title: The impact of remote ischemic preconditioning on cardiac biomarker and functional response to endurance exercise.
abstract: 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). Echocardiograms were performed at the same time points to assess left and right ventricular systolic (ejection fraction; EF and right ventricular fractional area change; RVFAC, respectively) and diastolic (early transmitral flow velocities; E) function. Baseline hs-cTnT was not different between RIPC and SHAM. Post-exercise hs-cTnT levels were consistently lower following RIPC (18 ± 3 vs 21 ± 3; 19 ± 3 vs 23 ± 3; and 20 ± 2 vs 25 ± 2 ng/L at 0, 1 and 3-h post-exercise, respectively; P < 0.05). There was no main effect of time, trial, or interaction for NT-proBNP and left ventricular EF or RVFAC (all P < 0.05). A main effect of time was evident for E which transiently declined immediately after exercise to a similar level in both trials (0.85 ± 0.04 vs 0.74 ± 0.04 m/s, respectively; P < 0.05). In summary, RIPC was associated with lower hs-cTnT levels after exercise but there was no independent effect of RIPC for NT-proBNP or LV systolic and diastolic function. The lower hs-cTnT levels after RIPC suggests that further research should evaluate the role of ischemia in exercise-induced elevation in hs-cTnT.
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.|Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
authors.forename: S
authors.initials: S
authors.lastname: Cocking
authors.affiliation: Radboud Institute of Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Landman
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
authors.forename: M
authors.initials: M
authors.lastname: Benson
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
authors.forename: R
authors.identifier: http://orcid.org/0000-0002-5385-7548
authors.initials: R
authors.lastname: Lord
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
authors.forename: H
authors.initials: H
authors.lastname: Jones
authors.affiliation: Department of Chemical Pathology, Cinical Blood Sciences, St. George's Healthcare National Health Service Trust, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Gaze
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.|Radboud Institute of Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: D H J
authors.initials: DHJ
authors.lastname: Thijssen
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
authors.forename: K
authors.initials: K
authors.lastname: George
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D004452:Echocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D006339:Heart Rate; D006801:Humans; D019194:Ischemic Preconditioning; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010807:Physical Endurance; D016037:Single-Blind Method; D013318:Stroke Volume; D020107:Troponin T / Q000097:blood*; D016277:Ventricular Function, Left; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Cardiovascular function; cardiac fatigue; ischemic preconditioning