Impact of ultra-marathon and marathon on biomarkers of myocyte necrosis and cardiac congestion: a prospective observatio
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ORIGINAL PAPER
Impact of ultra‑marathon and marathon on biomarkers of myocyte necrosis and cardiac congestion: a prospective observational study Claudia Wegberger1 · Maximilian Tscharre1,2 · Paul M. Haller1 · Edita Piackova1 · Irena Vujasin1 · Alja Gomiscek1 · Ioannis Tentzeris1 · Matthias K. Freynhofer1 · Bernhard Jäger1 · Johann Wojta3,4,5 · Kurt Huber1,6 Received: 2 December 2019 / Accepted: 13 March 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background An elevation of cardiac biomarkers is observed after intense or long-lasting physical activity. However, a recent meta-analysis has suggested that there might be an inverse relationship between duration of exercise and degree of biomarker elevation. The objective of this observational study was to investigate the impact of ultra-marathon (UM) vs. marathon (M) on biomarkers of myocyte necrosis and hemodynamic stress/congestion. Methods Well-trained endurance athletes were recruited to participate in a 130-km UM and a M run. Troponin I (TnI), creatine kinase (CK), N-terminal pro-brain natriuretic peptide (NT-proBNP), mid-regional pro-adrenomedullin (MR-proADM), and copeptin were measured after both events, respectively. Results Fifteen athletes (14 males, one female) were included. There was no difference in exercise intensity according to the Borg scale (UM 16 [IQR 15–17], M 16 [IQR 14–17]; p = 0.424). Biomarkers of myocyte necrosis both differed significantly with higher levels of TnI (UM 0.056 ng/L [IQR 0.022–0.104), M 0.028 ng/L [IQR 0.022–0.049]; p = 0.016) and CK (UM 6992 U/l [IQR 2886–23038], M 425 U/l [IQR 327–681]; p = 0.001) after UM compared to M. Also, NT-proBNP (UM 723 ng/L [IQR 378–1152], M 132 ng/L [IQR 64–198]; p = 0.001) and MR-proADM (UM 1.012 nmol/L [IQR 0.753–0.975], M 0.877 nmol/L [IQR 0.550–0.985]; p = 0.023) as markers of myocardial congestion were significantly higher after UM. There was a tendency for elevated copeptin levels after M, but did not reach statistical significance (p = 0.078). Conclusion Ultra-marathon is associated with higher levels of biomarkers of myocyte necrosis and cardiac congestion compared to marathon, highlighting the impact of exercise duration on the cardiovascular system. Keywords Marathon · Ultra-marathon · Myocyte necrosis · Cardiac congestion · Biomarkers
Claudia Wegberger and Maximilian Tscharre contributed equally to this manuscript. * Kurt Huber [email protected] 1
3rd Medical Department, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Montleartstrasse 37, 1160 Vienna, Austria
2
Institute for Cardiometabolic Diseases, Karl Landsteiner Society, St. Pölten, Austria
3
Division of Cardiology, Department of Internal Medicine 2, Medical University of Vienna, Vienna, Austria
4
Core Facilities, Medical University of Vienna, Vienna, Austria
5
Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
6
Medical School, Sigmund Freud University, Vienna, Austria
Introduction Regular low- to moderate-intensity exercise promote
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