Exercise Training Increases Serum Cardiac Troponin T Independent of Left Ventricular Mass

Abstract

The purpose of this study was to determine whether exercise training mediated cardiac troponin T (cTnT) and whether this was associated with increases in left ventricular mass (LVM). Fifty-four sedentary obese women were randomised to high-intensity interval training (HIIT, repeated 4–min cycling at 90% V̇O_2max interspersed with 3–min rest), work-equivalent continuous aerobic training (CAT, continuous cycling at 60% V̇O_2max) or a control group (CON). Resting serum cTnT was assessed using a high-sensitivity assay before and after 12 weeks of training. LVM was determined from 2D echocardiography at the same timepoints. Both HIIT and CAT induced a similar elevation (median 3.07 to 3.76 ng.l⁻¹, p<0.05) in resting cTnT compared with pre-training and the CON (3.49 to 3.45 ng.l⁻¹, p>0.05). LVM index in HIIT increased (62.2±7.8 to 73.1±14.1 g.m⁻², p<0.05), but not in CAT (66.1±9.7 to 67.6±9.6 g.m⁻², p>0.05) and CON (67.9±9.5 to 70.2±9.1 g.m⁻², p>0.05). Training-induced changes in resting cTnT did not correlate with changes in LVM index (r=−0.025, p=0.857). These findings suggest that twelve weeks of either HIIT or CAT increased resting cTnT, but the effects were independent of any changes in LVM in sedentary obese women.

Key words

cardiac biomarker - high-intensity interval training - aerobic training - cardiovascular risk factor

Publikationsverlauf

Eingereicht: 11. Juni 2021

Angenommen: 30. September 2021

Artikel online veröffentlicht:
06. Dezember 2021

• References

• 1 Park KC, Gaze DC, Collinson PO. et al. Cardiac troponins: from myocardial infarction to chronic disease. Cardiovasc Res 2017; 113: 1708-1718
• 2 Farmakis D, Mueller C, Apple FS. High-sensitivity cardiac troponin assays for cardiovascular risk stratification in the general population. Eur Heart J 2020; 41: 4050-4056
• 3 McEvoy JW, Chen Y, Ndumele CE. et al. Six-year change in high-sensitivity cardiac troponin t and risk of subsequent coronary heart disease, heart failure, and death. JAMA Cardiol 2016; 1: 519-528
• 4 Fretz A, McEvoy JW, Rebholz CM. et al. Relation of lifestyle factors and life's simple 7 score to temporal reduction in troponin levels measured by a high-sensitivity assay (from the Atherosclerosis Risk in Communities Study). Am J Cardiol 2018; 121: 430-436
• 5 Powers SK. Exercise: teaching myocytes new tricks. J Appl Physiol (1985) 2017; 123: 460-472
• 6 O’Connor CM, Ahmad T. Can we prevent heart failure with exercise?. J Am Coll Cardiol 2012; 60: 2548-2549
• 7 Harrington JL, Ayers C, Berry JD. et al. Sedentary behavior and subclinical cardiac injury: results from the Dallas Heart Study. Circulation 2017; 136: 1451-1453
• 8 Parsons TJ, Sartini C, Welsh P. et al. Objectively measured physical activity and cardiac biomarkers: a cross sectional population based study in older men. Int J Cardiol 2018; 254: 322-327
• 9 Legaz-Arrese A, Lopez-Laval I, George K. et al. Impact of an endurance training program on exercise-induced cardiac biomarker release. Am J Physiol Heart Circ Physiol 2015; 308: H913-H920
• 10 van der Linden N, Tieland M, Klinkenberg LJ. et al. The effect of a six-month resistance-type exercise training program on the course of high sensitive cardiac troponin T levels in (pre)frail elderly. Int J Cardiol 2014; 175: 374-375
• 11 van der Linden N, Klinkenberg LJ, Leenders M. et al. The effect of exercise training on the course of cardiac troponin T and I levels: Three independent training studies. Sci Rep 2015; 5: 18320
• 12 Legaz-Arrese A, Lopez-Laval I, George K. et al. Individual variability in cardiac biomarker release after 30 min of high-intensity rowing in elite and amateur athletes. Appl Physiol Nutr Metab 2015; 40: 951-958
• 13 Wallace TW, Abdullah SM, Drazner MH. et al. Prevalence and determinants of troponin T elevation in the general population. Circulation 2006; 113: 1958-1965
• 14 Xanthakis V, Larson MG, Wollert KC. et al. Association of novel biomarkers of cardiovascular stress with left ventricular hypertrophy and dysfunction: Implications for screening. J Am Heart Assoc 2013; 2: e000399
• 15 Lavie CJ, Ozemek C, Carbone S. et al. Sedentary behavior, exercise, and cardiovascular health. Circ Res 2019; 124: 799-815
• 16 Florido R, Ndumele CE, Kwak L. et al. Physical activity, obesity, and subclinical myocardial damage. JACC Heart Fail 2017; 5: 377-384
• 17 DeFina LF, Willis BL, Radford NB. et al. Cardiorespiratory fitness and highly sensitive cardiac troponin levels in a preventive medicine cohort. J Am Heart Assoc 2016; 5
• 18 Foryst-Ludwig A, Kintscher U. Sex differences in exercise-induced cardiac hypertrophy. Pflugers Arch 2013; 465: 731-737
• 19 Huang YC, Tsai HH, Fu TC. et al. High-intensity interval training improves left ventricular contractile function. Med Sci Sports Exerc 2019; 51: 1420-1428
• 20 World Health Organization. Regional Office for the Western Pacific. The Asia-Pacific perspective: Redefining Obesity and its Treatment. Sydney: Health Communications Australia;; 2000
• 21 Ainsworth BE, Macera CA, Jones DA. et al. Comparison of the 2001 BRFSS and the IPAQ Physical Activity Questionnaires. Med Sci Sports Exerc 2006; 38: 1584-1592
• 22 Harriss DJ, MacSween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
• 23 Gresslien T, Agewall S. Troponin and exercise. Int J Cardiol 2016; 221: 609-621
• 24 Li F, Hopkins WG, Wang X. et al. Kinetics, moderators and reference limits of exercise-induced elevation of cardiac troponin T in athletes: A systematic review and meta-analysis. Front Physiol 2021; 12: 651851
• 25 Nie J, Zhang H, Kong Z. et al. The impact of exercise modality and menstrual cycle phase on circulating cardiac troponin T. J Sci Med Sport 2020; 23: 309-314
• 26 Kyle UG, Bosaeus I, De Lorenzo AD. et al. Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr 2004; 23: 1430-1453
• 27 Tian Y, Nie J, Huang C. et al. The kinetics of highly sensitive cardiac troponin T release after prolonged treadmill exercise in adolescent and adult athletes. J Appl Physiol (1985) 2012; 113: 418-425
• 28 Giannitsis E, Kurz K, Hallermayer K. et al. Analytical validation of a high-sensitivity cardiac troponin T assay. Clin Chem 2010; 56: 254-261
• 29 Lang RM, Badano LP, Mor-Avi V. et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015; 28: 1-39 e14
• 30 Devereux RB, Alonso DR, Lutas EM. et al. Echocardiographic assessment of left ventricular hypertrophy: Comparison to necropsy findings. Am J Cardiol 1986; 57: 450-458
• 31 Ghali JK, Liao Y, Simmons B. et al. The prognostic role of left ventricular hypertrophy in patients with or without coronary artery disease. Ann Intern Med 1992; 117: 831-836
• 32 Palmieri V, Dahlof B, DeQuattro V. et al. Reliability of echocardiographic assessment of left ventricular structure and function. J Am Coll Cardiol 1999; 34: 1625-1632
• 33 Su L, Fu J, Sun S. et al. Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: A meta-analysis. PLoS One 2019; 14: e0210644
• 34 Batacan RB, Duncan MJ, Dalbo VJ. et al. Effects of high-intensity interval training on cardiometabolic health: A systematic review and meta-analysis of intervention studies. Br J Sports Med 2017; 51: 494-503
• 35 Lin X, Zhang X, Guo J. et al. Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc 2015; 4: e002014
• 36 Zhang H, Tong TK, Kong Z. et al. Exercise training-induced visceral fat loss in obese women: the role of training intensity and modality. Scand J Med Sci Sports 2021; 31: 30-43
• 37 Kemi OJ, Haram PM, Loennechen JP. et al. Moderate vs. high exercise intensity: differential effects on aerobic fitness, cardiomyocyte contractility, and endothelial function. Cardiovasc Res 2005; 67: 161-172
• 38 Wisloff U, Ellingsen O, Kemi OJ. High-intensity interval training to maximize cardiac benefits of exercise training?. Exerc Sport Sci Rev 2009; 37: 139-146
• 39 Sanchis-Gomar F, Lippi G. Physical activity – an important preanalytical variable. Biochem Med (Zagreb) 2014; 24: 68-79
• 40 Daniels LB. The enemy of good?: making the most of highly sensitive troponin assays. J Am Coll Cardiol 2013; 61: 1914-1916
• 41 de Lemos JA, Drazner MH, Omland T. et al. Association of troponin T detected with a highly sensitive assay and cardiac structure and mortality risk in the general population. Jama 2010; 304: 2503-2512
• 42 Ahmad T, Fiuzat M, Mark DB. et al. The effects of exercise on cardiovascular biomarkers in patients with chronic heart failure. Am Heart J 2014; 167: 193-202.e1
• 43 La Gerche A, Heidbuchel H, Burns AT. et al. Disproportionate exercise load and remodeling of the athlete's right ventricle. Med Sci Sports Exerc 2011; 43: 974-981