ORIGINAL ARTICLE   

Minerva Cardioangiologica 2020 August;68(4):305-12

DOI: 10.23736/S0026-4725.20.05281-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

The effects of a 50 km ultramarathon race on high sensitivity cardiac troponin I and NT-proBNP in highly trained athletes

Marco A. PERRONE ^{1, 2} ✉, Massimiliano MACRINI ¹, Alessio MAREGNANI ³, Massimiliano AMMIRABILE ³, Aldo CLERICO ⁴, Sergio BERNARDINI ^{2, 5}, Francesco ROMEO ¹

¹ Division of Cardiology, Tor Vergata University, Rome, Italy; ² University Sports Center, Tor Vergata University, Rome, Italy; ³ Division of Clinical Chemistry, Maggiore Polyclinic Hospital, IRCCS Ca’ Granda Foundation, Milan, Italy; ⁴ Laboratory of Cardiovascular Endocrinology and Cell Biology, Department of Laboratory Medicine, Gabriele Monasterio Tuscany Foundation, Sant’Anna School, Pisa, Italy; ⁵ Division of Clinical Biochemistry and Clinical Molecular Biology, Tor Vergata University, Rome, Italy

BACKGROUND: High sensitivity cardiac troponins I (hs-cTnI) and T (hs-cTnT) and natriuretic peptides (BNP and NT-proBNP) are universally recognized as cardiac reference biomarkers in patients with acute coronary syndromes and heart failure respectively. However, while on one hand the high sensitivity methods of cardiac biomarkers have provided answers to fundamental pathophysiological and clinical questions in patients with heart disease, less information is available on their assessment in paraphysiological conditions, such as high intensity exercise in healthy athletes. The aim of this study was to evaluate hs-cTnI and NT-proBNP in highly trained runners after a 50 km ultramarathon.
METHODS: We have enrolled 20 highly trained male athletes who have run a 50 km ultramarathon. Blood samples were collected 2 hours before the start of the race (T0) and 20 minutes after the end of the race (T1). The blood concentrations of hs-cTnI and NT-proBNP measured before the race were within reference intervals in all runners.
RESULTS: Hs-cTnI significantly increased after the end of the race (median: 19 ng/L [IQR: 12.5-25.75] versus 6 ng/L [IQR: 4.25-8.0]; P<0.001), in three cases over the upper reference limit (URL) of 34 ng/L. NT-proBNP also significantly increased (median: 78 ng/L [IQR: 68.25-87.75] versus 22 ng/L [IQR: 18.25-26.75]; P<0.001). Three other athletes reached concentration over the URL (125 ng/L).
CONCLUSIONS: Our study showed a significant increase in hs-cTnI and NT-proBNP in highly trained athletes after a 50 km ultramarathon race, and 30% of runners had the values of cardiac biomarkers above URL. More studies with a larger number of athletes will be needed to better understand the effects of intense exercise on the heart of trained athletes.

KEY WORDS: Athletes; Heart failure; Natriuretic peptides