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Abnormal cardiac enzyme responses after strenuous exercise: alternative diagnostic aids
British Medical Journal (Clinical Research Ed.)
|November 27, 1982
Summary
Marathon running can elevate cardiac enzyme levels, mimicking heart injury. Technetium-99m pyrophosphate scintigraphy and alpha(1)-acid glycoprotein measurements help differentiate true myocardial damage from exercise-induced changes.
Area of Science:
- Sports Medicine
- Cardiology
- Biochemistry
Background:
- Marathon running is a strenuous exercise that can impact cardiac biomarkers.
- Assessing cardiac health after endurance events is crucial for differentiating physiological adaptations from pathological conditions.
Purpose of the Study:
- To evaluate serial changes in cardiac enzymes and other markers post-marathon.
- To investigate the utility of myocardial scintigraphy and alpha(1)-acid glycoprotein in assessing cardiac status in marathon runners.
Main Methods:
- Serial measurements of creatine kinase (CK), CK-MB, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) in 15 male marathon runners.
- Technetium-99m pyrophosphate myocardial scintigraphy performed pre-race and post-race.
- Monitoring of alpha(1)-acid glycoprotein concentrations and electrocardiographic (ECG) features.
Main Results:
- Cardiac enzyme activities (CK, CK-MB, LDH, AST, ALT) increased significantly post-marathon, peaking at different intervals.
- ECG showed changes common in athletes, but myocardial scintigraphy did not reveal myocardial damage.
- Alpha(1)-acid glycoprotein levels remained normal throughout the study.
Conclusions:
- Standard enzyme tests and ECG may indicate false-positive myocardial injury after prolonged strenuous exercise.
- Technetium-99m pyrophosphate scintigraphy and alpha(1)-acid glycoprotein measurements provide valuable complementary information for evaluating cardiac status.