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[Biochemical changes after strenuous exercise – data from the Kalmar Ironman].

Jörg Carlsson1, Thony Ragnarsson2, Tom Danielsson2

  • 1Länssjukhuset - Medicin/kardiologi Kalmar, Sweden Länssjukhuset - Medicin/kardiologi Kalmar, Sweden.

Lakartidningen
|August 3, 2016
PubMed
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Strenuous exercise like Ironman triathlons can elevate cardiac biomarkers, including troponin T, potentially mimicking myocardial infarction. However, these changes in athletes typically resolve within days, questioning their clinical significance.

Area of Science:

  • Sports Medicine
  • Cardiovascular Physiology
  • Biochemistry

Background:

  • Prolonged strenuous exercise, such as triathlons, can induce biochemical changes.
  • These changes may affect biomarkers associated with cardiac, muscle, and kidney function.
  • Previous studies have indicated potential cardiac stress in endurance athletes.

Purpose of the Study:

  • To investigate biochemical changes in participants of the Kalmar Ironman 2015.
  • To assess cardiac, muscle, and kidney biomarkers following extreme endurance exercise.
  • To evaluate the pattern and resolution of troponin T elevations in athletes.

Main Methods:

  • Observational study of 30 participants (15 men, 15 women) in the Kalmar Ironman 2015.
  • Pre-race electrocardiograms (ECG) and echocardiograms were performed.

Related Experiment Videos

  • Post-race blood samples were analyzed for troponin T, creatine kinase, myoglobin, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and creatinine.
  • Biomarker levels were monitored for normalization, typically within 5-8 days.

    • Main Results:

    • A high frequency of abnormalities was observed in pre-race ECGs and echocardiograms.
    • Post-race, significant elevations in troponin T, creatine kinase, myoglobin, NT-proBNP, and creatinine were detected.
    • In nearly all participants, these elevated biomarkers returned to normal levels within 5-8 days.
    • The troponin T pattern in 29 out of 30 participants was consistent with myocardial infarction, though resolution occurred rapidly.

    Conclusions:

    • Strenuous endurance exercise leads to temporary elevations in cardiac biomarkers like troponin T.
    • The clinical significance of these exercise-induced troponin elevations remains unclear, with ongoing debate about myocardial damage versus transient membrane permeability changes.
    • Further research is needed to differentiate between true myocardial injury and benign physiological responses in athletes.