Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon

Multiple studies have individually documented cardiac dysfunction and biochemical evidence of cardiac injury after endurance sports; however, convincing associations between the two are lacking. We aimed to determine the associations between the observed transient cardiac dysfunction and biochemical...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2006-11, Vol.114 (22), p.2325-2333
Main Authors: NEILAN, Tomas G, JANUZZI, James L, LAWLOR, David, PICARD, Michael H, WOOD, Malissa J, LEE-LEWANDROWSKI, Elizabeth, TON-NU, Thanh-Thao, YOERGER, Danita M, JASSAL, Davinder S, LEWANDROWSKI, Kent B, SIEGEL, Arthur J, MARSHALL, Jane E, DOUGLAS, Pamela S
Format: Article
Language:English
Subjects:
Athletic Injuries - epidemiology
Athletic Injuries - etiology
Biological and medical sciences
Biomarkers - blood
Blood and lymphatic vessels
Blood Pressure
Boston
Cardiology. Vascular system
Coronary heart disease
Diastole
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Heart
Humans
Medical sciences
Miscellaneous
Myocardium
Physical Fitness
Running
Troponin T - blood
Ventricular Dysfunction, Right - epidemiology
Ventricular Dysfunction, Right - etiology
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Summary:Multiple studies have individually documented cardiac dysfunction and biochemical evidence of cardiac injury after endurance sports; however, convincing associations between the two are lacking. We aimed to determine the associations between the observed transient cardiac dysfunction and biochemical evidence of cardiac injury in amateur participants in endurance sports and to elicit the risk factors for the observed injury and dysfunction. We screened 60 nonelite participants, before and after the 2004 and 2005 Boston Marathons, with echocardiography and serum biomarkers. Echocardiography included conventional measures as well as tissue Doppler-derived strain and strain rate imaging. Biomarkers included cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP). All subjects completed the race. Echocardiographic abnormalities after the race included altered diastolic filling, increased pulmonary pressures and right ventricular dimensions, and decreased right ventricular systolic function. At baseline, all had unmeasurable troponin. After the race, > 60% of participants had increased cTnT > 99th percentile of normal (> 0.01 ng/mL), whereas 40% had a cTnT level at or above the decision limit for acute myocardial necrosis (> or = 0.03 ng/mL). After the race, NT-proBNP concentrations increased from 63 (interquartile range [IQR] 21 to 81) pg/mL to 131 (IQR 82 to 193) pg/mL (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.106.647461