Exercise-Induced Cardiac Troponin Elevations: From Underlying Mechanisms to Clinical Relevance
Vincent L Aengevaeren1,2, Aaron L Baggish3, Eugene H Chung4
1Radboud Institute for Health Sciences, Departments of Physiology (V.L.A., T.M.H.E.), Radboud University Medical Center, Nijmegen, The Netherlands.
Circulation
|December 13, 2021
Summary
Exercise can cause cardiac troponin (cTn) levels to rise, but recent research suggests these elevations may not be benign. Understanding exercise-induced cTn release is crucial for assessing cardiovascular health and future event risk.
Area of Science:
- Cardiology
- Biochemistry
- Exercise Physiology
Background:
- Serological assessment of cardiac troponins (cTn) is standard for myocardial injury.
- Elevated cTn levels correlate with reduced event-free survival.
- Exercise training improves cardiovascular health but can acutely raise cTn.
Purpose of the Study:
- To review the mechanisms and clinical relevance of exercise-induced cTn elevations.
- To explore the association of these elevations with cardiac function and cardiovascular disease.
- To provide recommendations for interpreting cTn findings in athletes and active individuals.
Main Methods:
- Review of biochemical characteristics of cTn assays.
- Analysis of factors influencing post-exercise cTn concentrations.
- Examination of cTn release kinetics and underlying mechanisms.
Main Results:
- Exercise-induced cTn elevations may exceed upper reference limits.
- Recent studies challenge the view of exercise-induced cTn elevations as solely benign.
- Findings link cTn release to cardiac function and cardiovascular disease risk.
Conclusions:
- The clinical relevance of exercise-induced cTn elevations requires further investigation.
- Understanding these elevations is key for accurate risk stratification.
- Future research should focus on the predictive value of exercise-induced cTn for cardiovascular events.
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