Endurance exercise can cause elevations in cardiac biomarkers such as troponin and BNP in healthy athletes, though it remains unclear if this represents clinically significant cardiac insult.
Does prolonged endurance exercise cause clinically significant increases in cardiac biomarkers in healthy athletes?
Provides an overview of exercise-induced cardiac biomarker elevations to aid clinicians in differential diagnosis and avoid inappropriate interventions in athletes.
At present, the risk of myocardial damage by endurance exercise is under debate because of reports on exercise-associated increases in cardiac biomarkers troponin and B-type natriuretic peptide (BNP); these markers are typically elevated in patients with acute myocardial infarction and chronic heart failure, respectively. Exercise-associated elevations of cardiac biomarkers can be present in elite and in recreational athletes, especially after prolonged and strenuous endurance exercise bouts (e.g., marathon and ultratriathlon). However, in contrast to cardiac patients, it is still unclear if the exercise-associated appearance or increase in cardiac biomarkers in obviously healthy athletes represents clinically significant cardiac insult or is indeed part of the physiological response to endurance exercise. In addition, elevations in cardiac biomarkers in athletes after exercise may generate difficulties for clinicians in terms of differential diagnosis and may result in inappropriate consequences. Therefore, the aim of this article is to provide an overview of exercise-associated alterations of the cardiac biomarkers troponin T and I, ischemia-modified albumin, BNP, and its cleaved inactive fragment N-terminal pro BNP for the athlete, coach, scientist, and clinician.
Scharhag et al. (2008) conducted a review in Exercise-associated increases in cardiac biomarkers. Endurance exercise was evaluated. Endurance exercise can cause elevations in cardiac biomarkers such as troponin and BNP in healthy athletes, though it remains unclear if this represents clinically significant cardiac insult.