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Elevated troponin in exercise induced

Polly Baker, Todd Leckie, Derek Harrington, Alan Richardson
Post-exercise cardiac troponin (cTn) elevation is a recognised phenomenon which historically has been detected using standard sensitivity assays. More recently high-sensitivity assays have been developed and are now the gold standard for detection of cTn in the clinical setting. Although the assay's enhanced sensitivity confers benefits it has created new challenges for clinicians. By evaluating the change in cTn values over time, taking into account biological and analytical variation, the clinician is able to differentiate between a pathological and normal cTn value...
March 2019: IJC Heart & Vasculature
Øyunn Kleiven, Torbjørn Omland, Øyvind Skadberg, Tor Harald Melberg, Magnus Friestad Bjørkavoll-Bergseth, Bjørn Auestad, Rolf Bergseth, Ole Jakob Greve, Kristin Moberg Aakre, Stein Ørn
BACKGROUND: The underlying mechanisms of the exercise-induced increase in cardiac troponins (cTn) are poorly understood. The aim of this study was to identify independent determinants of exercise-induced cTn increase in a large cohort of healthy recreational athletes. METHODS: A total of 1002 recreational cyclists without known cardiovascular disease or medication, participating in a 91-km mountain bike race were included. Median age was 47 years and 78% were males...
February 23, 2019: International Journal of Cardiology
Kristin M Aakre, Torbjørn Omland
Cardiac troponins constitute essential components of the cardiac contractile apparatus and are released into the bloodstream following cardiomyocyte injury. Because of their cardiac specificity, cardiac troponin I or T are the recommended biomarkers for diagnosing acute myocardial infarction. However, cardiac troponin concentrations also frequently increase acutely after strenuous prolonged exercise, making the interpretation of cardiac troponin test results in patients presenting with acute chest pain challenging...
March 2019: Progress in Cardiovascular Diseases
Eslam Samaha, Jamie Brown, Frank Brown, Sara C Martinez, Mitchell Scott, Allan S Jaffe, Victor G Davila-Roman, Peter Nagele
INTRODUCTION: Exercise (ESE) and dobutamine stress echocardiography (DSE) have high sensitivity and specificity to detect inducible myocardial ischemia in patients with significant coronary artery disease (CAD). High-sensitivity cardiac troponin (hs-cTn) assays detect troponin concentrations in the ng/L range. The aim of this study was to determine the kinetics of hs-cTnT in patients undergoing ESE and DSE and possible association of hs-cTnT with inducible myocardial ischemia. METHODS: In this prospective study adult patients undergoing ESE/DSE were enrolled...
January 2019: Clinical Biochemistry
Jinlei Nie, Haifeng Zhang, Yuxiu He, Wenling Cao, Yang Liu, Zhaowei Kong, Keith George
AIMS: This study characterized (1) the cardiac troponin T (cTnT) response to three forms of acute high-intensity interval exercise (HIE), and (2) the impact of 12 weeks of HIE training on the cTnT response to acute exercise in sedentary obese young women. METHODS: Thirty-six sedentary women were randomized to traditional HIE training (repeated 4-min cycling at 90% V̇O2max interspersed with 3-min rest, 200 kJ/session), work-equivalent sprint interval exercise (SIE) training (repeated 1-min cycling at 120% V̇O2max interspersed with 1...
November 26, 2018: Scandinavian Journal of Medicine & Science in Sports
Shaimaa M Bashar, Shereen M Samir El-Sherbeiny, Mohamed Z Boraie
Background Acute myocardial infarction is a major cause of death all over the world. Irisin is a novel myokine released after exercise. This work aimed to study the correlation between the serum irisin level and the severity of the acute myocardial infarction in the exercise-trained rats. Methods Forty-eight male rats were classified into four groups (12 for each): group I, control sedentary (C); group II, exercise-trained (EX) (swimming for 8 weeks); group III, isoprenaline-induced infarct (MI); and group IV, exercise-trained infarct (EX-MI) (swimming for 8 weeks followed by isoprenaline-induced infarction)...
September 28, 2018: Journal of Basic and Clinical Physiology and Pharmacology
Duarte Martins, Caroline Ovaert, Diala Khraiche, Nathalie Boddaert, Damien Bonnet, Francesca Raimondi
INTRODUCTION: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited myocardial disease with an elusive association with myocardial inflammation. A myocarditis phenotype has been well established without systematic evidence of a viral trigger. We intend to study the relationship between myocardial inflammation detected by Cardiac magnetic resonance (CMR) and ARVC in a paediatric population. METHODS: Retrospective case series of all patients <18 years admitted to two CMR units for clinical suspicion of myocarditis from March 2012 to June 2017 who had genetic testing for inherited cardiomyopathies including analysis for known ARVC genes...
November 15, 2018: International Journal of Cardiology
Sana Chams, Skye El Sayegh, Mulham Hamdon, Sarwan Kumar, Zain Kulairi
BACKGROUND: Takotsubo cardiomyopathy or stress cardiomyopathy is characterized by transient left ventricular apical ballooning in the absence of coronary occlusion. The underlying pathophysiological mechanism is still unclear but possible causes have been proposed mainly catecholamine cardiotoxicity, followed by metabolic disturbance, coronary microvascular impairment, and multivessel epicardial coronary artery vasospasm. Takotsubo cardiomyopathy accounts for 1-2% of patients presenting with acute coronary syndrome with the majority of patients diagnosed with Takotsubo cardiomyopathy being women > 55 years of age...
June 10, 2018: Journal of Medical Case Reports
Feifei Li, Longyan Yi, Huiping Yan, Xuejing Wang, Jinlei Nie, Haifeng Zhang, Frank Hoo Kin Fu, Yanpeng Zang, Shuo Yang, Yifan Lu
Objective: The purpose of this study was to investigate the effects of a single bout of high-intensity interval exercise (HIIE) on high-sensitivity cardiac troponin T (hs-cTnT) release and to explore the potential influencing factors. Methods: Twenty-one experienced marathon runners completed HIIE on treadmill. Each bout of HIIE included a hard run (15.8 ± 1.3 km·h-1 ) at 90% vVO2max for 2 min followed by an easy run (8.8 ± 0.7 km·h-1 ) at 50% vVO2max for 2 min performed 23 times within 92 min...
December 2017: Journal of Exercise Science and Fitness
Jinlei Nie, Haifeng Zhang, Zhaowei Kong, Keith George, Jonathan P Little, Tomas K Tong, Feifei Li, Qingde Shi
NEW FINDINGS: What is the central question of this study? Does exercise training impact resting and postexercise cardiac troponin T (cTnT) concentration? What is the main finding and its importance? This randomized controlled intervention study demonstrated that 12 weeks of either high-intensity interval training or moderate-intensity continuous training largely abolished the exercise-induced elevation in cTnT when exercise was performed at the same absolute intensity. There was no impact of training on resting cTnT or postexercise appearance of cTnT when exercise was performed at the same relative intensity...
March 1, 2018: Experimental Physiology
Juliane Herm, Agnieszka Töpper, Alexander Wutzler, Claudia Kunze, Matthias Krüll, Lars Brechtel, Jürgen Lock, Jochen B Fiebach, Peter U Heuschmann, Wilhelm Haverkamp, Matthias Endres, Gerhard Jan Jungehulsing, Karl Georg Haeusler
OBJECTIVES: While regular physical exercise has many health benefits, strenuous physical exercise may have a negative impact on cardiac function. The 'Berlin Beat of Running' study focused on feasibility and diagnostic value of continuous ECG monitoring in recreational endurance athletes during a marathon race. We hypothesised that cardiac arrhythmias and especially atrial fibrillation are frequently found in a cohort of recreational endurance athletes. The main secondary hypothesis was that pathological laboratory findings in these athletes are (in part) associated with cardiac arrhythmias...
August 3, 2017: BMJ Open
Marianne F Baird, Fergal Grace, Nicholas Sculthorpe, Scott M Graham, Audrey Fleming, Julien S Baker
RATIONALE: Following prolonged endurance events such as marathons, elevated levels of cardiospecific biomarkers are commonly reported. Although transiently raised levels are generally not considered to indicate clinical myocardial damage, comprehension of this phenomenon remains incomplete. The popularity of high-intensity interval training highlights a paucity of research measuring cardiac biomarker response to this type of exercise. This a posteriori case report discusses the elevation of cardiac troponins (cTn) associated with short interval, high-intensity exercise...
July 2017: Medicine (Baltimore)
Li-Hua Li, Chorng-Kuang How, Wei-Fong Kao, Yu-Hui Chiu, Chen Meng, Cheng-Chin Hsu, Yeou-Guang Tsay
BACKGROUND: Prolonged endurance exercise is known to cause elevation of cardiac troponin I (cTnI). Previous studies have reported the correlation of several factors with exercise-induced cTnI release. However, the investigation of the predictors for elevated cTnI and postrace kinetics of cTnI after ultramarathon running is lacking, especially in an Oriental population. METHODS: Twenty-six participants, including eight hepatitis B virus carrier (HBVc) runners, who finished a 100-km ultramarathon in Taiwan were enrolled...
June 2017: Journal of the Chinese Medical Association: JCMA
Muhammad Hammadah, Ibhar Al Mheid, Kobina Wilmot, Ronnie Ramadan, Ayman Alkhoder, Malik Obideen, Naser Abdelhadi, Shuyang Fang, Ijeoma Ibeanu, Pratik Pimple, Heval Mohamed Kelli, Amit J Shah, Brad Pearce, Yan Sun, Ernest V Garcia, Michael Kutner, Qi Long, Laura Ward, J Douglas Bremner, Fabio Esteves, Paolo Raggi, David Sheps, Viola Vaccarino, Arshed A Quyyumi
OBJECTIVES: This study sought to investigate whether patients with mental stress-induced myocardial ischemia will have high resting and post-mental stress high-sensitivity cardiac troponin I (hs-cTnI). BACKGROUND: Hs-cTnI is a marker of myocardial necrosis, and its elevated levels are associated with adverse outcomes. Hs-cTnI levels may increase with exercise in patients with coronary artery disease. Mental stress-induced myocardial ischemia is also linked to adverse outcomes...
April 2018: JACC. Cardiovascular Imaging
A Decloedt, H Borowicz, M Slowikowska, K Chiers, G van Loon, A Niedzwiedz
BACKGROUND: Pulmonary hypertension has been described in horses with severe equine asthma, but its effect on the right ventricle has not been fully elucidated. OBJECTIVES: To evaluate right ventricular structure and function after a 1-week period of pulmonary hypertension secondary to acute exacerbation of severe equine asthma. STUDY DESIGN: Prospective study. METHODS: A clinical episode of severe equine asthma was induced experimentally in six susceptible horses...
September 2017: Equine Veterinary Journal
Jinlei Nie, Keith George, Fei Duan, Tomas K Tong, Ye Tian
This study characterized cardiac troponin T (cTnT) appearance and associated histological evidence of reversible or irreversible changes in myocardial ultrastructure, determined via electron microscopy, in rats undertaking isoproterenol (ISO) infusion or an endurance exercise challenge. Male rats were randomized into ISO and exercise groups. In ISO trials rats were killed 5 h (ISO-5H) and 24 h (ISO-REC19H) after a single ISO or saline injection (SAL-5H; SAL-REC19H). In the exercise trials rats were killed before, as a control (EXE-CON), immediately after (EXE-END5H) and 19 h after (EXE-REC19H) a 5-h bout of swimming with 5% body weight attached to their tail...
December 2016: Physiological Reports
Markus Niemelä, Päivikki Kangastupa, Onni Niemelä, Risto Bloigu, Tatu Juvonen
Although strenuous physical activity is known to cause notable perturbations in blood chemistries, only few studies exist observing exercise-induced simultaneous changes in biomarkers of health status. We compared markers of muscle, cardiovascular, renal, hepatic and inflammatory status at baseline and at 3-h and at 48-h postrace in recreational runners who successfully completed either a marathon (mean age 27 ± 13 years, finishing time 199 ± 8 min, n = 4) or half-marathon (mean age 38 ± 13 years, finishing time 131 ± 6 min, n = 6) race...
November 2016: Scandinavian Journal of Clinical and Laboratory Investigation
Lars Wallentin, Lars Lindhagen, Elisabet Ärnström, Steen Husted, Magnus Janzon, Søren Paaske Johnsen, Frederic Kontny, Tibor Kempf, Lars-Åke Levin, Bertil Lindahl, Mats Stridsberg, Elisabeth Ståhle, Per Venge, Kai C Wollert, Eva Swahn, Bo Lagerqvist
BACKGROUND: The FRISC-II trial was the first randomised trial to show a reduction in death or myocardial infarction with an early invasive versus a non-invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome. Here we provide a remaining lifetime perspective on the effects on all cardiovascular events during 15 years' follow-up. METHODS: The FRISC-II prospective, randomised, multicentre trial was done at 58 Scandinavian centres in Sweden, Denmark, and Norway...
October 15, 2016: Lancet
Feifei Li, Jinlei Nie, Yifan Lu, Tom Kwok Keung Tong, Longyan Yi, Huiping Yan, Frank Hoo Kin Fu, Shengxia Ma
PURPOSE: To investigate the effects of hypoxic training on redox status and cardiac troponin (cTn) release after intermittent exercise. METHOD: Nine well-trained male marathon runners (age, 21.7 ± 2.3 year; body mass, 64.7 ± 4.8 kg; height, 177.9 ± 3.8 cm; and VO2max, 64.3 ± 6.7 ml kg(-1) min(-1)) completed intermittent exercise under normoxic [trial N; fraction of inspiration oxygen (FIO2), 21.0 %] and hypoxic (trial H; FIO2, 14.4 %) conditions in random order...
October 2016: European Journal of Applied Physiology
S Cocking, T Landman, M Benson, R Lord, H Jones, D Gaze, D H J Thijssen, K George
Remote ischemic preconditioning (RIPC; repeated short reversible periods of ischemia) protects the heart against subsequent ischemic injury. We explored whether RIPC can attenuate post-exercise changes in cardiac troponin T (cTnT) and cardiac function in healthy individuals. In a randomized, crossover design, 14 participants completed 1-h cycling time trials (TT) on two separate visits; preceded by RIPC (arms/legs, 4 × 5-min 220 mmHg), or SHAM-RIPC (20 mmHg). Venous blood was sampled before and 0-, 1-, and 3-h post-exercise to assess high sensitivity (hs-)cTnT and brain natriuretic peptide (NT-proBNP)...
October 2017: Scandinavian Journal of Medicine & Science in Sports
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