Research News Cardiovascular risk linked to exercise-induced biomarker release

9 July 2024

Exercise is healthy and increases longevity. However, those who exercise can still develop cardiovascular diseases. Many amateur athletes who have underlying cardiovascular diseases do not have complaints and may, therefore, be at risk for cardiovascular events without knowing they are.

Intriguingly, exercise produces transient cardiac troponin elevations, a biomarker that is vital in diagnosing cardiac damage. So far, the clinical relevance of exercise-induced elevations remains unclear. Therefore, the TREAT study team aims to investigate whether this simple blood test could be used following exercise to identify athletes with underlying cardiovascular disease.

More specifically, the study team will (1) investigate what could be considered a ‘normal’ troponin concentration following running, cycling, and walking exercise, (2) investigate the association between cardiac troponin release and the presence of occult coronary artery disease, and (3) assess the incidence of cardiovascular events during up to 20 years of follow-up. The TREAT study group, led by Thijs Eijsvogels from the Department of Medical BioSciences in collaboration with the Department of Clinical Chemistry at Maastricht UMC+, published the rationale and design of their study in BMJ Open Sport & Exercise Medicine on June 13th.

Thus far, the team has drawn blood before and after an exercise bout from 1,015 participants during mass-participation sports events like the 'Seven Hills Run', the 'Ronde van Nijmegen' cycling tour, and the Four Days Marches. Furthermore, 10% of participants were invited for a cardiac CT scan to assess the presence (and severity) of coronary artery disease. The researchers hypothesize that athletes with high post-exercise troponin concentrations more often have coronary artery disease than athletes with low troponin concentrations. Currently, the researchers are working on the analyses of the CT images in collaboration with the departments of Radiology (Dr Wouter van Everdingen and Dr Monique Brink) and Cardiology (Prof. Robin Nijveldt) to assess the prevalence and magnitude of coronary artery disease.

PhD candidate Sylvan Janssen expects to have the first results available by the end of 2024. These results could potentially improve the clinical interpretation of post-exercise troponin elevations and enhance the screening of amateur athletes for underlying cardiovascular diseases. Eventually, this may aid in the prevention of sports-related cardiac events.

Read the study here:  

Janssen SLJE, Lamers SK, Vroemen WHM, Denessen EJS, Berge K, Bekers O, Hopman MTE, Brink M, Habets J, Nijveldt R, Van Everdingen WM, Aengevaeren VL, Mingels AMA, Eijsvogels TMH. Cardiac troponin concentrations following exercise and the association with cardiovascular disease and outcomes: rationale and design of the prospective TREAT cohort study. BMJ Open Sport Exerc Med. 2024 Jun 13;10(2):e002070. doi: 10.1136/bmjsem-2024-002070. PMID: 38882206; PMCID: PMC11177668.

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