Abstract
The purpose of this study was to evaluate the interactive effects of exercise duration
and intensity on the elevation of serum cardiac troponin T (cTnT) in trained adolescent
athletes following prolonged exercise in a laboratory-based setting. Thirteen male
adolescent runners (mean age 14.8±1.6 year) performed two 45-min and two 90-min constant-load
treadmill runs with intensities set at the running speeds that corresponded to either
80% or 100% ventilatory threshold (Thvent ): 80%Thvent 45 min, 80%Thvent 90 min, 100%Thvent 45 min and 100%Thvent 90 min. Serum cTnT was assessed pre and post exercise. In the 100%Thvent 45 min trial, the post-exercise serum cTnT level [(Median) 0.015 ng.ml−1 ; (Range)<0.01–0.375 ng.ml−1 ] was greater than that of the 80%Thvent 45 min (undetectable cTnT) and 80%Thvent 90 min (detectable cTnT in two subjects, 0.021 and 0.133 ng.ml−1 ) trials (P<0.01). The serum cTnT level was further increased in the 100%Thvent 90 min trial [(Median) 0.063 ng.ml−1 ; (Range)<0.01–0.417 ng.ml−1 ] when the treadmill run was sustained for an additional 45 min (P<0.05). Similar
changes were observed in the cTnT positive rate in subjects. These findings suggest
that exercise duration and intensity are essential factors in eliciting cTnT release
interactively following an endurance exercise. Nevertheless, exercise intensity compared
to duration appears to cause a more pronounced increase in cTnT levels.
Key words
cardiac marker - exercise - myocardium
References
1
Alpert JS, Thygesen K, Antman E, Bassand JP.
Myocardial infarction redefined – a consensus document of The Joint European Society
of Cardiology/American College of Cardiology Committee for the redefinition of myocardial
infarction.
J Am Coll Cardiol.
2000;
36
959-969
2
Cheatham CC, Mahon AD, Brown JD, Bolster DR.
Cardiovascular responses during prolonged exercise at ventilatory threshold in boys
and men.
Med Sci Sports Exerc.
2000;
32
1080-1087
3
Chen Y, Serfass RC, Mackey-Bojack SM, Kelly KL, Titus JL, Apple FS.
Cardiac troponin T alterations in myocardium and serum of rats after stressful, prolonged
intense exercise.
J Appl Physiol.
2000;
88
1749-1755
4
Clausen JP.
Effect of physical training on cardiovascular adjustments to exercise in man.
Physiol Rev.
1977;
57
779-815
5
Cleave P, Boswell TD, Speedy DB, Boswell DR.
Plasma cardiac troponin concentrations after extreme exercise.
Clin Chem.
2001;
47
608-610
6
Collinson PO, Stubbs PJ, Kessler AC.
Multicentre evaluation of the diagnostic value of cardiac troponin T, CK-MB mass,
and myoglobin for assessing patients with suspected acute coronary syndromes in routine
clinical practice.
Heart.
2003;
89
280-286
7
Das DK, Flansaas D, Engelman RM, Rousou JA, Breyer RH, Jones R, Lemeshow S, Otani H.
Age-related development profiles of the antioxidative defense system and the peroxidative
status of the pig heart.
Biol Neonate.
1987;
51
156-169
8
Dawson E, George K, Shave R, Whyte G, Ball D.
Does the human heart fatigue subsequent to prolonged exercise?.
Sports Med.
2003;
33
365-380
9
Hammon
Jr
JW.
Myocardial protection in the immature heart.
Ann Thorac Surg.
1995;
60
839-842
10
Kannankeril PJ, Pahl E, Wax DF.
Usefulness of troponin I as a marker of myocardial injury after pediatric cardiac
catheterization.
Am J Cardiol.
2002;
90
1128-1132
11
Koller A.
Exercise-induced increases in cardiac troponins and prothrombotic markers.
Med Sci Sports Exerc.
2003;
35
444-448
12
Mair J, Schobersberger W, Koller A, Bialk P, Villiger B, Frey W, Puschendorf B.
Risk for exercise-induced myocardial injury for athletes performing prolonged strenuous
endurance exercise.
Am J Cardiol.
1997;
80
543-544
13
Nie J, Tong TK, Shi Q, Lin H, Zhao J, Tian Y.
Serum cardiac troponin response in adolescents playing basketball.
Int J Sports Med.
2008;
29
449-452
14 Pavlat DJ.
The effects of strenuous exercise on cardiac markers in a sedentary population . University of Northern Colorado 2002
15
Powers SK, DeRuisseau KC, Quindry J, Hamilton KL.
Dietary antioxidants and exercise.
J Sports Sci.
2004;
22
81-94
16
Rifai N, Douglas PS, O’Toole M, Rimm E, Ginsburg GS.
Cardiac troponin T and I, echocardiographic wall motion analyses, and ejection fractions
in athletes participating in the Hawaii Ironman Triathlon.
Am J Cardiol.
1999;
83
1085-1089
17
Roth HJ, Leithauser RM, Doppelmayr H, Doppelmayr M, Finkernagel H, Duvillard SP von,
Korff S, Katus HA, Giannitsis E, Beneke R.
Cardiospecificity of the 3rd generation cardiac troponin T assay during and after
a 216 km ultra-endurance marathon run in Death Valley.
Clin Res Cardiol.
2007;
96
359-364
18
Scharhag J, Shave R, George K, Whyte G, Kindermann W.
Exercise-induced increases in cardiac troponins in endurance athletes: A matter of
exercise duration and intensity?.
Clin Res Cardiol.
2008;
97
62-63
19
Schneider CD, Barp J, Ribeiro JL, Bello-Klein A, Oliveira AR.
Oxidative stress after three different intensities of running.
Can J Appl Physiol.
2005;
30
723-734
20
Shave R, Dawson E, Whyte G, George K, Ball D, Collinson P, Gaze D.
The cardiospecificity of the third-generation cTnT assay after exercise-induced muscle
damage.
Med Sci Sports Exerc.
2002;
34
651-654
21
Shave R, Dawson E, Whyte G, George K, Gaze D, Collinson P.
Altered cardiac function and minimal cardiac damage during prolonged exercise.
Med Sci Sports Exerc.
2004;
36
1098-1103
22
Shave R, George K, Gaze D.
The influence of exercise upon cardiac biomarkers: a practical guide for clinicians
and scientists.
Curr Med Chem.
2007;
14
1427-1436
23
Shave R, George KP, Atkinson G, Hart E, Middleton N, Whyte G, Gaze D, Collinson PO.
Exercise-induced cardiac troponin T release: a meta-analysis.
Med Sci Sports Exerc.
2007;
39
2099-2106
24
Shave RE, Whyte GP, George K, Gaze DC, Collinson PO.
Prolonged exercise should be considered alongside typical symptoms of acute myocardial
infarction when evaluating increases in cardiac troponin T.
Heart.
2005;
91
1219-1220
25
Stephenson C, MacCarthy J, Vikelis E, Shave R, Whyte G, Gaze D, George K.
Effect of weightlifting upon left ventricular function and markers of cardiomyocyte
damage.
Ergonomics.
2005;
48
1585-1593
26
Tian Y, Nie J, Tong TK, Cao J, Gao Q, Man J, Shi Q, Liu W.
Changes in serum cardiac troponins following a 21-km run in junior male runners.
J Sports Med Phys Fitness.
2006;
46
481-488
27
Turley KR.
Cardiovascular responses to exercise in children.
Sports Med.
1997;
24
241-257
28
Venditti P, Masullo P, Meo S Di, Agnisola C.
Effects of prolonged aerobic exercise on myocardial responses to ischaemia-reperfusion
in the rat.
Exp Physiol.
2001;
86
341-348
Correspondence
Prof. F. Fu
Faculty of Social Sciences
Hong Kong Baptist University
22 4 Waterloo Road
Hong Kong
China
Phone: +852/3411/71 27
Fax: +852/3411/57 77
Email: frankfu@hkbu.edu.hk