Abstract：
OBJECTIVE: We aimed to identify the major determinants of cardiac troponin changes response to exercise among non-elite runners participating in the Beijing 2022 marathon, with a particular focus on the associations with the cardiac function assessed by tissue Doppler echocardiography and speckle tracking.
METHODS: A prospective study.
METHODS: A total of 33 non-elite participants in the 2022 Beijing Marathon were included in the study. Echocardiographic assessment and blood sample collection were conducted before, immediately after, and two weeks after the marathon. Blood samples were analyzed using the same Abbot high-sensitivity cTnI STAT assay. Echocardiography included tissue Doppler and speckle tracking echocardiography.
RESULTS: Following the marathon, significant increases were observed in cardiac biomarkers, with hs-cTnI elevating from 3.1 [2.3-6.7] to 49.6 [32.5-76.9] ng/L (P < 0.0001). Over 72 % of participants had post-race hs-TnI levels surpassing the 99th percentile upper reference limit. There was a notable correlation between pre-marathon hs-cTnI levels (β coefficient, 0.56 [0.05, 1.07]; P = 0.042), weekly average training (β coefficient, -1.15 [-1.95, -0.35]; P = 0.009), and hs-cTnI rise post-marathon. Echocardiography revealed significant post-race cardiac function changes, including decreased E/A ratio (P < 0.0001), GWI (P < 0.0001), and GCW (P < 0.0001), with LVEF (β coefficients, 0.112 [0.01, 0.21]; P = 0.042) and RV GLS (β coefficients, 0.124 [0.01, 0.23]; P = 0.035) changes significantly associated with hs-TnI alterations. All echocardiographic and laboratory indicators reverted to baseline levels within two weeks.
CONCLUSIONS: Baseline hs-cTnI levels and weekly average training influence exercise-induced hs-cTnI elevation in non-elite runners. Echocardiography revealed post-race changes in cardiac function, with LVEF and RV GLS significantly associated with hs-TnI alterations. These findings contribute to understanding the cardiac response to exercise and could guide training and recovery strategies.
METHODS: A prospective study.
METHODS: A total of 33 non-elite participants in the 2022 Beijing Marathon were included in the study. Echocardiographic assessment and blood sample collection were conducted before, immediately after, and two weeks after the marathon. Blood samples were analyzed using the same Abbot high-sensitivity cTnI STAT assay. Echocardiography included tissue Doppler and speckle tracking echocardiography.
RESULTS: Following the marathon, significant increases were observed in cardiac biomarkers, with hs-cTnI elevating from 3.1 [2.3-6.7] to 49.6 [32.5-76.9] ng/L (P < 0.0001). Over 72 % of participants had post-race hs-TnI levels surpassing the 99th percentile upper reference limit. There was a notable correlation between pre-marathon hs-cTnI levels (β coefficient, 0.56 [0.05, 1.07]; P = 0.042), weekly average training (β coefficient, -1.15 [-1.95, -0.35]; P = 0.009), and hs-cTnI rise post-marathon. Echocardiography revealed significant post-race cardiac function changes, including decreased E/A ratio (P < 0.0001), GWI (P < 0.0001), and GCW (P < 0.0001), with LVEF (β coefficients, 0.112 [0.01, 0.21]; P = 0.042) and RV GLS (β coefficients, 0.124 [0.01, 0.23]; P = 0.035) changes significantly associated with hs-TnI alterations. All echocardiographic and laboratory indicators reverted to baseline levels within two weeks.
CONCLUSIONS: Baseline hs-cTnI levels and weekly average training influence exercise-induced hs-cTnI elevation in non-elite runners. Echocardiography revealed post-race changes in cardiac function, with LVEF and RV GLS significantly associated with hs-TnI alterations. These findings contribute to understanding the cardiac response to exercise and could guide training and recovery strategies.
摘要：
目的：我们旨在确定参加北京2022马拉松的非精英跑步者对运动反应的肌钙蛋白变化的主要决定因素，特别关注与通过组织多普勒超声心动图和斑点追踪评估的心脏功能的关联。
方法：前瞻性研究。
方法：将2022年北京马拉松比赛的33名非精英参与者纳入研究。之前进行超声心动图评估和血液样本收集，紧接着,马拉松比赛两周后.使用相同的Abbot高灵敏度cTnISTAT测定法分析血液样品。超声心动图包括组织多普勒和斑点追踪超声心动图。
结果：马拉松之后，在心脏生物标志物中观察到显著增加，hs-cTnI从3.1[2.3-6.7]升至49.6[32.5-76.9]ng/L（P<0.0001）。超过72％的参与者的赛后hs-TnI水平超过第99百分位数参考上限。马拉松前hs-cTnI水平之间存在显著相关性(β系数，0.56[0.05，1.07]；P=0.042），每周平均训练(β系数，-1.15[-1.95,-0.35];P=0.009),hs-cTnI在马拉松后崛起。超声心动图显示种族后明显的心功能变化，包括降低的E/A比（P<0.0001），GWI(P<0.0001),和GCW（P<0.0001），在LVEF(β系数，0.112[0.01，0.21]；P=0.042)和RVGLS(β系数，0.124[0.01，0.23]；P=0.035）变化与hs-TnI改变显着相关。所有超声心动图和实验室指标在两周内恢复到基线水平。
结论：基线hs-cTnI水平和每周平均训练影响非优秀跑步者运动诱发的hs-cTnI升高。超声心动图显示种族后心功能变化，LVEF和RVGLS与hs-TnI改变显著相关。这些发现有助于了解心脏对运动的反应，并可以指导训练和恢复策略。
方法：前瞻性研究。
方法：将2022年北京马拉松比赛的33名非精英参与者纳入研究。之前进行超声心动图评估和血液样本收集，紧接着,马拉松比赛两周后.使用相同的Abbot高灵敏度cTnISTAT测定法分析血液样品。超声心动图包括组织多普勒和斑点追踪超声心动图。
结果：马拉松之后，在心脏生物标志物中观察到显著增加，hs-cTnI从3.1[2.3-6.7]升至49.6[32.5-76.9]ng/L（P<0.0001）。超过72％的参与者的赛后hs-TnI水平超过第99百分位数参考上限。马拉松前hs-cTnI水平之间存在显著相关性(β系数，0.56[0.05，1.07]；P=0.042），每周平均训练(β系数，-1.15[-1.95,-0.35];P=0.009),hs-cTnI在马拉松后崛起。超声心动图显示种族后明显的心功能变化，包括降低的E/A比（P<0.0001），GWI(P<0.0001),和GCW（P<0.0001），在LVEF(β系数，0.112[0.01，0.21]；P=0.042)和RVGLS(β系数，0.124[0.01，0.23]；P=0.035）变化与hs-TnI改变显着相关。所有超声心动图和实验室指标在两周内恢复到基线水平。
结论：基线hs-cTnI水平和每周平均训练影响非优秀跑步者运动诱发的hs-cTnI升高。超声心动图显示种族后心功能变化，LVEF和RVGLS与hs-TnI改变显著相关。这些发现有助于了解心脏对运动的反应，并可以指导训练和恢复策略。
