Jassal D S, Moffat D, Krahn J, Ahmadie R, Fang T, Eschun G, Sharma S
Department of Cardiology, Cardiac Sciences, University of Manitoba, Winnipeg, Canada.
Int J Sports Med. 2009 Feb;30(2):75-9. doi: 10.1055/s-0028-1104572. Epub 2009 Jan 28.
An elevation of cardiac injury markers including creatinine kinase (CK), myoglobin (Myo) and cardiac troponin T (cTnT) has been observed in elite athletes following strenuous exercise. The mechanism and significance of this observation however have not been fully elucidated. The goals of this study were: 1) to determine whether these changes in biomarkers also occur in a large, heterogeneous group of non-elite athletes; and 2) to identify possible clinical or biochemical associations. We recruited 129 non-elite runners in 2006, 61 individuals who were taking part in the half (13.1 miles) marathon and 68 individuals participating in the full (26.2 miles) marathon. Demographic data and blood samples were collected for analysis of CK, Myo, cTnT, and Creatinine (Cr) levels within two hours of race start, at race completion, and 1-h post-race for both patient cohorts. In the 61 individuals (40 males, 40+/-12 yrs) completing the half marathon in a mean time of 150+/-20 min, 90.3%, 65.2%, and 30.6% of the subjects exhibited significant elevations in Myo, CK, and cTnT, respectively immediately post race and 100%, 74.9% and 45.9% in the same biomarkers one hour-post race. In the 68 individuals (44 males, 42+/-14 yrs) completing the full marathon in a mean time of 310+/-30 min, 95.3%, 70.2% and 35.7% exhibited significant elevations in Myo, CK and cTnT respectively immediately post race and 100%, 78.5% and 52.8% in the same biomarkers one hour-post race. The elevation in cTnT levels post-race were modestly associated with the time required to complete the race for the entire cohort of marathon runners. The serum levels of Cr, CK, and Myo post-race did not correlate however with age, sex, BMI, level of training, or prior marathon experience. Elevations of cardiac injury markers in non-elite athletes are extremely common following the completion of endurance events and correlate to the increased endurance time. Whether the increase in the levels of these enzymes represents true myocardial injury or a result of the release of cTnT from the myocytes requires further investigation.
在剧烈运动后,精英运动员中已观察到包括肌酸激酶(CK)、肌红蛋白(Myo)和心肌肌钙蛋白T(cTnT)在内的心脏损伤标志物升高。然而,这一观察结果的机制和意义尚未完全阐明。本研究的目的是:1)确定这些生物标志物的变化是否也发生在一大群异质性的非精英运动员中;2)确定可能的临床或生化关联。2006年,我们招募了129名非精英跑步者,其中61人参加半程(13.1英里)马拉松,68人参加全程(26.2英里)马拉松。在比赛开始后两小时内、比赛结束时以及赛后1小时,收集两个患者队列的人口统计学数据和血样,以分析CK、Myo、cTnT和肌酐(Cr)水平。在平均用时150±20分钟完成半程马拉松的61名个体(40名男性,40±12岁)中,赛后立即分别有90.3%、65.2%和30.6%的受试者Myo、CK和cTnT显著升高,赛后1小时,相同生物标志物的升高比例分别为100%、74.9%和45.9%。在平均用时310±30分钟完成全程马拉松的68名个体(44名男性,42±14岁)中,赛后立即分别有95.3%、70.2%和35.7%的受试者Myo、CK和cTnT显著升高,赛后1小时,相同生物标志物的升高比例分别为100%、78.5%和52.8%。赛后cTnT水平的升高与整个马拉松运动员队列完成比赛所需的时间适度相关。然而,赛后Cr、CK和Myo的血清水平与年龄、性别、BMI、训练水平或以往马拉松经验无关。非精英运动员在耐力赛事结束后,心脏损伤标志物升高极为常见,且与耐力时间增加相关。这些酶水平的升高是代表真正的心肌损伤还是肌细胞释放cTnT的结果,需要进一步研究。