Evidence of exercise induced cardiac dysfunction and elevated cTnT in separate cohorts competing in an ultra-endurance mountain marathon race

Shave, R., Dawson, E., Whyte, G., George, K., Ball, D., Gaze, D. and Collinson, P.O. 2002. Evidence of exercise induced cardiac dysfunction and elevated cTnT in separate cohorts competing in an ultra-endurance mountain marathon race. International Journal of Sports Medicine. 23 (7), pp. 489-494. https://doi.org/10.1055/s-2002-35069

TitleEvidence of exercise induced cardiac dysfunction and elevated cTnT in separate cohorts competing in an ultra-endurance mountain marathon race
TypeJournal article
AuthorsShave, R., Dawson, E., Whyte, G., George, K., Ball, D., Gaze, D. and Collinson, P.O.
Abstract

Cardiac damage has recently been implicated in the aetiology of "exercise induced cardiac dysfunction". The humoral markers of cardiac damage that have been utilised to date are not sufficiently cardio-specific to investigate this hypothesis. The aim of the present study was to examine cardiac function following prolonged exercise, and investigate the contention of cardiac damage utilising a new highly cardio-specific marker. Thirty-seven competitors in the 2-day Lowe Alpine Mountain Marathon 2000 volunteered for the study. Competitors were sub-divided into 2 groups. Group 1 (n = 11) were examined using echocardiography pre and post the event, examining left ventricular diastolic and systolic function. Group 2 (n = 26) had venous blood samples drawn prior to the event and immediately following day-1 and day-2. Blood samples were analysed for total creatine kinase activity (CK), creatine kinase isoenzyme MB(mass) (CK-MB(mass)), and cardiac troponin T. Echocardiographic results indicated left ventricular diastolic and systolic dysfunction following cessation of exercise. CK and CK-MB(mass) were both elevated following day-1, and immediately following race completion. Cardiac troponin T levels were below the 99th percentile (0.01 microg/L) in all subjects prior to the event, following day-1 cTnT was elevated above 0.01 microg/L in 13 subjects, but returned to below 0.01 microg/L following race completion on day-2. However, no individual data reached clinical cut-off levels for acute myocardial infarction (AMI) (0.1 microg/L). Two days arduous exercise over mountainous terrain resulted in cardiac dysfunction, and significant skeletal muscular degradation. The elevation of cTnT above the 99th percentile in the present study is suggestive of minimal myocardial damage. The clinical significance of and exact mechanism responsible for such damage remains to be elucidated.

JournalInternational Journal of Sports Medicine
Journal citation23 (7), pp. 489-494
ISSN0172-4622
Year2002
PublisherGeorg Thieme Verlag
Digital Object Identifier (DOI)https://doi.org/10.1055/s-2002-35069
Publication dates
PublishedOct 2002

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Gaze, D.C. 2009. The use of cardiac markers for the assessment of heart disease in men. in: Todd, A.B. and Mosley, M.H. (ed.) Heart Disease in Men New York Nova Science Publishers. pp. 167-182

Evidence of Cardiomyocyte Necrosis in Glycogen Storage Disease type-II
Gaze, D., Lawson, G. J., Harris, A. and Collinson, P.O. 2007. Evidence of Cardiomyocyte Necrosis in Glycogen Storage Disease type-II. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine. 44 (1), pp. 86-88. https://doi.org/10.1258/000456307779596048

Evaluation of ischaemia-modified albumin as a marker of myocardial ischaemia in end-stage renal disease
Sharma, R., Gaze, D.C., Pellerin, D., Mehta, R.L., Gregson, H., Streather, C.P., Collinson, P.O. and Brecker, S.J.D. 2007. Evaluation of ischaemia-modified albumin as a marker of myocardial ischaemia in end-stage renal disease. Clinical Science. 113 (1), p. 25–32. https://doi.org/10.1042/cs20070015

The role of existing and novel cardiac biomarkers for cardioprotection
Gaze, D.C. 2007. The role of existing and novel cardiac biomarkers for cardioprotection. Current opinion in investigational drugs. 8 (9), pp. 711-717.

Biomarkers of cardiovascular damage and dysfunction – An overview
Collinson, P.O. and Gaze, D. 2007. Biomarkers of cardiovascular damage and dysfunction – An overview. Heart, Lung & Circulation. 16 (3), pp. S71-S82. https://doi.org/10.1016/j.hlc.2007.05.006

Multicentre evaluation of a new point-of-care test for the determination of NT-proBNP in whole blood
Zugck, C., Nelles, M., Katus, H.A., Collinson, P.O., Gaze, D.C., Dikkeschei, B., Gurr, E., Hayen, W., Haass, M., Hechler, C., Van Hoof, V., Guerti, K., Van Waes, C., Printzen, G., Klopprogge, K., Schulz, I. and Zerback, R. 2006. Multicentre evaluation of a new point-of-care test for the determination of NT-proBNP in whole blood. Clinical Chemistry and Laboratory Medicine . 44 (10), pp. 1269-1277. https://doi.org/10.1515/cclm.2006.215

Role of reactive oxygen species on the formation of the novel diagnostic marker ischaemia modified albumin
Roy, D., Quiles, J., Gaze, D., Collinson, P.O., Kaski, J. C. and Baxter, G. F. 2006. Role of reactive oxygen species on the formation of the novel diagnostic marker ischaemia modified albumin. Heart. 92 (1). https://doi.org/10.1136/hrt.2004.049643

Risk stratification of chest pain patients by point-of-care cardiac troponin T and myoglobin measured in the emergency department
Ordóñez-Llanos, J., Santaló-Bel, M., Mercé-Muntañola J., Gaze, D., Collinson, P.O., Haass, M., Katus, H.A., Chwallek, F., Hirschl, M.M., Derhaschnig, U., Mueller-Bardorff, M., Kellett, J., Sylvén, C., Schulz, I. and Zerback, R. 2006. Risk stratification of chest pain patients by point-of-care cardiac troponin T and myoglobin measured in the emergency department. Clinica Chimica Acta. 365 (1-2), pp. 93-97. https://doi.org/10.1016/j.cca.2005.07.035

Novel application of flow propagation velocity and ischaemia modified albumin in analysis of post-exercise cardiac function in man
Middleton, N., Shave, R., George, K., Whyte, G., Forster, J., Oxborough, D., Gaze, D. and Collinson, P.O. 2006. Novel application of flow propagation velocity and ischaemia modified albumin in analysis of post-exercise cardiac function in man. Experimental Physiology. 91 (3), pp. 511-519. https://doi.org/10.1113/expphysiol.2005.032631

Utility of admission cardiac troponin and ‘Ischaemia Modified Albumin’ measurements for rapid evaluation and rule out of suspected acute myocardial infarction in the emergency department
Collinson, P.O., Gaze, D., Bainbridge, K., Morris, F., Morris, B., Price, A. and Goodacre, S. 2006. Utility of admission cardiac troponin and ‘Ischaemia Modified Albumin’ measurements for rapid evaluation and rule out of suspected acute myocardial infarction in the emergency department. Emergency Medicine Journal. 23 (4), pp. 256-261. https://doi.org/10.1136/emj.2005.028241

Comparison of biomarker strategies for rapid rule out of myocardial infarction in the emergency department using ACC/ESC diagnostic criteria
Collinson, P.O., Gaze, D., Morris, F., Morris, B., Price, A. and Goodacre, S. 2006. Comparison of biomarker strategies for rapid rule out of myocardial infarction in the emergency department using ACC/ESC diagnostic criteria. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine. 43 (4), pp. 273-280. https://doi.org/10.1258/000456306777695555

Ischemia-modified albumin (IMA) should be interpreted with caution in patients with low serum albumin concentrations
Gaze, D., Crompton, L. and Collinson, P.O. 2006. Ischemia-modified albumin (IMA) should be interpreted with caution in patients with low serum albumin concentrations. Medical Principles and Practice. 15 (4), pp. 322-324. https://doi.org/10.1159/000093000

Impact of marathon running on cardiac structure and function in recreational runners
Whyte, G., George, K., Shave, R., Dawson, E., Stephenson, C., Edwards, B., Gaze, D., Oxborough, D., Forster, J., Simspon, R. and Gaze, D.C. 2005. Impact of marathon running on cardiac structure and function in recreational runners. Clinical Science. 108 (1), p. 73–80. https://doi.org/10.1042/cs20040186

Cardiac troponin in intensive care
Collinson, P.O. and Gaze, D. 2005. Cardiac troponin in intensive care. Critical Care. 9, pp. 345-346. https://doi.org/10.1186/cc3776

The efficacy of ice massage in the treatment of exercise-induced muscle damage
Howatson, G., Gaze, D., Van Someren, K.A. and Gaze, D.C. 2005. The efficacy of ice massage in the treatment of exercise-induced muscle damage. Scandinavian Journal of Medicine and Science in Sports. 15 (6), pp. 416-422. https://doi.org/10.1111/j.1600-0838.2005.00437.x

Dobutamine stress echocardiography and the resting but not exercise electrocardiograph predict severe coronary artery disease in renal transplant candidates
Sharma, R., Pellerin, D., Gaze, D.C., Gregson, H., Streather, C.P., Collinson, P.O. and Brecker, S.J.D. 2005. Dobutamine stress echocardiography and the resting but not exercise electrocardiograph predict severe coronary artery disease in renal transplant candidates. Nephrology Dialysis Transplantation. 6 (5), p. 327–335. https://doi.org/10.1093/ndt/gfi005

Mitral annular myocardial velocity assessment of segmental left ventricular diastolic function after prolonged exercise in humans
George, K., Oxborough, D., Forster, J., Whyte, G., Shave, R., Dawson, E., Stephenson, C., Dugdill, L., Edwards, B., Gaze, D. and Gaze, D.C. 2005. Mitral annular myocardial velocity assessment of segmental left ventricular diastolic function after prolonged exercise in humans. Journal of Physiology. 569 (1), pp. 305-313. https://doi.org/10.1113/jphysiol.2005.095588

Cardiac troponins as biomarkers of drug and toxin induced cardiac toxicity and cardioprotection
Gaze, D. and Collinson, P.O. 2005. Cardiac troponins as biomarkers of drug and toxin induced cardiac toxicity and cardioprotection. Expert Opinion on Drug Metabolism & Toxicology. 1 (4), pp. 715-725. https://doi.org/10.1517/17425255.1.4.715

Bedside Testing of Cardiac Troponin T and Myoglobin for the Detection of Acute Myocardial Infarction in Patients with a Nondiagnostic Electrocardiogram in the Emergency Department
Kellett, J., Hirschl, M.M., Derhaschnig, U., Collinson, P.O., Gaze, D.C., Haass, M., Katus, H.A., Chwallek, F., Mueller-Bardorff, M., Ordóñez-Llanos, J., Mercé-Muntañola, J., Santaló-Bell, M., Sylvén, C., Schulz, I. and Zerback, R. 2004. Bedside Testing of Cardiac Troponin T and Myoglobin for the Detection of Acute Myocardial Infarction in Patients with a Nondiagnostic Electrocardiogram in the Emergency Department. Plastic Surgical Nursing. 3 (4), pp. 159-161. https://doi.org/10.1097/00134384-200412000-00004

Comparison of ischemia-modified albumin levels in patients undergoing percutaneous coronary intervention for unstable angina pectoris with versus without coronary collaterals
Garrido, I.P., Roy, D., Calviño, R., Vazquez-Rodriguez, J.M., Aldama, G., Cosin-Sales, J., Quiles, J., Gaze, D.C. and Kaski, J.C. 2004. Comparison of ischemia-modified albumin levels in patients undergoing percutaneous coronary intervention for unstable angina pectoris with versus without coronary collaterals. American Journal of Cardiology. 93 (1), pp. 88-90. https://doi.org/10.1016/j.amjcard.2003.09.019

Role of Ischemia Modified Albumin, a new biochemical marker of myocardial ischaemia in the early diagnosis of acute coronary syndromes
Sinha, M., Roy, D., Gaze, D., Collinson, P.O. and Kaski, J. C. 2004. Role of Ischemia Modified Albumin, a new biochemical marker of myocardial ischaemia in the early diagnosis of acute coronary syndromes. Emergency Medicine Journal. 21 (1), pp. 29-34. https://doi.org/10.1136/emj.2003.006007

Effect of prolonged exercise in a hypoxic environment on cardiac function and cardiac troponin T
Shave, R., Dawson, E., Whyte, G., George, K., Gaze, D. and Collinson, P.O. 2004. Effect of prolonged exercise in a hypoxic environment on cardiac function and cardiac troponin T. British Journal of Sports Medicine. 38 (1), pp. 86-88. https://doi.org/10.1136/bjsm.2002.002832

Left ventricular systolic function and diastolic filling after intermittent high-intensity team sports
George, K., Dawson, E., Shave, R., Whyte, G., Jones, M., Hare, E., Gaze, D. and Collinson, P.O. 2004. Left ventricular systolic function and diastolic filling after intermittent high-intensity team sports. British Journal of Sports Medicine. 38 (4), p. 452–456. https://doi.org/10.1136/bjsm.2003.004788

The impact of prolonged exercise in a cold environment upon cardiac function
Shave, R., Dawson, E., Whyte, G., George, K., Nimmo, M., Layden, J., Collinson, P., Gaze, D. and Gaze, D.C. 2004. The impact of prolonged exercise in a cold environment upon cardiac function. Medicine and Science in Sports and Exercise. 36 (9), pp. 1522-1527. https://doi.org/10.1249/01.mss.0000139801.84445.18

Diagnostic Efficiency of a Point-of-Care System for Quantitative Determination of Troponin T and Myoglobin in the Coronary Care Unit
Hirschl, M.M., Derhaschnig, U., Collinson, P.O., Gaze, D., Haass, M., Katus, H.A., Chwallek, F., Mueller-Bardorff, M., Kellett, J., Ordóñez-Llanos, J., Mercé-Muntañola, J., Santaló-Bell, M., Sylvén, C., Schulz, I., Zerback, R. and Gaze, D.C. 2004. Diagnostic Efficiency of a Point-of-Care System for Quantitative Determination of Troponin T and Myoglobin in the Coronary Care Unit. Plastic Surgical Nursing. 3 (4), pp. 162-164. https://doi.org/10.1097/00134384-200412000-00005

Ischemia Modified Albumin for the Assessment of Patients Presenting to the Emergency Department with Acute Chest Pain but Normal or Non-Diagnostic 12-lead Electrocardiograms and Negative Cardiac Troponin T
Roy, D., Quiles, J., Aldama, G., Sinha, M., Avanzas, P., Arroyo-Espliguero, R., Gaze, D., Collinson, P.O. and Kaski, J.C. 2004. Ischemia Modified Albumin for the Assessment of Patients Presenting to the Emergency Department with Acute Chest Pain but Normal or Non-Diagnostic 12-lead Electrocardiograms and Negative Cardiac Troponin T . International Journal of Cardiology. 97 (2), pp. 297-301. https://doi.org/10.1016/j.ijcard.2004.05.042

Cardiac troponin I should be interpreted with caution in paediatric neonatal patients
Gaze, D. and Collinson, P.O. 2004. Cardiac troponin I should be interpreted with caution in paediatric neonatal patients. Neonatology. 86, p. 131–137. https://doi.org/10.1159/000080890

Use of a quantitative point-of-care system greatly reduces the turnaround time of cardiac marker determination
Gaze, D., Collinson, P.O., Haass, M., Derhaschnig, U., Hirschl, M.M., Katus, H. A., Chwallek, F., Mueller-Bardorff, M., Kellett, J., Ordóñez-Llanos, J., Santaló-Bel, M., Mercé-Muntañola, J., Sylvén, C., Schulz, I. and Zerback, R. 2004. Use of a quantitative point-of-care system greatly reduces the turnaround time of cardiac marker determination. Point of Care The Journal of Near-Patient Testing & Technology. 3 (4), pp. 156-158. https://doi.org/10.1097/00134384-200412000-00003

Measurement of cardiac troponin I in striated muscle using three experimental methods
Fredericks, S., Bainbridge, K., Murray, J.F., Collinson, P.O., Carter, N.D. and Holt, D.W. 2003. Measurement of cardiac troponin I in striated muscle using three experimental methods. Annals of Clinical Biochemistry. 40 (3), pp. 244-248. https://doi.org/10.1258/000456303321610547

Ischemia modified albumin is a sensitive marker of myocardial ischemia after percutaneous coronary intervention
Sinha, M.K., Gaze, D.C., Tippins, J.R., Collinson, P.O. and Kaski, J.C. 2003. Ischemia modified albumin is a sensitive marker of myocardial ischemia after percutaneous coronary intervention. Circulation. 107, p. 2403–2405. https://doi.org/10.1161/01.cir.0000072764.18315.6b

Relation of ischemia-modified albumin (IMA) levels following elective angioplasty for stable angina pectoris to duration of balloon-induced myocardial ischemia
Quiles, J., Roy, D., Gaze, D., Garrido, I.P., Avanzas, P., Sinha, M., Kaski, J.C. and Gaze, D.C. 2003. Relation of ischemia-modified albumin (IMA) levels following elective angioplasty for stable angina pectoris to duration of balloon-induced myocardial ischemia. American Journal of Cardiology. 92 (3), pp. 322-324. https://doi.org/10.1016/s0002-9149(03)00638-6

Cardiac troponin T and creatine kinase MB content in skeletal muscle of the uremic rat
Fredericks, S., Murray, J.F., Carter, N.D., Chesser, A.M.S., Papachristou, S., Yaqoob, M.M., Collinson, P.O., Gaze, D. and Holt, D.W. 2002. Cardiac troponin T and creatine kinase MB content in skeletal muscle of the uremic rat. Clinical Chemistry. 48 (6), pp. 859-868.

The cardiospecificity of the third-generation cTnT assay after exercise-induced muscle damage
Shave, R., Dawson, E., Whyte, G., George, K., Ball, D., Collinson, P., Gaze, D. and Gaze, D.C. 2002. The cardiospecificity of the third-generation cTnT assay after exercise-induced muscle damage. Medicine and Science in Sports and Exercise. 34 (4), pp. 651-654. https://doi.org/10.1249/00005768-200204000-00014

Cardiac Troponin T and Creatine Kinase MB Content in Skeletal Muscle of the Uremic Rat
Fredericks, S., Murray, J. F., Carter, N.D., Chesser, A.M.S., Papachristou, S., Yaqoob, M.M., Collinson, P.O., Gaze, D. and Holt, D.W. 2002. Cardiac Troponin T and Creatine Kinase MB Content in Skeletal Muscle of the Uremic Rat. Clinical Chemistry. 48 (6), p. 859–868. https://doi.org/10.1093/clinchem/48.6.859

Cardiac troponin T and creatine kinase MB are not increased in exterior oblique muscle of patients with renal failure
Fredericks, S., Murray, J.F., Bewick, M., Chang, R., Collinson, P.O., Carter, N.D. and Holt, D.W. 2001. Cardiac troponin T and creatine kinase MB are not increased in exterior oblique muscle of patients with renal failure. Clinical Chemistry. 47 (6), pp. 1023-1030.

Measurement of cardiac troponins
Collinson, P.O., Boa, F.G. and Gaze, D.C. 2001. Measurement of cardiac troponins. Annals of Clinical Biochemistry. 38 (5), pp. 423-449. https://doi.org/10.1258/0004563011901109

Clinical evaluation of the ACS:180 cardiac troponin I assay
Collinson, P.O., Wiggins, N. and Gaze, D.C. 2001. Clinical evaluation of the ACS:180 cardiac troponin I assay. Annals of Clinical Biochemistry. 38 (5), pp. 509-519. https://doi.org/10.1258/0004563011901325

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