What question did this study set out to answer?

To assess whether elevations in cardiac enzymes and electrocardiographic abnormalities after marathon running indicate true myocardial damage.

November 27, 1982BMJOpen Access

Abnormal cardiac enzyme responses after strenuous exercise: alternative diagnostic aids

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To assess whether elevations in cardiac enzymes and electrocardiographic abnormalities after marathon running indicate true myocardial damage.
Assessed N=15 healthy, well-trained male marathon runners before and at 1, 24, and 96 hours after a race.
Measured serial serum levels of CK, CK-MB, AST, ALT, LDH, and alpha(1)-acid glycoprotein.
Performed electrocardiography and technetium-99m pyrophosphate myocardial scintigraphy before and 48 to 96 hours post-race.
Total CK and CK-MB peaked 24 hours post-race, with CK-MB comprising ≥5% of total CK in 2 of 15 subjects at 1 hour and 5 of 15 subjects at 96 hours.
LDH peaked at 1 hour, AST at 24 hours, and ALT at 96 hours post-race, with all enzymes demonstrating significant increases from baseline.
Technetium-99m pyrophosphate myocardial scintigraphy detected no myocardial injury, and alpha(1)-acid glycoprotein concentrations remained normal throughout.

Structured PICO

Population

15 healthy well-trained male marathon runners

Intervention

Strenuous exercise (marathon race)

Comparator

Prerace baseline assessment

Outcome

Serial estimations of activities of creatine kinase, creatine kinase MB, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, alpha(1)-acid glycoprotein, electrocardiographic features, and Technetium-99m pyrophosphate myocardial scintigraphysurrogate

Standard cardiac enzymes and ECG criteria may yield false-positive indicators of myocardial injury after strenuous exercise, whereas Technetium-99m pyrophosphate scintigraphy and alpha(1)-acid glycoprotein can help differentiate true injury.

Discussion

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Implication

Post-marathon enzyme rises and ECG changes may mislead on injury; leaves open scintigraphy role for confirmation in athletes.

Cite This Study

Ohman et al. (1982) studied this question.

synapsesocial.com/papers/6a76dbb3f6b553d308ae16ec https://doi.org/10.1136/bmj.285.6354.1523

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Abnormal cardiac enzyme responses after strenuous exercise: alternative diagnostic aids

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Abnormal cardiac enzyme responses after strenuous exercise: alternative diagnostic aids

Key Points

Structured PICO

Discussion

Implication

Cite This Study