PDF(Pubmed)
Abstract：
Exercise can produce transient elevations of cardiac troponin (cTn) concentrations, which may resemble the cTn release profile of myocardial infarction. Consequently, clinical interpretation of postexercise cTn elevations (ie, values above the 99th percentile upper reference limit) remains challenging and may cause clinical confusion. Therefore, insight into the physiological versus pathological nature of postexercise cTn concentrations is warranted. We aim to (1) establish resting and postexercise reference values for recreational athletes engaged in walking, cycling or running exercise; (2) compare the prevalence of (sub)clinical coronary artery disease in athletes with high versus low postexercise cTn concentrations and (3) determine the association between postexercise cTn concentrations and the incidence of major adverse cardiovascular events (MACE) and mortality during long-term follow-up. For this purpose, the prospective TRoponin concentrations following Exercise and the Association with cardiovascular ouTcomes (TREAT) observational cohort study was designed to recruit 1500 recreational athletes aged ≥40 to <70 years who will participate in Dutch walking, cycling and running events. Baseline and postexercise high-sensitivity cTnT and cTnI concentrations will be determined. The prevalence and magnitude of coronary atherosclerosis on computed tomography (eg, coronary artery calcium score, plaque type, stenosis degree and CT-derived fractional flow reserve) will be compared between n=100 athletes with high postexercise cTn concentrations vs n=50 age-matched, sex-matched and sport type-matched athletes with low postexercise cTn concentrations. The incidence of MACE and mortality will be assessed in the entire cohort up to 20 years follow-up. The TREAT study will advance our understanding of the clinical significance of exercise-induced cTn elevations in middle-aged and older recreational athletes. Trial registration number NCT06295081.
摘要：
运动可以引起心肌肌钙蛋白（cTn）浓度的瞬时升高，这可能类似于心肌梗死的cTn释放曲线。因此,运动后cTn升高的临床解释(即，高于第99百分位数参考上限的值)仍然具有挑战性，可能会导致临床混乱。因此,有必要了解运动后cTn浓度的生理和病理性质。我们的目标是（1）为从事步行的休闲运动员建立休息和运动后的参考值，骑自行车或跑步运动;(2)比较运动后cTn浓度高和低的运动员(亚)临床冠状动脉疾病的患病率;(3)确定运动后cTn浓度与长期随访期间主要不良心血管事件(MACE)发生率和死亡率之间的关系.为此,运动后TRoponin的前瞻性浓度和与心血管运动的关联（TREAT）观察性队列研究旨在招募1500名年龄≥40至<70岁的休闲运动员参加荷兰步行，骑自行车和跑步活动。将测定基线和运动后高灵敏度cTnT和cTnI浓度。计算机断层扫描显示冠状动脉粥样硬化的患病率和程度（例如，冠状动脉钙积分,斑块类型,狭窄程度和CT得出的血流储备分数）将在n=100名运动后cTn浓度较高的运动员与n=50年龄匹配的运动员之间进行比较，运动后cTn浓度低的性别匹配和运动类型匹配的运动员。MACE的发生率和死亡率将在长达20年的随访中评估整个队列。TREAT研究将增进我们对中年和老年休闲运动员运动引起的cTn升高的临床意义的理解。试验注册号NCT06295081。
