Int J Sports Med 1999; 20(7): 482-486
DOI: 10.1055/s-1999-8824
Orthopedics and Clinical Science
Georg Thieme Verlag Stuttgart ·New York

Short-Term Effects of Marathon Running in Master Runners: No Evidence of Myocardial Injury

  A.  Lucía1 ,  M. Morán2 ,  M. Pérez1 ,  A. Saborido2 ,  E. Díaz3 ,  A. Megías2 ,  J. L. Chicharro4
  • 1 Departamento de Ciencias Morfológicas y Fisiología, Universidad Europea de Madrid, Madrid, Spain
  • 2 Departamento de Bioquímica y Biología Molecular I, Facultad des Ciencias Biológicas, Universidad Complutense de Madrid, Madrid, Spain
  • 3 Centro Nacional de Investigación y Ciencias del Deporte (CNICD), Consejo Superior de Deportes (CSD), Madrid, Spain
  • 4 Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
Further Information

Publication History

Publication Date:
31 December 1999 (online)

The purpose of this investigation was to analyze the short-term effects of marathon running on serum levels of cardiac markers in a group of master runners (> 60 yrs). Ten marathoners (9 male and 1 female; 63 ± 4 yrs) were enrolled in the study. All of them completed the Madrid Marathon (1998). Venous blood was drawn from each subject three times during the study (48 h before the race, immediately after the race, and 24 h post-competition) for the determination of the several biochemical markers, such as total creatine kinase catalytic activity (total CK), mass concentration of creatine kinase isoenzyme MB (CK-MB mass), and cardiac troponin I (TnI-c). The most important finding was that in each sample (pre- or post-race) serum TnI-c was below the commonly accepted level of 0.1 ng × ml-1 indicative of myocardial injury. Although further research is needed using more complete methodology, our results suggest that marathon running does not have an acute deleterious effect on the hearts of the elderly.

References

  • 1 Adams J E, Bodor G S, Dávila-Román V G, Delmez J A, Apple F S, Ladenson L H, Jaffe S. Cardiac troponin I. A marker with high specificity for cardiac injury.  Circulation. 1993;  88 101-6
  • 2 American College of Sports Medicine .Guidelines for Exercise Testing and Prescription.  Philadelphia,; Lea & Febiger, 1986: 95-6
  • 3 Anderson P AW, Malouf N NN, Oakeley A E, Pagani E D, Allen P D. Troponin T isoform expression in humans: a comparison among normal and failing adult heart, fetal heart, and adult and fetal skeletal muscle.  Circulation. 1991;  69 1226-33
  • 4 Antman E M, Tanasijevic M J, Thompson B, Schactman M, McGabe C H, Cannon C P, Fischer G A, Fung A Y, Thompson C, Wybengad D, Braunwald E. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes.  N Engl J Med. 1996;  335 1342-9
  • 5 Apple F S, Rogers M A, Sherman W M. Profile of creatine kinase isoenzymes in skeletal muscles of marathon runners.  Clin Chem. 1984;  30 413-6
  • 6 Apple F S, Rogers M A, Casal D C, Lewis L, Ivy J L, Lampe J W. Skeletal muscle creatine kinase MB mass measurement/total CK activity ratio.  Clin Chem. 1986;  32 291-5
  • 7 Bakker A J, Gorgels J PMC, Van Vlies B, Haagen F DM, Smits R. The mass concentrations of serum troponin T and creatine kinase-MB are elevated before creatine kinase and creatine kinase-MB activities in acute myocardial infarction.  Eur J Clin Chem Clin Biochem. 1993;  31 715-24
  • 8 Bodor G S, Porter S, Landt Y, Landenson J H. The development of monoclonal antibodies and an assay for cardiac troponin-I with preliminary results in suspected acute myocardial infarction.  Clin Chem. 1992;  11 2203-14
  • 9 Bonetti A, Tirelli F, Albertini R, Monica C, Monica M, Tredici G. Serum cardiac troponin T after repeated endurance exercise events.  Int J Sports Med. 1996;  17 259-62
  • 10 Cummins B, Auckland M, Cummins P. Cardiac-specific troponin-I radioimmunoassay in the diagnosis of acute myocardial infarction.  Am Heart J. 1987;  113 1333-44
  • 11 Cummins P, Young A, Auckland M L, Michie C A, Stone P CW. Comparison of serum cardiac specific troponin-I with creatine kinase, creatine kinase-MB isoenzyme, tropomyosin, myoglobin and C-reactive protein release in marathon runners: cardiac or skeletal muscle trauma?.  Eur J Clin Invest. 1987;  17 217-48
  • 12 Dávila-Román V G, Guest T M, Tuteur P G, Rowe W J, Ladenson J H, Jaffe A S. Transient right but not left ventricular dysfunction after strenuous exercise at high altitude.  J Am Coll Cardiol. 1997;  30 468-73
  • 13 Dill D B, Costill D L. Calculation of percentage change in volumes of blood, plasma and red cells in rehydration.  J Appl Physiol. 1979;  37 247-8
  • 14 El Allaf M, Chapelle J P, El Allaf D, Adam A, Faymonville M E, Laurent P, Heusghem C. Differentiating muscle damage from myocardial injury by means of the serum creatine kinase (CK) isoenzyme MB mass measurement/total CK activity ratio.  Clin Chem. 1986;  32 291-5
  • 15 Fleg J L, Shaphiro E P, O'Connor F, Taube J, Goldberg P, Lakatta E G. Left ventricular diastolic filling performance in older male athletes.  JAMA. 1995;  273 1371-5
  • 16 Galvani M, Ottani F, Landenson J H, Ferrini D, Destro A, Baccos D. Adverse influence of elevated cardiac troponin I in patients with unstable angina (Abstract).  Circulation. 1995;  92 598
  • 17 Galvani M, Ottani F, Ferrini D, Landenson J H, Destro A, Baccos D, Rusticali F, Jaffe A S. Prognostic influence of elevated values of cardiac troponin I in unstable angina.  Circulation. 1997;  95 2053-9
  • 18 Hamm C W, Goldmann B U, Heeschen C, Kreymann G, Berger J, Meinertz T. Emergency room triage of patients with acute chest pain by means of rapid testing for cardiac troponin T or troponin I.  N Engl J Med. 1997;  337 1648-53
  • 19 Koller A, Mair J, Mayr M, Calzolari C, Larue C, Puschendorf B. Diagnosis of myocardial injury in marathon runners.  Ann N Y Acad Sci. 1995;  752 234-5
  • 20 Laslett L, Eisenbud E, Lind R. Evidence of myocardial injury during prolonged strenuous exercise.  Am J Cardiol. 1996;  78 488-90
  • 21 Lucía A, Serratosa L, Saborido A, Pardo J, Boraita A, Morán M, Bandrés F, Megía A, Chicharro J L. Short-term effects of marathon running: no evidence of cardiac dysfunction. Med Sci Sports Exerc. 1999 in press
  • 22 Mair J, Koller A, Artner-Dworzak E, Haid C, Wicke K, Judmaier W, Puschendorf B. Effects of exercise on plasma myosin heavy chain fragments and MRI of skeletal muscle.  J Appl Physiol. 1992;  72 656-63
  • 23 Mair J, Morandell D, Genser N, Lechleitner P, Dienstl F, Puschendorf B. Equivalent early sensitivities of myoglobin, creatine kinase MG mass, creatine kinase isoform ratios, and cardiac troponins I and T for acute myocardial infarction.  Clin Chem. 1995;  41 1266-72
  • 24 Mair J, Genser N, Morandell D, Maier J, Mair P, Lechleitner P, Calzolari C, Larue C, Ambach E, Dienstl F, Pau B, Puschendorf B. Cardiac troponin I in the diagnosis of myocardial injury and infarction.  Clin Chim Acta. 1996;  245 19-38
  • 25 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 (letter).  Am J Cardiol. 1997;  80 543-4
  • 26 Musha H, Nagashima J, Awaya T, Oomiya K, Takada H, Murayama M. Myocardial injury in a 100 km ultramarathon.  Curr Ther Res Clin. 1997;  58 587-93
  • 27 Ohman E M, Teo K K, Johnson A H, Collins P B, Dowsett D G, Ennis J T, Horgan J H. Abnormal cardiac enzyme responses after strenuous exercise: alternative diagnostic aids.  Br Med J. 1982;  285 1523-6
  • 28 Ordóñez-Llanos J, Serra-Grima J R, Mercé-Muntañola J, González-Sastre F. Ratio of creatine kinase 2 mass concentration to total creatine kinase activity not altered by heavy physical exercise.  Clin Chem. 1992;  38 2224-7
  • 29 Polanczyk C A, Lee T H, Cook E F, Walls R, Wybenga D, Printy-Klein G, Ludwig L, Guldbrandsen G, Johnson P A. Cardiac troponin as a predictor of major cardiac events in emergency department patients with acute chest pain.  J Am Coll Cardiol. 1998;  32 8-14
  • 30 Schulman S P, Lakatta E G, Fleg J L, Lakatta L, Becker L C, Gerstenblith G. Age-related decline in left ventricular filling at rest and exercise.  Am J Physiol. 1992;  263 8
  • 31 Siegel A J, Silverman L M, Holman B L. Elevated creatine kinase MB isoenzyme levels in marathon runners: Normal myocardial scintigrams suggest noncardiac source.  J Am Med Assoc. 1981;  246 2049-51
  • 32 Siegel A J, Sholar M, Yang J, Dhanak E, Lewandrowski K B. Elevated serum cardiac markers in asymptomatic marathon runners after competition: is the myocardium stunned?.  Cardiology. 1997;  88 487-91
  • 33 Spina R J, Miller T R, Bogenhagen W H, Schechtman K B, Ehsani A A. Gender-related differences in left ventricular filling dynamics in older subjects after endurance exercise training.  J Geront. 1996;  1A 7
  • 34 Spirduso W W. Cardiovascular and pulmonary function. In: Spirdusso WW (ed). Physical Dimensions of Aging.  Champaign, IL,; Human Kinetics, 1995: 95-122
  • 35 Wu A, Xue-Ming W, Gornet T G, Ordóñez-Llanos J. Creatine kinase MB isoforms in patients with skeletal muscle injury: ramifications for early detection of acute myocardial infarction.  Clin Chem. 1992;  38 2396-400
  • 36 Wu A HB, Feng Y J, Contois J H, Azar R, Waters D. Prognostic value of cardiac troponin I in patients with chest pain.  Clin Chem. 1996;  42 651-2

PhD MD José L. Chicharro

Escuela de Enfermería, Fisioterapia y Podología Facultad de Medicina Universidad Complutense de Madrid

E-28040 Madrid

Spain

Phone: +34 (1) 3941366

Fax: +34 (1) 3941539

Email: jlchicharro@enf.ucm.es

    >