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ULTIMO FASCICOLOTHE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

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Original articles  EXERCISE AND SPORTS CARDIOLOGY


The Journal of Sports Medicine and Physical Fitness 2008 Marzo;48(1):90-6

lingua: Inglese

Elevation of serum N-terminal pro-brain natriuretic peptide after exercise is an index of myocardial damage or a cytoprotective reflection?

Faviou E.1, 2, Zachari A. 3, Nounopoulos C. 3, Agrafiotis E. 2, Vourli G. 1, Dionyssiou-Asteriou A. 1, 3

1 Department of Clinical Biochemistry, Medical School University of Athens, Attikon University Hospital, Athens, Greece
2 Biocheck International, Athliatric Unit, Athens, Greece
3 Department of Biological Chemistry, Medical School University of Athens, Athens, Greece


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Aim. Recent investigations have suggested the occurrence of transient cardiac dysfunction and reversible myocardial injury in healthy individuals after heavy exercise. Our purpose was to examine if the release of N-terminal pro-brain natriuretic peptide (NT-proBNP) after intense exercise in obviously healthy participants may have cytoprotective and growth-regulating effects or may result from myocardial dysfunction/damage with changes in cTnT as a marker for myocardial cell necrosis during exercise.
Methods. In 43 highly-trained male athletes <35 years old, who were examined immediately after exercising as well as 2 days later, 21 age-matched male patients classified as stage-B according to ACC/AHA guidelines and 35 healthy age-matched males, we evaluated NT-proBNP and 3rd generation’s cTnT by electrochemiluminescence immunoassay. All participants underwent a detailed cardiac protocol including echocardiography and electrocardiogram (ECG).
Results. In athletes, cTnT consistently remained <0.01 µg/L after exercising as well as after 2 days. NTproBNP immediately after exercising was 58.27±19.48 ng/L, without reaching pathological levels, decreasing 2 days later to 22.93±10.22 ng/L. Our patients maintained high levels of NTproBNP, as much as a six-fold increase with reference to the levels of our study’s control group and with cTnT <0.01 µg/L. In the control group, cTnT and NTproBNP levels were statistically similar with those of the athletes 2 days after exercising. NT-proBNP as a biological marker can reliably discriminate pathological from physiological cardiac hypertrophy.
Conclusion. A normal plasma concentration of NT-proBNP in consecutive routine check-up, before and after exercise, could minimize the possibility of cardiac dysfunction, whereas persistent elevated plasma concentrations warrant further cardiological evaluation.

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