Predictors of cardiac troponin release after a marathon

Objectives: Exercise leads to an increase in cardiac troponin I in healthy, asymptomatic athletes after a marathon. Previous studies revealed single factors to relate to post-race cardiac troponin I levels. Integrating these factors into our study, we aimed to identify independent predictors for the exercise-induced cardiac troponin I release. Design: Observational study. Methods: Ninety-two participants participated in a marathon at a self-selected speed. Demographic data, health status, physical activity levels and marathon experience were obtained. Before and immediately after the marathon fluid intake was recorded, body mass changes were measured to determine fluid balance and venous blood was drawn for analysis of high-sensitive cardiac troponin I. Exercise intensity was examined by recording heart rate. We included age, participation in previous marathons, exercise duration, exercise intensity and hydration status (relative weight change) in our model as potential determinants to predict post-exercise cardiac troponin I level. Results: Cardiac troponin I increased significantly from 14. ±. 12. ng/L at baseline to 94. ±. 102. ng/L post-race, with 69% of the participants demonstrating cardiac troponin I levels above the clinical cut-off value (40. ng/L) for an acute myocardial infarction. Linear backward regression analysis identified younger age (β=. -0.27) and longer exercise duration (β=. 0.23) as significant predictors of higher post-race cardiac troponin I levels (total r=. 0.31, p<. 0.05), but not participation in previous marathons, relative weight change and exercise intensity. Conclusions: We found that cardiac troponin I levels significantly increased in a large heterogeneous group of athletes after completing a marathon. The magnitude of this response could only be partially explained, with a lower age and longer exercise duration being related to higher post-race cardiac troponin I levels

Venoarterielle ECMO als "bridge to recovery": Kardiogener Schock und Verdacht auf Myokarditis bei einer 37-Jährigen [Veno-arterial ECMO as bridge to recovery. Cardiogenic shock and suspected myocarditis in a 37-year-old patient]

We report a case of a 37-year-old patient presenting with fulminant cardiogenic shock, almost noncontractile ventricles, followed by electromechanical dissociation. During performance of cardiopulmonary resuscitation, a veno-arterial extracorporeal membrane oxygenation device (VA ECMO) was implanted, which became necessary for 13 days. Subsequently, a total arrest of ventricular function was observed and prominent multiple organ failure emerged. A rapid test for respiratory syncytial virus was positive, supporting the suspected diagnosis of myocarditis. Despite numerous complications, complete recovery was achieved

Spatial distribution of soft-bottom molluscs in the Ensenada de San Simón (NW Spain)

11 páginasDistribution and abundance of the molluscan fauna was studied in the intertidal and subtidal soft-bottoms of the Ensenada de San Simón (NW Spain). Depth, grain size, and total organic matter were the most important factors in determining distribution patterns of molluscs in this inlet. Three major malacological assemblages have been determined in the Ensenada de San Simón, two of them subdivided in two facies. In the intertidal area of the inlet, one facies (A1) was located in areas associated with seagrass meadows of Zostera spp. and was dominated by Hydrobia ulvae (Pennant, 1777) whereas the second facies (A2) had a high dominance of H. ulvae, Cerastoderma edule (Linnaeus, 1758), and Tapes decussatus (Linnaeus, 1758). An impoverished facies of this community was present in reduced, muddy bottoms (Group C). In the subtidal bottoms, one group (B1) was located in the central part of the inlet with H. ulvae, Rissoa labiosa (Montagu, 1803), Turboella radiata (Philippi, 1836), Parvicardium exiguum (Gmelin in Linnaeus, 1791), Loripes lacteus (Linnaeus, 1758), and Abra nitida (Müller, 1789) as characteristic species. A second facies (B2) was found in outer areas of the inlet, characterized by Thyasira flexuosa (Montagu, 1803), Mysella bidentata (Montagu, 1803), Abra alba (Wood, 1802), and Nucula nitidosa Winckworth, 1930.Peer reviewe