The kinetics of highly sensitive cardiac troponin T release after prolonged treadmill exercise in adolescent and adult athletes

Tian Y, Nie J, Huang C, George KP. The kinetics of highly sensitive cardiac troponin T release after prolonged treadmill exercise in adolescent and adult athletes. J Appl Physiol 113: 418-425, 2012. First published May 31, 2012; doi: 10.1152/japplphysiol.00247.2012.-The nature and kinetics of postexercise cardiac troponin (cTn) appearance is poorly described and understood in most athlete populations. We compared the kinetics of high-sensitivity cTn T (hs-cTnT) after endurance running in training-matched adolescents and adults. Thirteen male adolescent (mean age: 14.1 +/- 1.1 yr) and 13 male adult (24.0 +/- 3.6 yr) runners performed a 90-min constant-load treadmill run at 95% of ventilatory threshold. Serum hs-cTnT levels were assessed preexercise, immediately postexercise, and at 1, 2, 3, 4, 5, 6, and 24 h postexercise. Serum NH2-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels were recorded preexercise and 3, 6, and 24 h postexercise. Left ventricular function was assessed preexercise, immediately postexercise, and 6 h postexercise. Peak hs-cTnT occurred at 3-4 h postexercise in all subjects, but was substantially higher (P < 0.05) in adolescents [median (range): 211.0 (11.2-794.5) ng/l] compared with adults [median (range): 19.1 (9.7-305.6) ng/l]. Peak hs-cTnT was followed by a rapid decrease in both groups, although adolescent data had not returned to baseline at 24 h. Substantial interindividual variability was noted in peak hs-cTnT, especially in the adolescents. NT-pro-BNP was significantly elevated postexercise in both adults and adolescents and remained above baseline at 24 h in both groups. In both groups, left ventricular ejection fraction and the ratio of early-to-atrial peak Doppler flow velocities were significantly decreased immediately postexercise. Peak hs-cTnT was not related to changes in ejection fraction, ratio of early-to-atrial peak Doppler flow velocities, or NT-pro-BNP. The present data suggest that postexercise hs-cTnT elevation 1) occurred in all runners, 2) peaked 3-4 h postexercise, and 3) the peak hs-cTnT concentration after prolonged exercise was higher in adolescents than adults.