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Troponin and exercise

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https://www.readbyqxmd.com/read/28330668/mental-stress-exercise-and-other%C3%A2-determinants-of-elevation-in-high-sensitivity-troponin-levels-a-call-for-standardization-of-laboratory-protocols
#1
EDITORIAL
Alan Rozanski, Chirag Bavishi
No abstract text is available yet for this article.
March 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28330661/association-between-high-sensitivity-cardiac-troponin-levels-and-myocardial-ischemia-during-mental-stress-and-conventional-stress
#2
Muhammad Hammadah, Ibhar Al Mheid, Kobina Wilmot, Ronnie Ramadan, Ayman Alkhoder, Malik Obideen, Naser Abdelhadi, Shuyang Fang, Ijeoma Ibeanu, Pratik Pimple, Heval Mohamed Kelli, Amit J Shah, Brad Pearce, Yan Sun, Ernest V Garcia, Michael Kutner, Qi Long, Laura Ward, J Douglas Bremner, Fabio Esteves, Paolo Raggi, David Sheps, Viola Vaccarino, Arshed A Quyyumi
OBJECTIVES: This study sought to investigate whether patients with mental stress-induced myocardial ischemia will have high resting and post-mental stress high-sensitivity cardiac troponin I (hs-cTnI). BACKGROUND: Hs-cTnI is a marker of myocardial necrosis, and its elevated levels are associated with adverse outcomes. Hs-cTnI levels may increase with exercise in patients with coronary artery disease. Mental stress-induced myocardial ischemia is also linked to adverse outcomes...
March 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28320636/the-significance-of-equivocal-exercise-treadmill-ecg-for-intermediate-risk-chest-pain-assessment-insight-from-coronary-ct-angiography-data
#3
Gary T E Lau, Henry Wei, Jo Wickham, Andrew C Y To
BACKGROUND: Exercise treadmill test (ETT) is commonly the first-line investigation in troponin-negative chest pain patients. Inconclusive results are common and often lead to repeated functional testings. Coronary computed tomographic angiography (CCTA) has excellent negative predictive value for coronary artery disease detection and may play an important role in their diagnostic workup. We aim to analyse ETT and CCTA findings to understand their modern roles in intermediate risk chest pain population with inconclusive ETT...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28314078/high-physical-fitness-is-associated-with-reduction-in-basal-and-exercise-induced-inflammation
#4
Øyunn Kleiven, Magnus Bjørkavoll-Bergseth, Tor Melberg, Øyvind Skadberg, Rolf Bergseth, Jone Selvåg, Bjørn Auestad, Pål Aukrust, Torbjørn Aarsland, Stein Ørn
C-reactive protein (CRP) increases after strenuous exercise. It has been a concern that prolonged strenuous exercise may be harmful, and induce a deleterious inflammatory response. The purpose of this study was to 1) Assess and quantify the magnitude of CRP response following an endurance cycling competition in healthy middle-aged recreational cyclists. 2) Identify important determinants of this response. 3) Identify the relationship between CRP, myocardial damage (cardiac Troponin I (cTnI)) and myocardial strain (B-type natriuretic peptide (BNP))...
March 17, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/28301473/%C3%AE%C2%BA-opioid-receptor-is-involved-in-the-cardioprotection-induced-by-exercise-training
#5
Xiao Geng, Honglin Zhao, Shumiao Zhang, Juan Li, Fei Tian, Na Feng, Rong Fan, Min Jia, Haitao Guo, Liang Cheng, Jincheng Liu, Wensheng Chen, Jianming Pei
The present study was designed to test the hypothesis that exercise training elicited a cardioprotective effect against ischemia and reperfusion (I/R) via the κ-opioid receptor (κ-OR)-mediated signaling pathway. Rats were randomly divided into four groups: the control group, the moderate intensity exercise (ME) group, the high intensity exercise (HE) group, and the acute exercise (AE) group. For the exercise training protocols, the rats were subjected to one week of adaptive treadmill training, while from the second week, the ME and HE groups were subjected to eight weeks of exercise training, and the AE group was subjected to three days of adaptive treadmill training and one day of vigorous exercise...
2017: PloS One
https://www.readbyqxmd.com/read/28299447/markers-of-physiological-stress-during-exercise-under-conditions-of-normoxia-normobaric-hypoxia-hypobaric-hypoxia-and-genuine-high-altitude
#6
David Richard Woods, John Paul O'Hara, Christopher John Boos, Peter David Hodkinson, Costas Tsakirides, Neil Edward Hill, Darren Jose, Amanda Hawkins, Kelly Phillipson, Antonia Hazlerigg, Nicola Arjomandkhah, Liam Gallagher, David Holdsworth, Mark Cooke, Nicholas Donald Charles Green, Adrian Mellor
PURPOSE: To investigate whether there is a differential response at rest and following exercise to conditions of genuine high altitude (GHA), normobaric hypoxia (NH), hypobaric hypoxia (HH), and normobaric normoxia (NN). METHOD: Markers of sympathoadrenal and adrenocortical function [plasma normetanephrine (PNORMET), metanephrine (PMET), cortisol], myocardial injury [highly sensitive cardiac troponin T (hscTnT)], and function [N-terminal brain natriuretic peptide (NT-proBNP)] were evaluated at rest and with exercise under NN, at 3375 m in the Alps (GHA) and at equivalent simulated altitude under NH and HH...
March 15, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28263716/statistical-considerations-for-determining-high-sensitivity-cardiac-troponin-reference-intervals
#7
Peter E Hickman, Gus Koerbin, Julia M Potter, Walter P Abhayaratna
The troponin 99th percentile is used as the laboratory decision point in the diagnosis of acute myocardial infarction. A recent publication has shown that the statistical treatment for outlier removal may dramatically change the calculated troponin 99th percentile. We have used our large database from the previously reported Canberra Heart Study to independently assess the effect of various methods for removing outliers on the calculated 99th percentile. We have performed the same exercise using the troponin 97...
March 1, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28261908/acute-coronary-syndrome-screening-and-diagnostic-practice-variation
#8
Maame Yaa A B Maya Yiadom, Xulei Liu, Conor M McWade, Dandan Liu, Alan B Storrow
BACKGROUND: In the absence of the existing acute coronary syndrome guidelines directing the clinical practice implementation of ED screening and diagnosis, there is variable screening and diagnostic clinical practice across ED facilities. This practice diversity may be warranted. Understanding the variability may identify opportunities for more consistent practice. METHODS: This is a cross-sectional clinical practice epidemiology study with the emergency department (ED) as the unit of analysis characterizing variability in the acute coronary syndrome (ACS) evaluation across 62 diverse EDs...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28256427/midterm-effect-of-balloon-pulmonary-angioplasty-on-hemodynamics-and-subclinical-myocardial-damage-in-chronic-thromboembolic-pulmonary-hypertension
#9
Mai Kimura, Takashi Kohno, Takashi Kawakami, Masaharu Kataoka, Toshimitsu Tsugu, Keitaro Akita, Sarasa Isobe, Yuji Itabashi, Yuichiro Maekawa, Mitsushige Murata, Keiichi Fukuda
BACKGROUND: The acute favourable effect of balloon pulmonary angioplasty (BPA) has been proven in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, data on its effect 6 months after therapy (from now on referred to as mid-term) and influence on the right ventricle and myocardial damage are sparse. To evaluate factors that influence improvement in cardiac output (CO) and subclinical myocardial damage, we examined hemodynamics and serum high-sensitivity troponin T (hs-TnT) levels before, 1 week after, and 6 months after BPA...
December 8, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28241245/the-burden-of-early-phenotypes-and-the-influence-of-wall-thickness-in-hypertrophic-cardiomyopathy-mutation-carriers-findings-from-the-hcmnet-study
#10
Carolyn Y Ho, Sharlene M Day, Steven D Colan, Mark W Russell, Jeffrey A Towbin, Mark V Sherrid, Charles E Canter, John L Jefferies, Anne M Murphy, Allison L Cirino, Theodore P Abraham, Matthew Taylor, Luisa Mestroni, David A Bluemke, Petr Jarolim, Ling Shi, Lynn A Sleeper, Christine E Seidman, E John Orav
Importance: Sarcomere mutations and left ventricular (LV) hypertrophy (LVH) are cardinal features of hypertrophic cardiomyopathy (HCM). However, little is known about the full spectrum of phenotypic manifestations or how LVH influences disease expression. Objectives: (1) To characterize and assess phenotypic burden in sarcomere mutation carriers (genotype positive [G+]) and (2) to investigate the correlation between LV wall thickness (LVWT) and other disease features in mutation carriers...
February 22, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28214153/arrhythmogenic-right-ventricular-dysplasia-atypical-clinical-presentation
#11
José Marçalo, Luiz Menezes Falcão
A 67-year-old man was admitted to our hospital after episodes of syncope preceded by malaise and diffuse neck and chest discomfort. No family history of cardiac disease was reported. Laboratory workup was within normal limits, including D-dimers, serum troponin I and arterial blood gases. The electrocardiogram showed sinus rhythm with T-wave inversion in leads V1 to V3. Computed tomography angiography to investigate pulmonary embolism showed no abnormal findings. Transthoracic echocardiography (TTE) displayed massive enlargement of the right ventricle with intact interatrial septum and no pulmonary hypertension...
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28196358/wellens-syndrome-a-bad-omen
#12
Madalena Coutinho Cruz, Isabel Luiz, Lurdes Ferreira, Rui Cruz Ferreira
Wellens' syndrome is characterized by an electrocardiographic pattern of T-wave changes associated with a critical stenosis of the left anterior descending artery (LAD), which progresses to an extensive anterior myocardial infarction in the majority of cases. For this reason, its recognition and early treatment are extremely important. We report 2 cases of Wellens' syndrome: an 83-year-old male presenting with ill-characterized chest pain, biphasic T waves in V1-V3 during an asymptomatic period, negative cardiac biomarkers, and a 64% stenosis in LAD with a fractional flow reserve of 0...
February 15, 2017: Cardiology
https://www.readbyqxmd.com/read/28186443/highly-increased-troponin-i-levels-following-high-intensity-endurance-cycling-may-detect-subclinical-coronary-artery-disease-in-presumably-healthy-leisure-sport-cyclists-the-north-sea-race-endurance-exercise-study-needed-2013
#13
Øyvind Skadberg, Øyunn Kleiven, Magnus Bjørkavoll-Bergseth, Tor Melberg, Rolf Bergseth, Jone Selvåg, Bjørn Auestad, Ole J Greve, Kenneth Dickstein, Torbjørn Aarsland, Stein Ørn
Background Circulating cardiac troponin levels increase following prolonged intense physical exercise. The aim of this study was to identify participants with highly elevated cardiac troponins after prolonged, high intensity exercise, and to evaluate these for subclinical coronary artery disease. Methods and results Ninety-seven recreational cyclists without known cardiovascular disease or diabetes, participating in a 91 km mountain bike race were included, 74 (76%) were males, age: 43 ± 10 years, race duration: 4...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28179611/asymptomatic-cocaine-abuse%C3%A3-myocardial-tissue-characterization-using-cardiac-biomarkers-and-cardiovascular-magnetic-resonance-imaging
#14
Ulf K Radunski, Ulrike Fuger, Sebastian Bohnen, Gunnar K Lund, Christian Stehning, Tanja Zeller, Enver Tahir, Maxim Avanesov, Gerhard Adam, Stefan Blankenberg, Jens Reimer, Kai Muellerleile
BACKGROUND: Use of cocaine is widespread and associated with several cardiovascular diseases. Recent CMR studies indicate frequent myocardial scar/fibrosis in asymptomatic cocaine abusers (CA).Methods and Results:This study used a combination of advanced CMR tissue characterization techniques, including late gadolinium enhancement (LGE) for focal, and extracellular volume (ECV) imaging for diffuse myocardial injury/fibrosis, with circulating biomarkers for a comprehensive characterization of myocardial injury...
February 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28145667/acute-coronary-syndrome-diagnostic-evaluation
#15
Craig Barstow, Matthew Rice, Jonathan D McDivitt
Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common presentation in patients with MI; however, there are multiple noncardiac causes of chest pain, and the diagnosis cannot always be made based on initial presentation. The assessment of a possible MI includes evaluation of risk factors and presenting signs and symptoms, rapid electrocardiography, and serum cardiac troponin measurements...
February 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28139138/the-value-of-predischarge-exercise-ecg-testing-in-chest-pain-patients-in-the-era-of-high-sensitivity-troponins
#16
Lina Ljung, Martin Sundqvist, Tomas Jernberg, Kai M Eggers, Gunnar Ljunggren, Mats Frick
BACKGROUND: The aim of this study was to examine the value of predischarge exercise electrocardiogram (ECG) testing of chest pain patients in whom acute myocardial infarction (MI) had been ruled out by means of high-sensitivity troponins, ECG and history. METHODS: All patients hospitalised for chest pain who underwent exercise ECG testing before discharge from the Department of Cardiology, Södersjukhuset, Stockholm, Sweden from January 2011 to June 2012 were included...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28132404/right-ventricular-function-during-acute-exacerbation-of-severe-equine-asthma
#17
A Decloedt, H Borowicz, M Slowikowska, K Chiers, G van Loon, A Niedzwiedz
BACKGROUND: Pulmonary hypertension has been described in horses with severe equine asthma but its effect on the right ventricle has not been fully elucidated. OBJECTIVES: To evaluate right ventricular structure and function after a one-week period of pulmonary hypertension secondary to acute exacerbation of severe equine asthma. STUDY DESIGN: Prospective study. METHODS: A clinical episode of severe equine asthma was induced experimentally in six susceptible horses...
January 28, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28115646/response-of-novel-skeletal-muscle-biomarkers-in-dogs-to-drug-induced-skeletal-muscle-injury-or-sustained-endurance-exercise
#18
Katerina Vlasakova, Pamela Lane, Laura Michna, Nagaraja Muniappa, Frank D Sistare, Warren E Glaab
The skeletal muscle (SKM) injury biomarkers, skeletal troponin I (sTnI), myosin light chain 3 (Myl3), and creatine kinase muscle isoform (Ckm) have been shown recently to be more sensitive and specific for monitoring drug-induced SKM injury than the conventional biomarkers, aspartate transaminase (AST) and creatine kinase (CK) enzymatic assays in rat toxicology studies. To evaluate the utility of these SKM biomarkers across species, they were assessed in two dog models: a drug-induced injury study in Beagle dogs and a 160 km endurance exercise run completed by Alaskan sled dogs...
January 23, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28096042/acute-effect-of-intermittent-and-continuous-aerobic-exercise-on-release-of-cardiac-troponin-t-in-sedentary-men
#19
Rouhollah Ranjbar, Mohammad Amin Ahmadi, Abdossaleh Zar, Peter Krustrup
BACKGROUND: Studies have shown that acute exercise can increase serum concentrations of cardiac biomarkers, including cardiac troponin T (cTnT). We investigated the acute effects of intermittent (IE) and continuous (CE) exercise at the same cardiac workload on myocardial necrosis biomarkers in sedentary men. METHODS: Eleven sedentary healthy men aged 22.3±1.9years completed the study. The subjects were divided into two groups and performed, in random order, IE (intensity alternating between 50% (2min) and 80% (1min) HRreserve) or CE (60% HRreserve)...
January 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28087154/evaluation-of-serial-high-sensitivity-troponin-t-levels-in-individuals-without-overt-coronary-heart-disease-following-exercise-stress-testing
#20
Yousef M E Saad, Hanan Idris, Ibrahim M Shugman, Krishna K Kadappu, Rohan Rajaratnam, Liza Thomas, Christian Mussap, Dominic Y C Leung, Craig P Juergens, John K French
BACKGROUND: Detectable levels of high sensitivity (cardiac) troponin T (HsTnT), occur in the majority of patients with stable coronary heart disease (CHD), and often in 'healthy' individuals. Extreme physical activity may lead to marked elevations in creatine kinase MB and TnT levels. However, whether HsTnT elevations occur commonly after exercise stress testing (EST), and if so, whether this has clinical significance, needs clarification. METHODS: To determine whether HsTnT levels become elevated after EST (Bruce protocol) to ≥95% of predicted maximum heart rate in presumed healthy subjects without overt CHD, we assayed HsTnT levels for ∼5h post-EST in 105 subjects (median age 37 years)...
December 9, 2016: Heart, Lung & Circulation
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