serologic markers, of myocardial ischemic injuries in patients subjected to intense physical exertion presents some limitations due to the elevation in serum levels of creatine phosphokinase MB-isoenzyme (CK-MB) [15] due to an increase in its level in the skeletal musculature [2, 17].The solution to this problem is the analysis of the serum levels of troponins, regulatory proteins found in cardiac and skeletal myocytes that modulate the actin– myosin interaction [6].We found a few articles in the literature showing increases in the cardiac troponin levels of young subjects after highly intensive sports activities such as marathons, ultra marathons, and Ironman-type triathlons, some of them performed at high altitudes [3, 5, 9, 11, 13, 14].In the search to analyze this risk in elderly patients, the only article investigating the specific behavior of enzymatic changes was the study by Lucía et al [10], who found no changes in cardiac troponin I levels during the Madrid Marathon.Under these conditions, we proposed to study the enzymatic profile of normal elderly subjects after long-distance runs such as the São Silvestre International street race (15,000 m). The detection, by serologic markers, of myocardial ischemic injuries in patients subjected to intense physical exertion presents some limitations due to the elevation in serum levels of creatine phosphokinase MB-isoenzyme (CK-MB) [15] due to an increase in its level in the skeletal musculature [2, 17]. The solution to this problem is the analysis of the serum levels of troponins, regulatory proteins found in cardiac and skeletal myocytes that modulate the actin– myosin interaction [6].
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