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Biomarkers of Cardiac Stress and Injury in Athletes: What Do They Mean?

  • Biomarkers of Heart Failure (J Grodin & W.H.W. Tang, Section Editors)
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Abstract

Purpose of the Review

Markers of myocardial stress, including troponin, creatine kinase, and brain natriuretic peptide are frequently elevated after endurance athletic pursuits. Here, we summarize the current literature pertaining to the potential mechanism of cardiac enzyme release in athletes and seek to determine the clinical implications of these findings.

Recent Findings

Recent studies have highlighted the potential adverse cardiac effects of long-term extreme endurance exercise. While troponin release occurs in a pattern distinct from ischemic damage, BNP release has been correlated with right ventricular dysfunction and is likely related to wall stress from prolonged increases in cardiac output. Higher intensity pre-race training regimes are associated with lower race-day enzyme release.

Summary

While the holistic benefits of regular moderate exercise are indisputable, recent studies have raised concerns about the potential risks of extreme endurance exercise. Release of serum biomarkers suggesting myocardial damage was first described in the 1970s, yet our understanding of the implications of these findings remains incomplete. The mechanisms of release are complex but appear to be primarily physiological phenomena rather than pathologic.

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  1. Department of Cardiovascular Medicine, Cleveland Clinic, Desk J1-5, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Eoin Donnellan & Dermot Phelan

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Donnellan, E., Phelan, D. Biomarkers of Cardiac Stress and Injury in Athletes: What Do They Mean?. Curr Heart Fail Rep 15, 116–122 (2018). https://doi.org/10.1007/s11897-018-0385-9

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