Cardiac Troponin T and I Release After a 30-km Run.
Prolonged endurance-type exercise is associated with elevated cardiac troponin (cTn) levels in asymptomatic recreational athletes. It is unclear whether exercise-induced cTn release mirrors a physiological or pathological underlying process. The aim of this study was to provide a direct comparison of the release kinetics of high-sensitivity cTnI (hs-cTnI) and T (hs-cTnT) after endurance-type exercise. In addition, the effect of remote ischemic preconditioning (RIPC), a cardioprotective strategy that limits ischemia-reperfusion injury, was investigated in a randomized controlled crossover manner. Twenty-five healthy volunteers completed an outdoor 30-km running trial preceded by RIPC (4 × 5 min 220 mm Hg unilateral occlusion) or control intervention. hs-cTnT, hs-cTnI, and sensitive cTnI (s-cTnI) concentrations were examined before, immediately after, 2 and 5 hours after the trial. The completion of a 30-km run resulted in a significant increase in circulating cTn (time: all p <0.001), with maximum hs-cTnT, hs-cTnI, and s-cTnI levels of 47 ± 27, 69 ± 62, and 82 ± 64 ng/L (mean ± SD), respectively. Maximum hs-cTnT concentrations were measured in 60% of the participants at 2 hours after exercise, compared with maximum hs-cTnI and s-cTnI concentrations at 5 hours in 84% and 80% of the participants. Application of an RIPC stimulus did not reduce exercise-induced cTn release (time × trial: all p >0.5). In conclusion, in contrast to acute myocardial infarction, maximum hs-cTnT levels after exercise precede maximum hs-cTnI levels. Distinct release kinetics of hs-cTnT and hs-cTnI and the absence of an effect of RIPC favors the concept that exercise-induced cTn release may be mechanistically distinct from cTn release in acute myocardial infarction.
Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
Lieke J J
LJ
Klinkenberg
Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Peter
P
Luyten
Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
Noreen
N
van der Linden
Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Kim
K
Urgel
Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands.
Daniëlle P C
DP
Snijders
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Christian
C
Knackstedt
Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Robert
R
Dennert
Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Bastiaan L J H
BL
Kietselaer
Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
Alma M A
AM
Mingels
Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
Eline P M
EP
Cardinaels
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Frederique E C M
FE
Peeters
Department of Clinical Chemistry and Laboratory Hematology, Gelre ziekenhuizen, Apeldoorn/Zutphen, the Netherlands.
Jeroen D E
JD
van Suijlen
Department of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard-Geleen, the Netherlands.
Joop
J
Ten Kate
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Pathology, Maastricht University Medical Center, Maastricht, the Netherlands.
Elke
E
Marsch
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Pathology, Maastricht University Medical Center, Maastricht, the Netherlands.
Thomas L
TL
Theelen
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Pathology, Maastricht University Medical Center, Maastricht, the Netherlands.
Judith C
JC
Sluimer
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Internal Medicine, Laboratory for Metabolism and Vascular Medicine, Maastricht University Medical Center, Maastricht, the Netherlands.
Kristiaan
K
Wouters
Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
Otto
O
Bekers
Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Sebastiaan C A M
SC
Bekkers
Department of Human Movement Sciences, School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands.
Luc J C
LJ
van Loon
Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands.
Marja P
MP
van Dieijen-Visser
Department of Clinical Chemistry, Maastricht University Medical Center, Maastricht, the Netherlands; Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands. Electronic address: steven.meex@mumc.nl.
Steven J R
SJ
Meex
D000328:Adult; D056352:Athletes; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010807:Physical Endurance; D012420:Running; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
D010446:Peptide Fragments; D019210:Troponin I; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form