scholarly journals Determinants of Interindividual Variation in Exercise‐Induced Cardiac Troponin I Levels

Author(s):  
Magnus Bjørkavoll‐Bergseth ◽  
Christine Bjørkvik Erevik ◽  
Øyunn Kleiven ◽  
Thijs M. H. Eijsvogels ◽  
Øyvind Skadberg ◽  
...  

Background Postexercise cardiac troponin levels show considerable interindividual variations. This study aimed to identify the major determinants of this postexercise variation in cardiac troponin I (cTnI) following 3 episodes of prolonged high‐intensity endurance exercise. Methods and Results Study subjects were recruited among prior participants in a study of recreational cyclists completing a 91‐km mountain bike race in either 2013 or 2014 (first race). In 2018, study participants completed a cardiopulmonary exercise test 2 to 3 weeks before renewed participation in the same race (second race). Blood was sampled before and at 3 and 24 hours following all exercises. Blood samples were analyzed using the same Abbot high‐sensitivity cTnI STAT assay. Fifty‐nine individuals (aged 50±9 years, 13 women) without cardiovascular disease were included. Troponin values were lowest before, highest at 3 hours, and declining at 24 hours. The largest cTnI difference was at 3 hours following exercise between the most (first race) (cTnI: 200 [87–300] ng/L) and the least strenuous exercise (cardiopulmonary exercise test) (cTnI: 12 [7–23] ng/L; P <0.001). The strongest correlation between troponin values at corresponding times was before exercise ( r =0.92, P <0.0001). The strongest correlations at 3 hours were between the 2 races ( r =0.72, P <0.001) and at 24 hours between the cardiopulmonary exercise test and the second race ( r =0.83, P <0.001). Participants with the highest or lowest cTnI levels showed no differences in race performance or baseline echocardiographic parameters. Conclusions The variation in exercise‐induced cTnI elevation is largely determined by a unique individual cTnI response that is dependent on the duration of high‐intensity exercise and the timing of cTnI sampling. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02166216 .

Author(s):  
William J.M. Kinnear ◽  
James H. Hull

This chapter describes how desaturation during a cardiopulmonary exercise test (CPET) is uncommon. A fall of more than 4% from resting values is considered abnormal. Oxygen desaturation is usually caused by lung or pulmonary vascular disease, reflecting ventilation–perfusion inequality or impaired diffusion. Occasionally, a right-to-left shunt will open up in the heart during exercise. Some elite athletes show exercise-induced arterial hypoxaemia, when the ability of their muscles to utilize oxygen cannot be met by the subject’s ventilatory capacity.


Circulation ◽  
2019 ◽  
Vol 140 (10) ◽  
pp. 804-814 ◽  
Author(s):  
Vincent L. Aengevaeren ◽  
Maria T.E. Hopman ◽  
Paul D. Thompson ◽  
Esmée A. Bakker ◽  
Keith P. George ◽  
...  

2011 ◽  
Vol 43 (Suppl 1) ◽  
pp. 659
Author(s):  
Rob E. Shave ◽  
David Gaze ◽  
Ritan Mehta ◽  
Rachael Jeffries ◽  
Karen Williams ◽  
...  

2016 ◽  
Vol 49 (6) ◽  
pp. 421-432 ◽  
Author(s):  
Seoung Mann Sou ◽  
Christian Puelacher ◽  
Raphael Twerenbold ◽  
Max Wagener ◽  
Ursina Honegger ◽  
...  

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Federica Re ◽  
Geza Halasz ◽  
Francesco Moroni ◽  
Matteo Beltrami ◽  
Pasquale Baratta ◽  
...  

Abstract Aims Pulmonary arterial hypertension (PAH) has been described in patients with hypertrophic cardiomyopathy (HCM) and it was associated with a worse prognosis. Nevertheless in most HCM patients, despite normal pulmonary pressures at rest, congestive symptoms are elicited by exercise. In the present study, combining cardiopulmonary exercise test (CPET) with echocardiography, we aimed to evaluate the presence of exercise-induced pulmonary hypertension (EiPAH) its role in functional limitation and its prognostic significance in a cohort of patients with obstructive and non-obstructive HCM. Methods and results 182 HCM patients (35% females, mean age 47.5 ± 15.9) undergoing CPET. During CPET, LVOT velocities and trans-tricuspid gradient were measured. Thirty-seven patients (20%) developed sPAP &gt; 40 mmHg at peak exercise (EiPAH). EiPAH was associated with an lower exercise performance, larger left atrial volumes, higher left ventricular gradient and higher VE/VCO2 slope .At multivariable model baseline sPAP (P &lt; 0.0001) and baseline left ventricular obstruction (LVOT) (P = 0.028) were significantly associated with EiPAH .Kaplan-Meier curve analysis showed EiPAH was a significant predictor of HCM –related morbidity (hazards ratio: 6.21, 95% CI: 1.47–26.19; P = 0.05; 4.21, 95% CI: 1.94–9.12; P &lt; 0.001) for the primary and the secondary endpoint respectively. Conclusions EiPAH was present in about one fifth of HCM patients without evidence of elevated pulmonary pressures at rest, and was associated with adverse clinical outcome. Diagnosing EiPAH by exercise echo/CPET may help physicians to detect early stage of PAH requiring a closer clinical monitoring and individualized treatment strategies.


2016 ◽  
Vol 173 ◽  
pp. 8-17 ◽  
Author(s):  
Gino Lee ◽  
Raphael Twerenbold ◽  
Yunus Tanglay ◽  
Tobias Reichlin ◽  
Ursina Honegger ◽  
...  

2020 ◽  
Vol 19 (1) ◽  
pp. 40
Author(s):  
Francisco Tiago Oliveira De Oliveira ◽  
Paula Guerra Duplat ◽  
Cristiane Maria Carvalho Costa Dias

Background: Cardiovascular rehabilitation has the objective of reducing the risks of mortality and within this intervention there are two training modalities: high intensity interval training (HIIT) and moderate continuous intensity training (MIT). The exercise prescription is performed by cardiopulmonary exercise test. There are differences about which one is the best training for this patient. Aim: To compare the effects of HIIT and moderate continuous training on the variables of the cardiopulmonary exercise test (CPX) in patients with coronary artery disease. Methods: This is a systematic review of randomized clinical trials on coronary artery disease. This study was registered on PROSPERO. The search was executed on the databases: Medline, Scielo, Lilacs and Pedro. The selection of studies was a two-phase process: Reading of title and abstract and reading of full article. The data extraction was performed by the transcription of information. The methodological quality was evaluated by the PEDro scale and the risk of bias scale. The statistical analysis was performed using the RStudio software by random effect model and was applied the Q-Cochran test to evaluate the statistical heterogeneity. Results: 10 clinical trials were included. The methodological quality assessed by PEDro generated scores of four to nine, and the bias risk scale detected a low risk of bias. For the variables:  VO2 peak (p = 0.04), Ventilatory Threshold (p = 0.05), HR max (p = 0.01), SBP max (p = 0.02), the HIIT proved to be more effective. The other variables did not present differences between the two modalities. Conclusion: HIIT showed to be the most effective training modality for the increase of VO2 max, Ventilatory Threshold, SBP max and HR max.Keywords: coronary heart disease, high intensity interval training, moderate continuous training.


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