Troponin release following endurance exercise

Is inflammation the cause? A cardiovascular magnetic resonance study

Rory O'Hanlon, Mat Wilson, Riccardo Wage, Gillian Smith, Francisco Alpendurada, Joyce Wong, Annette Dahl, Dave Oxborough, Richard Godfrey, Sanjay Sharma, Michael Roughton, Keith George, Dudley Pennell, Greg Whyte, Sanjay Prasad

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background. The aetiology and clinical significance of troponin release following endurance exercise is unclear but may be due to transient myocardial inflammation. Cardiovascular magnetic resonance (CMR) affords us the opportunity to evaluate the presence of myocardial inflammation and focal fibrosis and is the ideal imaging modality to study this hypothesis. We sought to correlate the relationship between acute bouts of ultra endurance exercise leading to cardiac biomarkers elevation and the presence of myocardial inflammation and fibrosis using CMR. Methods. 17 recreation athletes (33.5 6.5 years) were studied before and after a marathon run with troponin, NTproBNP, and CMR. Specific imaging parameters to look for inflammation included T2 weighted images, and T1 weighted spin-echo images before and after an intravenous gadolinium-DTPA to detect myocardial hyperemia secondary to inflammation. Late gadolinium imaging was performed (LGE) to detect any focal regions of replacement fibrosis. Results. Eleven of the 17 participant had elevations of TnI above levels of cut off for myocardial infarction 6 hrs after the marathon (0.075 0.02, p = 0.007). Left ventricular volumes were reduced post marathon and a small increase in ejection fraction was noted (64 1% pre, 67 1.2% post, P = 0.014). Right ventricular volumes, stroke volume, and ejection fraction were unchanged post marathon. No athlete fulfilled criteria for myocardial inflammation based on current criteria. No regions of focal fibrosis were seen in any of the participants. Conclusion. Exercise induced cardiac biomarker release is not associated with any functional changes by CMR or any detectable myocardial inflammation or fibrosis.

Original languageEnglish
Article number38
Pages (from-to)1-7
Number of pages7
JournalJournal of Cardiovascular Magnetic Resonance
Volume12
Issue number1
DOIs
Publication statusPublished - 2010
Externally publishedYes

Fingerprint

Troponin
Magnetic Resonance Spectroscopy
Exercise
Inflammation
Fibrosis
Athletes
Biomarkers
Recreation
Gadolinium DTPA
Hyperemia
Gadolinium
Stroke Volume
Myocardial Infarction

Cite this

O'Hanlon, Rory ; Wilson, Mat ; Wage, Riccardo ; Smith, Gillian ; Alpendurada, Francisco ; Wong, Joyce ; Dahl, Annette ; Oxborough, Dave ; Godfrey, Richard ; Sharma, Sanjay ; Roughton, Michael ; George, Keith ; Pennell, Dudley ; Whyte, Greg ; Prasad, Sanjay. / Troponin release following endurance exercise : Is inflammation the cause? A cardiovascular magnetic resonance study. In: Journal of Cardiovascular Magnetic Resonance. 2010 ; Vol. 12, No. 1. pp. 1-7.
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abstract = "Background. The aetiology and clinical significance of troponin release following endurance exercise is unclear but may be due to transient myocardial inflammation. Cardiovascular magnetic resonance (CMR) affords us the opportunity to evaluate the presence of myocardial inflammation and focal fibrosis and is the ideal imaging modality to study this hypothesis. We sought to correlate the relationship between acute bouts of ultra endurance exercise leading to cardiac biomarkers elevation and the presence of myocardial inflammation and fibrosis using CMR. Methods. 17 recreation athletes (33.5 6.5 years) were studied before and after a marathon run with troponin, NTproBNP, and CMR. Specific imaging parameters to look for inflammation included T2 weighted images, and T1 weighted spin-echo images before and after an intravenous gadolinium-DTPA to detect myocardial hyperemia secondary to inflammation. Late gadolinium imaging was performed (LGE) to detect any focal regions of replacement fibrosis. Results. Eleven of the 17 participant had elevations of TnI above levels of cut off for myocardial infarction 6 hrs after the marathon (0.075 0.02, p = 0.007). Left ventricular volumes were reduced post marathon and a small increase in ejection fraction was noted (64 1{\%} pre, 67 1.2{\%} post, P = 0.014). Right ventricular volumes, stroke volume, and ejection fraction were unchanged post marathon. No athlete fulfilled criteria for myocardial inflammation based on current criteria. No regions of focal fibrosis were seen in any of the participants. Conclusion. Exercise induced cardiac biomarker release is not associated with any functional changes by CMR or any detectable myocardial inflammation or fibrosis.",
author = "Rory O'Hanlon and Mat Wilson and Riccardo Wage and Gillian Smith and Francisco Alpendurada and Joyce Wong and Annette Dahl and Dave Oxborough and Richard Godfrey and Sanjay Sharma and Michael Roughton and Keith George and Dudley Pennell and Greg Whyte and Sanjay Prasad",
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O'Hanlon, R, Wilson, M, Wage, R, Smith, G, Alpendurada, F, Wong, J, Dahl, A, Oxborough, D, Godfrey, R, Sharma, S, Roughton, M, George, K, Pennell, D, Whyte, G & Prasad, S 2010, 'Troponin release following endurance exercise: Is inflammation the cause? A cardiovascular magnetic resonance study', Journal of Cardiovascular Magnetic Resonance, vol. 12, no. 1, 38, pp. 1-7. https://doi.org/10.1186/1532-429X-12-38

Troponin release following endurance exercise : Is inflammation the cause? A cardiovascular magnetic resonance study. / O'Hanlon, Rory; Wilson, Mat; Wage, Riccardo; Smith, Gillian; Alpendurada, Francisco; Wong, Joyce; Dahl, Annette; Oxborough, Dave; Godfrey, Richard; Sharma, Sanjay; Roughton, Michael; George, Keith; Pennell, Dudley; Whyte, Greg; Prasad, Sanjay.

In: Journal of Cardiovascular Magnetic Resonance, Vol. 12, No. 1, 38, 2010, p. 1-7.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Troponin release following endurance exercise

T2 - Is inflammation the cause? A cardiovascular magnetic resonance study

AU - O'Hanlon, Rory

AU - Wilson, Mat

AU - Wage, Riccardo

AU - Smith, Gillian

AU - Alpendurada, Francisco

AU - Wong, Joyce

AU - Dahl, Annette

AU - Oxborough, Dave

AU - Godfrey, Richard

AU - Sharma, Sanjay

AU - Roughton, Michael

AU - George, Keith

AU - Pennell, Dudley

AU - Whyte, Greg

AU - Prasad, Sanjay

PY - 2010

Y1 - 2010

N2 - Background. The aetiology and clinical significance of troponin release following endurance exercise is unclear but may be due to transient myocardial inflammation. Cardiovascular magnetic resonance (CMR) affords us the opportunity to evaluate the presence of myocardial inflammation and focal fibrosis and is the ideal imaging modality to study this hypothesis. We sought to correlate the relationship between acute bouts of ultra endurance exercise leading to cardiac biomarkers elevation and the presence of myocardial inflammation and fibrosis using CMR. Methods. 17 recreation athletes (33.5 6.5 years) were studied before and after a marathon run with troponin, NTproBNP, and CMR. Specific imaging parameters to look for inflammation included T2 weighted images, and T1 weighted spin-echo images before and after an intravenous gadolinium-DTPA to detect myocardial hyperemia secondary to inflammation. Late gadolinium imaging was performed (LGE) to detect any focal regions of replacement fibrosis. Results. Eleven of the 17 participant had elevations of TnI above levels of cut off for myocardial infarction 6 hrs after the marathon (0.075 0.02, p = 0.007). Left ventricular volumes were reduced post marathon and a small increase in ejection fraction was noted (64 1% pre, 67 1.2% post, P = 0.014). Right ventricular volumes, stroke volume, and ejection fraction were unchanged post marathon. No athlete fulfilled criteria for myocardial inflammation based on current criteria. No regions of focal fibrosis were seen in any of the participants. Conclusion. Exercise induced cardiac biomarker release is not associated with any functional changes by CMR or any detectable myocardial inflammation or fibrosis.

AB - Background. The aetiology and clinical significance of troponin release following endurance exercise is unclear but may be due to transient myocardial inflammation. Cardiovascular magnetic resonance (CMR) affords us the opportunity to evaluate the presence of myocardial inflammation and focal fibrosis and is the ideal imaging modality to study this hypothesis. We sought to correlate the relationship between acute bouts of ultra endurance exercise leading to cardiac biomarkers elevation and the presence of myocardial inflammation and fibrosis using CMR. Methods. 17 recreation athletes (33.5 6.5 years) were studied before and after a marathon run with troponin, NTproBNP, and CMR. Specific imaging parameters to look for inflammation included T2 weighted images, and T1 weighted spin-echo images before and after an intravenous gadolinium-DTPA to detect myocardial hyperemia secondary to inflammation. Late gadolinium imaging was performed (LGE) to detect any focal regions of replacement fibrosis. Results. Eleven of the 17 participant had elevations of TnI above levels of cut off for myocardial infarction 6 hrs after the marathon (0.075 0.02, p = 0.007). Left ventricular volumes were reduced post marathon and a small increase in ejection fraction was noted (64 1% pre, 67 1.2% post, P = 0.014). Right ventricular volumes, stroke volume, and ejection fraction were unchanged post marathon. No athlete fulfilled criteria for myocardial inflammation based on current criteria. No regions of focal fibrosis were seen in any of the participants. Conclusion. Exercise induced cardiac biomarker release is not associated with any functional changes by CMR or any detectable myocardial inflammation or fibrosis.

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