Abstract
Background: Intensive and prolonged exercise leads to a rise of troponin concentration in blood. The mechanism responsible for troponin release during exercise remains ill-defined. The study aim was to search for risk factors of troponin increase after a prolonged endurance competition. Methods: The study included a group of 18 amateurs, healthy volunteers (median age 41.5 years, interquartile range – IQR 36–53 years, 83% male) who participated in a 100 km running ultra-marathon. Information on demographic characteristics, pre- and post-race heart rate, blood pressure, body composition and glucose, lactate (L), troponin T (hs-TnT) and C reactive protein (hs-CRP) concentration were obtained. Additionally, data on L and glucose levels every 9.2 km and fluid/food intakes during the race were collected. Results: There was a significant hs-TnT increase after the race exceeding upper reference values in 66% of runners (from 5 IQR 3–7 ng/L to 14 IQR 12–26 ng/L, p < 0.0001). None of the baseline parameters predicted a post-race hs-TnT increase. The only factors, correlating with changes of hs-TnT were mean L concentration during the race (rho = 0.52, p = 0.03) and change of hs-CRP concentration (rho = 0.59, p = 0.01). Conclusions: Participation in a 100 km ultra-marathon leads to a modest, but significant hs-TnT increase in the majority of runners. Among analysed parameters only mean lactate concentration during the race and change in hs-CRP correlated with troponin change.
Highlights
Regular physical activity leads to many health benefits including cardio-protective activity [1,2].Recent guidelines of the European Society of Cardiology have increased the recommended weekly volume of moderate to vigorous exercise from 150 min to 210–420 min as optimal cardiovascular prevention [3]
Each study participant underwent initial screening in the form of a medical questionnaire to exclude any known medical conditions. It was followed by the assessment of (1) body composition including body mass, total body water (TBW), body fat (FAT) and free fatty mass (FFM), (2) resting heart rate (HR) and blood pressure (BP) measurement and (3) blood draw from an antecubital vein for baseline analysis of high-sensitivity troponin T and high sensitivity C-reactive protein
We have demonstrated that participation in a 100 km marathon leads to a significant increase of high-sensitivity troponin T (hs-TnT) beyond upper reference limits in 66% of runners
Summary
Regular physical activity leads to many health benefits including cardio-protective activity [1,2].Recent guidelines of the European Society of Cardiology have increased the recommended weekly volume of moderate to vigorous exercise from 150 min to 210–420 min as optimal cardiovascular prevention [3]. There is a group of athletes who far exceed these recommendations by engaging in long-lasting training and ultra-endurance competitions. The effects of these extreme forms of exercise on health are much less studied [2]. Intensive and prolonged exercise leads to a rise of troponin concentration in blood. Conclusions: Participation in a 100 km ultra-marathon leads to a modest, but significant hs-TnT increase in the majority of runners. Among analysed parameters only mean lactate concentration during the race and change in hs-CRP correlated with troponin change
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