Key result
Strenuous endurance cycling increases myocardial T1 relaxation time by ~50 ms and elevates cTnI.
Why the study?
Although cardiac troponin I increases after strenuous exercise, the development of exercise-induced myocardial edema remains unclear.
Does strenuous endurance exercise induce acute myocardial changes (T1/T2 relaxation times, RV dysfunction, and cTnI release) in recreational male cyclists?
Cohort (n=19)
Blinded outcome assessment
Yes
Does strenuous endurance exercise induce acute myocardial changes (T1/T2 relaxation times, RV dysfunction, and cTnI release) in recreational male cyclists?
Absolute Event Rate: 1182% vs 1133%
p-value: p=<0.001
Strenuous endurance cycling induces acute, correlated increases in myocardial T1 relaxation time and cardiac troponin I, alongside right ventricular dysfunction, suggesting transient exercise-induced myocardial edema.
May signal transient myocardial edema after strenuous cycling; leaves open long-term prognostic implications in recreational athletes.
PURPOSE: Although cardiac troponin I (cTnI) increase following strenuous exercise has been observed, the development of exercise-induced myocardial edema remains unclear. Cardiac magnetic resonance (CMR) native T1/T2 mapping is sensitive to the pathological increase of myocardial water content. Therefore, we evaluated exercise-induced acute myocardial changes in recreational cyclists by incorporating biomarkers, echocardiography and CMR. METHODS: Nineteen male recreational participants (age: 48 ± 5 years) cycled the 'L'étape du tour de France" (EDT) 2021' (175 km, 3600 altimeters). One week before the race, a maximal graded cycling test was conducted to determine individual heart rate (HR) training zones. One day before and 3-6 h post-exercise 3 T CMR and echocardiography were performed to assess myocardial native T1/T2 relaxation times and cardiac function, and blood samples were collected. All participants were asked to cycle 2 h around their anaerobic gas exchange threshold (HR zone 4). RESULTS: Eighteen participants completed the EDT stage in 537 ± 58 min, including 154 ± 61 min of cycling time in HR zone 4. Post-race right ventricular (RV) dysfunction with reduced strain and increased volumes (p < 0.05) and borderline significant left ventricular global longitudinal strain reduction (p = 0.05) were observed. Post-exercise cTnI (0.75 ± 5.1 ng/l to 69.9 ± 41.6 ng/l; p < 0.001) and T1 relaxation times (1133 ± 48 ms to 1182 ± 46 ms, p < 0.001) increased significantly with no significant change in T2 (p = 0.474). cTnI release correlated with increase in T1 relaxation time (p = 0.002; r = 0.703), post-race RV dysfunction (p < 0.05; r = 0.562) and longer cycling in HR zone 4 (p < 0.05; r = 0.607). CONCLUSION: Strenuous exercise causes early post-race cTnI increase, increased T1 relaxation time and RV dysfunction in recreational cyclists, which showed interdependent correlation. The long-term clinical significance of these changes needs further investigation. TRIAL REGISTRATION NUMBERS AND DATE: NCT04940650 06/18/2021. NCT05138003 06/18/2021.
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Ghekiere et al. (2023) conducted a cohort in Healthy recreational cyclists (n=19). Strenuous endurance cycling vs. Baseline (pre-exercise) was evaluated on Myocardial native T1 relaxation time (p=<0.001). Strenuous endurance cycling significantly increased myocardial T1 relaxation time from 1133 ms to 1182 ms and elevated cardiac troponin I levels in recreational cyclists.
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