Department of Rehabilitation Medicine, Inje University Paik Hospital, Seoul, Republic of Korea.
Int J Sports Med. 2013 Sep;34(9):777-82. doi: 10.1055/s-0032-1331257. Epub 2013 Feb 26.
The aim of the present study was to determine the changes in cardiac makers and endothelin-1 (ET-1) in marathoners with exercise induced hypertension compared to normotensive controls before and after running a marathon. Among a total of 70 volunteers, 10 marathoners with systolic blood pressure (SBP) greater than 210 mmHg during a treadmill exercise stress test were selected as an exercise-induced hypertension group (EIH) and 10 marathoners with normal SBP were selected as a control group (CON). Blood was collected from all volunteers 2 h before and immediately after a marathon: creatinine kinase (CK), CK-MB, cardiac tropoin-I (cTnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), and endothelin-1(ET-1). Cardiac markers, CK, CK-MB, and CK-MB/CK ratio significantly increased in both EIH and CON; significance was not observed between the groups. Significant increases were not observed in high sensitive-C reactive protein (hs-CRP) after the race nor between the groups. Significant increases in cTnI and NT-proBNP were observed after the race in both groups. In addition, EIH showed greater increase than CON after the race. In conclusion, increased vascular tone in EIH during a marathon increased blood pressure and myocardial burden which in turn increased myocardial cell membrane permeability to further increase myocardial tension to the point of cTnI release.
本研究旨在比较运动性高血压马拉松运动员与血压正常对照组在马拉松前后心脏标志物和内皮素-1（ET-1）的变化。在总共 70 名志愿者中，选择 10 名在跑步机运动应激试验中收缩压（SBP）大于 210mmHg 的马拉松运动员作为运动性高血压组（EIH），10 名 SBP 正常的马拉松运动员作为对照组（CON）。所有志愿者在马拉松前 2 小时和赛后立即采血：肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、心脏肌钙蛋白-I（cTnI）、氨基末端脑钠肽前体（NT-proBNP）和内皮素-1（ET-1）。EIH 和 CON 两组的心脏标志物 CK、CK-MB 和 CK-MB/CK 比值均显著升高；组间无显著性差异。赛后两组高敏 C 反应蛋白（hs-CRP）均无显著升高，组间亦无差异。两组赛后 cTnI 和 NT-proBNP 均显著升高，EIH 升高幅度大于 CON。结论：马拉松比赛中 EIH 血管张力增加导致血压和心肌负荷增加，进而增加心肌细胞膜通透性，进一步增加心肌张力至 cTnI 释放点。
