Cardiac Department, National University Heart Centre Singapore, Singapore, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Clin Cardiol. 2020 Dec;43(12):1443-1449. doi: 10.1002/clc.23459. Epub 2020 Sep 3.
Highly trained athletes running 42 km or more demonstrate elevated cardiac biomarkers, ventricular dysfunction, and decreased glomerular filtration rate (GFR). Whether similar changes occur in the much larger population of recreational runners following half-marathon distance running is unclear.
Recreational runners exhibit changes in myocardial and renal biomarkers, including ventricular strain, after a half-marathon treadmill run.
10 recreational subjects (mean age 36.5 ± 6.5 years) ran 21 km on a treadmill (mean completion time 121.6 ± 16.1 minutes). Serum high-sensitivity troponin T (hsTnT), amino-terminal pro-brain natriuretic peptide (NT-proBNP), creatinine, and neutrophil gelatinase-associated lipocalin (NGAL) were measured prior to, 1 hour post-, and 24 hours post-exercise. Pre- and post-exercise echocardiograms were performed.
All biomarkers increased 1 hour post-exercise: hsTnT by 8.5 ± 8.5 pg/ml (P < .05), NT-ProBNP by 26.2 ± 22.8 pg/ml (P < .05) and NGAL by 29.5 ± 37.7 ng/ml (P=NS). By 24 hours post-run, these biomarkers declined toward baseline levels. Right ventricle (RV) free wall and left ventricle global longitudinal strain decreased by 5.5% and 1.8%, respectively (P < .001). Changes in NGAL correlated well with changes in serum creatinine (R = 0.79, P < .01) and GFR (R = -0.73, P < .05). Faster 21 km completion times, and a larger reduction in post-exercise RV strain, were associated with higher NGAL levels: (R = -0.75, P = .01) and (R = 0.66, P < .05), respectively.
A 21 km run in recreational runners is associated with transient ventricular stunning and reversible changes in myocardial and renal biomarkers. Whether repeated bouts of similar activity contributes to chronic cardiac or kidney dysfunction deserves further evaluation.
高强度训练的运动员在完成 42 公里或更长距离的跑步后，其心脏生物标志物水平会升高，心室功能障碍，肾小球滤过率（GFR）降低。但不清楚在参加半程马拉松距离跑步的业余跑者中，是否会出现类似的变化。
业余跑者在完成半程马拉松跑步机跑步后，心肌和肾脏生物标志物（包括心室应变）会发生变化。
10 名业余运动员（平均年龄 36.5±6.5 岁）在跑步机上跑 21 公里（平均完成时间 121.6±16.1 分钟）。在运动前、运动后 1 小时和 24 小时测量血清高敏肌钙蛋白 T（hsTnT）、氨基末端脑利钠肽前体（NT-proBNP）、肌酐和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）。进行运动前后的超声心动图检查。
所有生物标志物在运动后 1 小时均升高：hsTnT 升高 8.5±8.5pg/ml（P<.05），NT-proBNP 升高 26.2±22.8pg/ml（P<.05），NGAL 升高 29.5±37.7ng/ml（P=NS）。在跑步后 24 小时，这些生物标志物的水平下降到基线水平。右心室（RV）游离壁和左心室整体纵向应变分别下降 5.5%和 1.8%（P<.001）。NGAL 的变化与血清肌酐（R=0.79，P<.01）和 GFR（R=-0.73，P<.05）的变化密切相关。更快的 21 公里完成时间和运动后 RV 应变的较大减少与更高的 NGAL 水平相关：（R=-0.75，P=0.01）和（R=0.66，P<.05）。
业余跑者完成 21 公里的跑步会导致短暂的心室顿抑和心肌和肾脏生物标志物的可逆变化。反复进行类似的活动是否会导致慢性心脏或肾脏功能障碍，值得进一步评估。
