Scharhag Jürgen, Herrmann Markus, Urhausen Axel, Haschke Michaela, Herrmann Wolfgang, Kindermann Wilfried
Institute of Sports and Preventive Medicine, University of Saarland, Saarbrücken/Homburg, Germany.
Am Heart J. 2005 Dec;150(6):1128-34. doi: 10.1016/j.ahj.2005.01.051.
Although elevated resting brain natriuretic peptide (BNP) concentrations reflect heart disease, the meaning of exercise-induced increases is poorly understood and has been examined in small groups only. Therefore, the present study aimed to examine the increase in N-terminal pro-brain natriuretic peptide (NT-proBNP) and relations to cardiac troponin I and T (cTnI, cTnT) elevations after prolonged strenuous exercise in a large cohort of athletes.
We examined exercise-induced changes in NT-proBNP, cTnI, and cTnT in 105 obviously healthy endurance athletes (40 +/- 8 years) before and after prolonged strenuous exercise. Blood samples were taken before, 15 minutes, and 3 hours after a marathon (n = 46), a 100-km run (n = 14), and a mountain bike marathon (n = 45).
Eighty-one of 105 athletes exceeded the upper reference limit of NT-proBNP (males/females 88:153 ng/L) after exercise. NT-proBNP increased in all 3 events (P < .001) with the highest increase in the 100-km runners (median increase 200 ng/L; 25th/75th percentile 115/770 ng/L), which differed from the increase in the marathon (97 ng/L; 36/254 ng/L) or the mountain bike marathon (78 ng/L; 37/196 ng/L) (P < .01). Cardiac troponin I exceeded 0.04 microg/L in 74%; cTnT exceeded 0.01 microg/L in 47% of athletes after exercise. NT-proBNP was not related to exercise-induced increases in cTnI or cTnT, but correlated with exercise time (r = 0.55, P < .001).
Increases in NT-proBNP can be found in a major part of obviously healthy athletes after prolonged strenuous exercise. The release of BNP during and after exercise may not result from myocardial damage but may have cytoprotective and growth-regulating effects. The different nature of exercise-induced increases in BNP and cardiac troponins has to be elucidated in the future.
尽管静息状态下脑钠肽（BNP）浓度升高反映了心脏疾病，但运动诱导的BNP升高的意义却鲜为人知，且仅在小群体中进行过研究。因此，本研究旨在检测一大群运动员在长时间剧烈运动后N末端脑钠肽前体（NT-proBNP）的升高情况及其与心肌肌钙蛋白I和T（cTnI、cTnT）升高的关系。
我们检测了105名明显健康的耐力运动员（40±8岁）在长时间剧烈运动前后运动诱导的NT-proBNP、cTnI和cTnT的变化。在马拉松（n = 46）、100公里跑（n = 14）和山地自行车马拉松（n = 45）前、运动后15分钟和3小时采集血样。
105名运动员中有81名在运动后超过了NT-proBNP的参考上限（男性/女性为88:153 ng/L）。在所有3项赛事中NT-proBNP均升高（P <.001），100公里跑者升高幅度最大（中位数升高200 ng/L；第25/75百分位数为115/770 ng/L），这与马拉松（97 ng/L；36/254 ng/L）或山地自行车马拉松（78 ng/L；37/196 ng/L）的升高情况不同（P <.01）。运动后74%的运动员心肌肌钙蛋白I超过0.04 μg/L；47%的运动员cTnT超过0.01 μg/L。NT-proBNP与运动诱导的cTnI或cTnT升高无关，但与运动时间相关（r = 0.55，P <.001）。
在长时间剧烈运动后，大部分明显健康的运动员中可发现NT-proBNP升高。运动期间及运动后BNP的释放可能并非源于心肌损伤，而可能具有细胞保护和生长调节作用。未来必须阐明运动诱导的BNP和心肌肌钙蛋白升高的不同性质。
