The Korean Journal of Physiology and Pharmacology

The Korean Society of Pharmacology (대한약리학회)
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Cardiac Damage Biomarkers Following a Triathlon in Elite and Non-elite Triathletes

  • Park, Chan-Ho (Department of Physical Education, Pusan National University) ;
  • Kim, Kwi-Baek (Department of Sports & Health Management, Youngsan University) ;
  • Han, Jin (National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University) ;
  • Ji, Jin-Goo (Department of Physical Education, Dong-Eui University) ;
  • Kwak, Yi-Sub (Department of Physical Education, Dong-Eui University)
  • Received : 2014.06.12
  • Accepted : 2014.08.18
  • Published : 2014.10.30
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Abstract

The purpose of the present study was to investigate cardiac damage biomarkers after a triathlon race in elite and non-elite athlete groups. Fifteen healthy men participated in the study. Based on performance, they were divided into elite athlete group (EG: n＝7) and non-elite athlete group (NEG: n＝8). Participants' blood samples were obtained during four periods: before, immediately, 2 hours and 7 days after finishing the race. creatine kinase (CK), creatine kinase-myoglobin (CK-MB), myoglobin, and lactate dehydrogenase (LDH) were significantly increased in both groups immediately after, and 2 hours after finishing the race (p<.05). CK, CK-MB, and myoglobin were completely recovered after 7 days (p<.05). Hematocrit (Hct) was significantly decreased in both groups (p<.05) 7 days after the race. LDH was significantly decreased in the EG (p<.05) only 7 days after the race. Homoglobin (Hb) was significantly decreased in the NEG (p<.05) only 2 hours after the race. Although cardiac troponin T (cTnT) was significantly increased in the EG but not in the NEG 2hours after the race (p<.05), there was no group-by-time interaction. cTnT was completely recovered in both groups 7 days after the race. In conclusion, cardiac damage occurs during a triathlon race and, is greater in elite than in non-elite. However, all cardiac damage markers return to normal range within 1 week.

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References

  1. Frassl W, Kowoll R, Katz N, Speth M, Stangl A, Brechtel L, Joscht B, Boldt LH, Meier-Buttermilch R, Schlemmer M, Roecker L, Gunga HC. Cardiac markers (BNP, NT-pro-BNP, Troponin I, Troponin T, in female amateur runners before and up until three days after a marathon. Clin Lab. 2008;54:81-87.
  2. Fortescue EB, Shin AY, Greenes DS, Mannix RC, Agarwal S, Feldman BJ, Shah MI, Rifai N, Landzberg MJ, Newburger JW, Almond CS. Cardiac troponin increases among runners in the Boston Marathon. Ann Emerg Med. 2007;49:137-143. https://doi.org/10.1016/j.annemergmed.2006.09.024
  3. Kratz A, Lewandrowski KB, Siegel AJ, Chun KY, Flood JG, Van Cott EM, Lee-Lewandrowski E. Effect of marathon running on hematologic and biochemical laboratory parameters, including cardiac markers. Am J Clin Pathol. 2002;118:856-863. https://doi.org/10.1309/14TY-2TDJ-1X0Y-1V6V
  4. Neubauer O, Konig D, Wagner KH. Recovery after an Ironman triathlon: sustained inflammatory responses and muscular stress. Eur J Appl Physiol. 2008;104:417-426. https://doi.org/10.1007/s00421-008-0787-6
  5. Sulzer NU, Schwellnus MP, Noakes TD. Serum electrolytes in Ironman triathletes with exercise-associated muscle cramping. Med Sci Sports Exerc. 2005;37:1081-1085. https://doi.org/10.1249/01.mss.0000169723.79558.cf
  6. Suzuki K, Peake J, Nosaka K, Okutsu M, Abbiss CR, Surriano R, Bishop D, Quod MJ, Lee H, Martin DT, Laursen PB. Changes in markers of muscle damage, inflammation and HSP70 after an Ironman Triathlon race. Eur J Appl Physiol. 2006;98:525-534. https://doi.org/10.1007/s00421-006-0296-4
  7. Tulloh L, Robinson D, Patel A, Ware A, Prendergast C, Sullivan D, Pressley L. Raised troponin T and echocardiographic abnormalities after prolonged strenuous exercise--the Australian Ironman Triathlon. Br J Sports Med. 2006;40:605-609. https://doi.org/10.1136/bjsm.2005.022319
  8. Kim K, Kyung T, Kim W, Shin C, Song Y, Lee MY, Lee H, Cho Y. Efficient management design for swimming exercise treatment. Korean J Physiol Pharmacol. 2009;13:497-502. https://doi.org/10.4196/kjpp.2009.13.6.497
  9. O'Toole ML, Hiller WD, Roalstad MS, Douglas PS. Hemolysis during triathlon races: its relation to race distance. Med Sci Sports Exerc. 1988;20:272-275. https://doi.org/10.1249/00005768-198806000-00010
  10. Park CH, Park TG, Kim TU, Kwak YS. Changes of immunlogical markers in elite and amateur triathletes. International SportMed Journal. 2008;9:116-130.
  11. Lippi G, Schena F, Salvagno GL, Montagnana M, Gelati M, Tarperi C, Banfi G, Guidi GC. Acute variation of biochemical markers of muscle damage following a 21-km, half-marathon run. Scand J Clin Lab Invest. 2008;68:667-672. https://doi.org/10.1080/00365510802126844
  12. Park CH, Kwak YS, Kim TU. Triathlon-related overuse injury and medical issues. Journal of Life Science. 2010;20:314-320. https://doi.org/10.5352/JLS.2010.20.2.314
  13. Whyte GP. Clinical significance of cardiac damage and changes in function after exercise. Med Sci Sports Exerc. 2008;40:1416-1423. https://doi.org/10.1249/MSS.0b013e318172cefd
  14. Lim CL, Mackinnon LT. The roles of exercise-induced immune system disturbances in the pathology of heat stroke : the dual pathway model of heat stroke. Sports Med. 2006;36:39-64. https://doi.org/10.2165/00007256-200636010-00004
  15. Smith JE, Garbutt G, Lopes P, Pedoe DT. Effects of prolonged strenuous exercise (marathon running) on biochemical and haematological markers used in the investigation of patients in the emergency department. Br J Sports Med. 2004;38:292-294. https://doi.org/10.1136/bjsm.2002.002873
  16. Engel G, Rockson SG. Rapid diagnosis of myocardial injury with troponin T and CK-MB relative index. Mol Diagn Ther. 2007;11:109-116. https://doi.org/10.1007/BF03256230
  17. Brancaccio P, Maffulli N, Limongelli FM. Creatine kinase monitoring in sport medicine. Br Med Bull. 2007;81-82:209-230. https://doi.org/10.1093/bmb/ldm014
  18. Jassal DS, Moffat D, Krahn J, Ahmadie R, Fang T, Eschun G, Sharma S. Cardiac injury markers in non-elite marathon runners. Int J Sports Med. 2009;30:75-79. https://doi.org/10.1055/s-0028-1104572
  19. Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research. Int J Sports Med. 2009;30:701-702. https://doi.org/10.1055/s-0029-1237378
  20. Maron BJ, Pelliccia A. The heart of trained athletes: cardiac remodeling and the risks of sports, including sudden death. Circulation. 2006;114:1633-1644. https://doi.org/10.1161/CIRCULATIONAHA.106.613562
  21. Albert CM, Mittleman MA, Chae CU, Lee IM, Hennekens CH, Manson JE. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med. 2000;343:1355-1361. https://doi.org/10.1056/NEJM200011093431902
  22. Corrado D, Basso C, Rizzoli G, Schiavon M, Thiene G. Does sports activity enhance the risk of sudden death in adolescents and young adults? J Am Coll Cardiol. 2003;42:1959-1963. https://doi.org/10.1016/j.jacc.2003.03.002
  23. Kanter MM. Free radicals, exercise, and antioxidant supplementation. Int J Sport Nutr. 1994;4:205-220.
  24. Farber H, Arbetter J, Schaeffer E, Hill S, Dallal G, Grimaldi R, Hill N. Acute metabolic effects of an endurance triathlon. Ann Sports Med. 1987;3:131-138.
  25. Roth HJ, Leithauser RM, Doppelmayr H, Doppelmayr M, Finkernagel H, von Duvillard SP, 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. https://doi.org/10.1007/s00392-007-0509-9
  26. Frontera WR, Meredith CN, O'Reilly KP, Evans WJ. Strength training and determinants of VO2max in older men. J Appl Physiol (1985). 1990;68:329-333.
  27. Mair J, Thome-Kromer B, Wagner I, Lechleitner P, Dienstl F, Puschendorf B, Michel G. Concentration time courses of troponin and myosin subunits after acute myocardial infarction. Coron Artery Dis. 1994;5:865-872.
  28. Fehrenbach E, Niess AM, Schlotz E, Passek F, Dickhuth HH, Northoff H. Transcriptional and translational regulation of heat shock proteins in leukocytes of endurance runners. J Appl Physiol (1985). 2000;89:704-710.
  29. Yamin C, Oliveira J, Meckel Y, Eynon N, Sagiv M, Ayalon M, Alves AJ, Duarte JA. CK-MM gene polymorphism does not influence the blood CK activity levels after exhaustive eccentric exercise. Int J Sports Med. 2010;31:213-217. https://doi.org/10.1055/s-0029-1243256
  30. Douglas PS, O'Toole ML, Katz SE. Prolonged exercise alters cardiac chronotropic responsiveness in endurance athletes. J Sports Med Phys Fitness. 1998;38:158-163.
  31. 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 (1985). 2000;88:1749-1755.
  32. Konig D, Schumacher YO, Heinrich L, Schmid A, Berg A, Dickhuth HH. Myocardial stress after competitive exercise in professional road cyclists. Med Sci Sports Exerc. 2003;35:1679-1683. https://doi.org/10.1249/01.MSS.0000089248.37173.E7
  33. 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. https://doi.org/10.1097/00005768-200204000-00014
  34. Leetmaa TH, Dam A, Glintborg D, Markenvard JD. Myocardial response to a triathlon in male athletes evaluated by Doppler tissue imaging and biochemical parameters. Scand J Med Sci Sports. 2008;18:698-705. https://doi.org/10.1111/j.1600-0838.2007.00647.x
  35. Michielsen EC, Wodzig WK, Van Dieijen-Visser MP. Cardiac troponin T release after prolonged strenuous exercise. Sports Med. 2008;38:425-435. https://doi.org/10.2165/00007256-200838050-00005
  36. Mair J, Dienstl F, Puschendorf B. Cardiac troponin T in the diagnosis of myocardial injury. Crit Rev Clin Lab Sci. 1992;29: 31-57. https://doi.org/10.3109/10408369209105245
  37. Park CH, Kim TU. The effect of different triathlon on weight, sodium and hematological changes. Journal of Life Science. 2009;19:46-51. https://doi.org/10.5352/JLS.2009.19.1.046

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