12 research outputs found
High-Sensitivity Cardiac Troponin I and T Response Following Strenuous Activity is Attenuated by Smokeless Tobacco: NEEDED (North Sea Race Endurance Exercise Study) 2014
Background
Use of snus, a smokeless tobacco product, is increasing in Scandinavia. Strenuous physical activity is associated with an acute increase in highâsensitivity cardiac troponin (swhsâcTn) concentrations. Current smoking is associated with lower hsâcTn, but whether this also holds true for smokeless tobacco and whether tobacco affects the hsâcTn response to exercise remain unknown.
Methods and Results
We measured hsâcTnI and hsâcTnT concentrations in 914 recreational athletes before and 3 and 24 hours after a 91âkm bicycle race. Selfâreported snus tobacco habits were reported as noncurrent (n=796) and current (n=118). The association between snus use and change in logâtransformed hsâcTnI and hsâcTnT concentrations (ie, the differences between concentrations at baseline and 3 hours and 24 hours ) were assessed by multivariable linear regression analysis. Concentrations of hsâcTn at baseline were lower in current than in noncurrent snus users (hsâcTnI median, 1.7 ng/L; Q1 to Q3: 1.6â2.3 versus 2.0 ng/L; Q1 to Q3: 1.6â3.2 [P=0.020]; and hsâcTnT: median, 2.9 ng/L, Q1 to Q3: 2.9â3.5 versus 2.9 ng/L, Q1 to Q3: 2.9â4.3 [P=0.021]). In fully adjusted multivariable models, use of snus was associated with lower change in hsâcTn concentrations from baseline to 3 hours (hsâcTnI: â29% [P=0.002], hsâcTnT: â18% [P=0.010]) and 24 hours (hscTnI: â30% [P=0.010], hsâcTnT â19%, [P=0.013]).
Conclusions
Resting hsâcTn concentrations are lower and the exerciseâinduced cardiac troponin response is attenuated in current users of smokeless tobacco compared with nonusers. Further insight into the pathophysiological processes underlying the attenuated cardiac troponin response to exercise in tobacco users is needed.publishedVersio
Occult obstructive coronary artery disease is associated with prolonged cardiac troponin elevation following strenuous exercise
Background
Sudden cardiac death among middle-aged recreational athletes is predominantly due to myocardial ischaemia. This study examined whether measuring cardiac troponin I and T (cTnI and cTnT) after strenuous exercise could identify occult obstructive coronary artery disease.
Design
Prospective observational study.
Methods
Subjects were recruited from 1002 asymptomatic recreational cyclists completing a 91-km mountain bike race (North Sea Race Endurance Exercise Study). No subject had known cardiovascular disease or took cardiovascular medication. Blood samples were collected within 24âh before and 3âh and 24âh after the race. Coronary computed tomography angiography was performed in 80 participants with the highest post-exercise cTnI and in 40 reference subjects with moderately elevated cTnI values.
Results
Study subjects (Nâ=â120) were 45 (36â52) years old and 74% were male. There were similar demographics in the High-cTnI group and the Reference group. The cTn concentrations were highest at 3âh post-race: cTnI, 224 (125â304) ng/L; cTnT, 89 (55â124) ng/L. Nine subjects had obstructive coronary artery disease on coronary computed tomography angiography, eight of whom were High-cTnI responders. Two subjects had myocardial bridging, both High-cTnI responders. Troponin concentrations at 24âh post-race were higher in subjects with obstructive coronary artery disease than in the rest of the cohort (nâ=â109): cTnI, 151 (72â233) ng/L vs. 24 (19â82) ng/L, pâ=â0.005; cTnT, 39 (25â55) ng/L vs. 20 (14â31) ng/L, pâ=â0.002. The areas under the receiver operating characteristic curves for predicting obstructive coronary artery disease were 0.79, pâ=â0.005 (cTnI) and 0.82, pâ=â0.002 (cTnT).
Conclusion
In subjects with occult obstructive coronary artery disease there was a prolonged elevation of cTn following strenuous exercise.acceptedVersio
Duration of elevated heart rate Is an important predictor of exercise-induced troponin elevation
Background
The precise mechanisms causing cardiac troponin (cTn) increase after exercise remain to be determined. The aim of this study was to investigate the impact of heart rate (HR) on exerciseâinduced cTn increase by using sports watch data from a large bicycle competition.
Methods and Results
Participants were recruited from NEEDED (North Sea Race Endurance Exercise Study). All completed a 91âkm recreational mountain bike race (North Sea Race). Clinical status, ECG, blood pressure, and blood samples were obtained 24 hours before and 3 and 24 hours after the race. Participants (n=177) were, on average, 44 years old; 31 (18%) were women. Both cTnI and cTnT increased in all individuals, reaching the highest level (of the 3 time points assessed) at 3 hours after the race (P150 beats per minute was a significant predictor of both cTnI and cTnT, at both 3 and 24 hours after exercise. Neither mean HR nor mean HR in percentage of maximum HR was a significant predictor of the cTn response at 3 and 24 hours after exercise.
Conclusions
The duration of elevated HR is an important predictor of physiological exerciseâinduced cTn elevation.publishedVersio
Endurance exercise training volume is not associated with progression of coronary artery calcification
Background
Recent crossâsectional studies have suggested a doseâdependent relationship between lifelong exposure to physical activity and the burden of calcified coronary artery disease (CAD). No longitudinal studies have addressed this concern.
Hypothesis
Exercise volume is associated with progression of coronary artery calcium (CAC), defined as âĽ10 units increase in CAC score.
Methods
Sixtyâone recreational athletes who were assessed by coronary computed tomography angiography (CCTA) as part of the NEEDED 2013/14 study were reâassessed 4â5 years later, in 2018.
Results
Subjects were 45.9 Âą 9.6 years old at inclusion, and 46 (74%) were male. Between 2013 and 2018, the participants reported median 5 (range: 0â20, 25thâ75th percentile: 4â6) hours of highâintensity exercise per week. None of the included subjects smoked during followâup. At inclusion, 21 (33%) participants had coronary artery calcifications. On followâup CCTA in 2018, 15 (25%) subjects had progressive coronary calcification (âĽ10 Agatston units increase in CAC). These subjects were older (53 Âą 9 vs 44 Âą 9 years old, P = .002) and had higher levels of lowâdensity lipoprotein at baseline (3.5 (2.9â4.3) vs 2.9 (2.3â3.5) mmol/L, P = .031) as compared to subjects with stable condition. No relationship was found between hours of endurance training per week and progression of coronary artery calcification. In multiple regression analysis, age and baseline CAC were the only significant predictors of progressive CAC.
Conclusion
No relationship between exercise training volume and the progression of coronary artery calcification was found in this longitudinal study of middleâaged recreational athletes.publishedVersio
The copeptin response after physical activity is not associated with cardiac biomarkers or asymptomatic coronary artery disease: The North Sea Race Endurance Exercise Study (NEEDED) 2013
Background:Copeptin concentrations increase both during acute coronary syndrome and following physicalexercise. The relationship between copeptin increase following physical exercise and coronary artery disease(CAD) is uncertain. The aim of this study was to 1) describe the copeptin response following strenuous physicalexercise, and 2) investigate the determinants of exercise induced copeptin concentrations, particularly in rela-tion to cardiac biomarkers and CAD.Methods:Serum samples were collected from 97 recreational cyclists 24 h before, and immediately, 3 and 24 hafter a 91-km bike race. Three subjects were subsequently diagnosed with significant asymptomatic CAD. Deltacopeptin concentrations were correlated to patient characteristics and to biomarker concentrations.Results:Participants were 42.8 Âą 9.6 years, and 76.3% were male. Copeptin concentrations increased tomaximal levels immediately after the race and were normalized in > 90% after 3 h. A total of 53% and 39%exceeded the 95th and 99th percentile of the assay (10 and 19 pmol/L) respectively. In multivariate models, racetime, serum sodium, creatinine and cortisol were significant predictors of copeptin levels. There was no cor-relation between changes in copeptin and changes in cardiac biomarkers (hs-cTnI, hs-cTnT and BNP). Copeptinconcentrations were normal in the subjects with asymptomatic CAD.Conclusions:The moderate, short-term, exercise induced copeptin increase observed in the present study was notrelated to hs-cTn or BNP levels. Copeptin was normal in three asymptomatic recreational athletes with significant CAD
Regular consumption of cod liver oil is associated with reduced basal and exercise-induced C-reactive protein levels; a prospective observational trial
Background
Dietary supplement use among recreational athletes is common, with the intention of reducing inflammation and improving recovery. We aimed to describe the relationship between omega-3 fatty acid supplement use and inflammation induced by strenuous exercise.
Methods
C-reactive protein (CRP) concentrations were measured in 1002 healthy recreational athletes before and 24âh after a 91-km bicycle race. The use of omega-3 fatty acid supplements was reported in 856 out of 1002 recreational athletes, and the association between supplement use and the exercise-induced CRP response was assessed.
Results
Two hundred seventy-four subjects reported regular use of omega-3 fatty acid supplements. One hundred seventy-three of these used cod liver oil (CLO). Regular users of omega-3 fatty acid supplements had significantly lower basal and exercise-induced CRP levels as compared to non-users (nâ=â348, pâ<â0.001). Compared to non-users, regular users had a 27% (95% confidence interval (CI): 14â40) reduction in Ln CRP response (unadjusted model, pâ<â0.001) and 16% (95% CI: 5â28, pâ=â0.006) reduction after adjusting for age, sex, race duration, body mass index, delta creatine kinase, MET hours per week, resting heart rate and higher education. CLO was the primary driver of this response with a 34% (95% CI: 19â49) reduction (unadjusted model, pâ<â0.001) compared to non-users. Corresponding numbers in the adjusted model were 24% (95% CI: 11â38, pâ<â0.001).
Conclusion
Basal CRP levels were reduced, and the exercise-induced CRP response was attenuated in healthy recreational cyclists who used omega-3 fatty acid supplements regularly. This effect was only present in regular users of CLO.publishedVersio
High-Sensitivity Cardiac Troponin I and T Response Following Strenuous Activity is Attenuated by Smokeless Tobacco: NEEDED (North Sea Race Endurance Exercise Study) 2014
Background
Use of snus, a smokeless tobacco product, is increasing in Scandinavia. Strenuous physical activity is associated with an acute increase in highâsensitivity cardiac troponin (swhsâcTn) concentrations. Current smoking is associated with lower hsâcTn, but whether this also holds true for smokeless tobacco and whether tobacco affects the hsâcTn response to exercise remain unknown.
Methods and Results
We measured hsâcTnI and hsâcTnT concentrations in 914 recreational athletes before and 3 and 24 hours after a 91âkm bicycle race. Selfâreported snus tobacco habits were reported as noncurrent (n=796) and current (n=118). The association between snus use and change in logâtransformed hsâcTnI and hsâcTnT concentrations (ie, the differences between concentrations at baseline and 3 hours and 24 hours ) were assessed by multivariable linear regression analysis. Concentrations of hsâcTn at baseline were lower in current than in noncurrent snus users (hsâcTnI median, 1.7 ng/L; Q1 to Q3: 1.6â2.3 versus 2.0 ng/L; Q1 to Q3: 1.6â3.2 [P=0.020]; and hsâcTnT: median, 2.9 ng/L, Q1 to Q3: 2.9â3.5 versus 2.9 ng/L, Q1 to Q3: 2.9â4.3 [P=0.021]). In fully adjusted multivariable models, use of snus was associated with lower change in hsâcTn concentrations from baseline to 3 hours (hsâcTnI: â29% [P=0.002], hsâcTnT: â18% [P=0.010]) and 24 hours (hscTnI: â30% [P=0.010], hsâcTnT â19%, [P=0.013]).
Conclusions
Resting hsâcTn concentrations are lower and the exerciseâinduced cardiac troponin response is attenuated in current users of smokeless tobacco compared with nonusers. Further insight into the pathophysiological processes underlying the attenuated cardiac troponin response to exercise in tobacco users is needed
Race duration and blood pressure are major predictors of exercise-induced cardiac troponin elevation
Background
The underlying mechanisms of the exercise-induced increase in cardiac troponins (cTn) are poorly understood. The aim of this study was to identify independent determinants of exercise-induced cTn increase in a large cohort of healthy recreational athletes.
Methods
A total of 1002 recreational cyclists without known cardiovascular disease or medication, participating in a 91-km mountain bike race were included. Median age was 47âŻyears and 78% were males. Blood samples were obtained 24âŻh prior to, and 3 and 24âŻh after the race.
Results
Cardiac TnI concentrations increased markedly from baseline [1.9 (1.6â3.0) ng/L] to 3âŻh after the race [52.1 (32.4â91.8) ng/L], declining at 24âŻh after the race [9.9 (6.0â20.0) ng/L]. Similarly, cTnT increased from baseline [3.0 (3.0â4.2) ng/L] to 3âŻh after the race [35.6 (24.4â54.4) ng/L], followed by a decline at 24âŻh after the race [10.0 (6.9â15.6) ng/L]. The 99th percentile was exceeded at 3âŻh after the race in 84% (nâŻ=âŻ842) of subjects using the cTnI assay and in 92% (nâŻ=âŻ925) of study subjects using the cTnT assay. Shorter race duration and higher systolic blood pressure (SBP) at baseline were highly significant (pâŻ<âŻ0.001) independent predictors of exercise-induced cTn increase both in bivariate and multivariable analysis. The age, gender, body mass index, training experience and cardiovascular risk of participants were found to be less consistent predictors.
Conclusion
Systolic blood pressure and race duration were consistent predictors of the exercise-induced cTn increase. These variables likely reflect important mechanisms involved in the exercise-induced cTn elevation.acceptedVersio
Race duration and blood pressure are major predictors of exercise-induced cardiac troponin elevation
Background: The underlying mechanisms of the exercise-induced increase in cardiac troponins (cTn) are poorly understood. The aim of this study was to identify independent determinants of exercise-induced cTn increase in a large cohort of healthy recreational athletes. Methods: A total of 1002 recreational cyclists without known cardiovascular disease or medication, participating in a 91-km mountain bike race were included. Median age was 47âŻyears and 78% were males. Blood samples were obtained 24âŻh prior to, and 3 and 24âŻh after the race. Results: Cardiac TnI concentrations increased markedly from baseline [1.9 (1.6â3.0) ng/L] to 3âŻh after the race [52.1 (32.4â91.8) ng/L], declining at 24âŻh after the race [9.9 (6.0â20.0) ng/L]. Similarly, cTnT increased from baseline [3.0 (3.0â4.2) ng/L] to 3âŻh after the race [35.6 (24.4â54.4) ng/L], followed by a decline at 24âŻh after the race [10.0 (6.9â15.6) ng/L]. The 99th percentile was exceeded at 3âŻh after the race in 84% (nâŻ=âŻ842) of subjects using the cTnI assay and in 92% (nâŻ=âŻ925) of study subjects using the cTnT assay. Shorter race duration and higher systolic blood pressure (SBP) at baseline were highly significant (pâŻ<âŻ0.001) independent predictors of exercise-induced cTn increase both in bivariate and multivariable analysis. The age, gender, body mass index, training experience and cardiovascular risk of participants were found to be less consistent predictors. Conclusion: Systolic blood pressure and race duration were consistent predictors of the exercise-induced cTn increase. These variables likely reflect important mechanisms involved in the exercise-induced cTn elevation
Duration of elevated heart rate Is an important predictor of exercise-induced troponin elevation
Background
The precise mechanisms causing cardiac troponin (cTn) increase after exercise remain to be determined. The aim of this study was to investigate the impact of heart rate (HR) on exerciseâinduced cTn increase by using sports watch data from a large bicycle competition.
Methods and Results
Participants were recruited from NEEDED (North Sea Race Endurance Exercise Study). All completed a 91âkm recreational mountain bike race (North Sea Race). Clinical status, ECG, blood pressure, and blood samples were obtained 24 hours before and 3 and 24 hours after the race. Participants (n=177) were, on average, 44 years old; 31 (18%) were women. Both cTnI and cTnT increased in all individuals, reaching the highest level (of the 3 time points assessed) at 3 hours after the race (P150 beats per minute was a significant predictor of both cTnI and cTnT, at both 3 and 24 hours after exercise. Neither mean HR nor mean HR in percentage of maximum HR was a significant predictor of the cTn response at 3 and 24 hours after exercise.
Conclusions
The duration of elevated HR is an important predictor of physiological exerciseâinduced cTn elevation.
Clinical Trial Registration
URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02166216