Cardiospecificity of the 3rd generation cardiac troponin T assay during and after a 216 km ultra-endurance marathon run in Death Valley
Tóm tắt
The reasons
for the appearance of cardiacspecific
troponin (cTnT) after
strenuous exercise are unclear. The
aim of the present study was to
evaluate the cardiospecificity of the
3rd generation cardiac cTnT assay
during and after an ultra-endurance
race of 216 km at extreme
environmental conditions in Death
Valley. We measured serially cTnT, creatine
kinase (CK), activity and
mass of the isoenzyme MB of CK
(CK-MBact and CK-MBmass), and
myoglobin in 10 well-trained athletes
before, repeatedly during and
after the race. Six of 10
participants finished the race
within a preset time of 60 hours.
Postrace values of biochemical
markers CK, CK-MBact, CKMBmass,
and myoglobin were significantly
increased compared to
baseline (p<0.05). CK-MBact increased
from (median (25th/
75thpercentile) 12 (10/13) U/L to 72
(32/110) U/L, CK-MBmass from 3.9
(2.9/5.6) U/L to 65 (18/80) U/L and
CK increased from median 136 (98/
228) U/L to 3,570 (985/6,884) U/L
respectively. Pre-race myoglobin
was 27 (22/31) µg/l compared to
530 (178/657) µg/l after the run.
One runner developed significant
exercise-induced rhabdomyolysis
with spontaneous recovery. cTnT
values remained below the 99th
percentile reference limit in all
athletes including the runner who
developed significant rhabdomyolysis
(peak CK 27,951 U/L). Strenuous endurance exercise,
even under extreme environmental
conditions, does not
result in structural myocardial
damage in well-trained ultra-endurance
athletes. We found no
crossreactivity between cTnT and
CK, neither in exercise-induced
skeletal muscle trauma nor after
rhabdomyolysis underscoring the
excellent analytical performance of
3rd generation cTnT assay.
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