Document Detail

Elevated serum cardiac markers in asymptomatic marathon runners after competition: is the myocardium stunned?
MedLine Citation:
PMID:  9397299     Owner:  NLM     Status:  MEDLINE    
Prolonged strenuous exercise may trigger acute myocardial infarction (AMI), as exemplified by the occurrence of sudden cardiac death during marathon running. Serum creatine kinase MB (CK-MB) may be elevated in asymptomatic marathon runners after competition from exertional rhabdomyolysis of skeletal muscle altered by training, limiting its utility for evaluating acute cardiac injury in such athletes. Myoglobin and CK-MB2 isoform levels are emerging as earlier markers of AMI and troponin subunits as more specific than serum CK-MB mass. We tested runners before and sequentially after the 1995 Boston Marathon for conventional and newer markers including myoglobin, CK-MB mass and isoforms, cardiac troponin T, and cardiac troponin I using standard laboratory methods and rapid format assays if available. The mean serum values for myoglobin, CK-MB mass, CK-MB/myoglobin rapid panel tests, and CK-MB2 isoforms were normal or negative pre-race and elevated or positive 4 and 24 h after competition. These markers lack specificity for acute cardiac injury in trained runners. While the mean serum values for cardiac troponins T and I remained normal, 9 of 45 runners (20%) showed an increase in subunits by first-generation assays. All runners remained asymptomatic for cardiac disease and completed subsequent marathons 1 year later, making reversible myocardial injury or stunning unlikely. Elevated values of serum markers for AMI, including first-generation assays for both troponin subunits should be interpreted with caution in trained runners.
A J Siegel; M Sholar; J Yang; E Dhanak; K B Lewandrowski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology     Volume:  88     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:    1997 Nov-Dec
Date Detail:
Created Date:  1998-01-16     Completed Date:  1998-01-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  487-91     Citation Subset:  IM    
Department of Medicine, McLean Hospital, Boston, Mass., USA.
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MeSH Terms
Acute Disease
Biological Markers / blood
Creatine Kinase / blood*
Enzyme-Linked Immunosorbent Assay
Middle Aged
Myocardial Stunning / blood*,  diagnosis,  etiology
Myocardium / metabolism*
Myoglobin / blood*
Reference Values
Retrospective Studies
Running / physiology*
Sensitivity and Specificity
Troponin / blood*
Troponin I / blood*
Troponin T
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; 0/Myoglobin; 0/Troponin; 0/Troponin I; 0/Troponin T; EC Kinase

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