Cardiac Troponin Increase After Endurance Exercise

Name: Work Video:
Duration: 3 min 30 s
Torbjørn Omland; Kristin M. Aakre
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[155, 1039, 1956], 'concentrations': [156, 184, 225, 254, 391, 429, 614, 1169, 1186, 1503], 'in': [157, 185, 226, 257, 286, 293, 371, 375, 608, 698, 753, 851, 881, 956, 1037, 1124, 1133, 1148, 1176, 1184, 1187, 1221, 1228, 1245, 1352, 1499, 1515, 1525, 1554, 1570, 1708, 1779, 1816, 1909, 1950, 1998, 2147, 2169, 2333, 2345, 2490, 2498, 2507, 2557, 2636, 2703, 2762, 2770, 2789, 2792], 'normal': [159, 316], 'state': [160], 'chronic': [163], 'myocardial': [164, 209, 264, 401, 590, 859, 942, 961, 965, 1085, 1095, 1100, 1207, 1212, 1256, 2336], 'injury': [165, 815, 860, 943, 966, 973, 983, 1086], 'associated': [167, 212, 240, 386, 658, 1089, 1139, 1180, 1490, 1520, 2037], 'with': [168, 187, 213, 219, 229, 241, 387, 397, 416, 533, 611, 624, 628, 659, 958, 1079, 1090, 1126, 1140, 1155, 1162, 1181, 1223, 1390, 1441, 1465, 1521, 1768, 1895, 1954, 2038, 2559, 2562, 2679], 'low-grade,': [169], 'stable': [170, 230, 977, 1583, 1910], 'elevation': [171, 270, 309, 340, 725, 1585, 2042], 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1912, 1948, 2034], 'disease': [233, 1165, 1200, 1475, 1949, 2035], 'general': [236, 1781, 1818], 'population': [237, 1230, 1433, 1464], 'strongly': [239], 'risk': [243, 506, 642, 1448, 1471, 1491, 1637, 1778, 1958, 2344], 'incident': [245, 2078], 'failure': [247, 2343, 2561], 'cardiovascular': [249, 329, 354, 441, 472, 505, 516, 586, 675, 1447, 1452, 1470, 1474, 1562, 1628, 2081], 'death.1,4Transient': [250], 'increase': [251, 466, 821, 890, 1132, 1175, 1241, 1529, 1540, 1589, 2076], 'may': [255, 384, 767, 808, 836, 861, 914, 1020, 1028, 1087, 1214, 1258, 1336, 1356, 2398], 'occur': [256], 'variety': [259], 'circumstances,': [261], 'reflecting': [262], 'acute': [263, 353, 595], 'injury.': [265], 'general,': [267], 'short-term': [268, 936, 982, 1094, 1216], 'been': [272, 283, 300, 320, 360, 444, 1104, 1519], 'considered': [273, 301, 1622], 'reflect': [275, 2210], 'harmful': [276], 'pathophysiological': [277], 'processes.': [278], 'One': [279], 'notable': [280], 'exception': [281], 'rise': [285], 'concentration': [288, 1065], 'observed': [289, 785, 891], 'after': [290, 312, 341, 392, 410, 437, 467, 525, 638, 654, 707, 774, 786, 824, 892, 908, 921, 940, 999, 1541, 1592, 1617, 2150], 'endurance': [291, 333, 342, 380, 438, 468, 893, 909, 1285, 1542, 1593, 1618, 1952], 'exercise': [292, 313, 381, 393, 439, 469, 528, 655, 948, 1000, 1018, 1036, 1220, 1318, 1543, 1594, 1619, 2045, 2174], 'presumably': [294, 1232], 'healthy': [295, 1233, 2499], 'individuals,': [296, 1234], 'which': [297], 'commonly': [299], 'benign': [303], 'phenomenon.': [304], 'The': [305, 474, 634, 663, 729, 932, 994, 1598, 2389, 2620], 'theory': [306, 358, 791, 1081], 'transient': [308, 819, 879, 1588, 1992], 'physiological': [317, 720, 1235], 'response': [318, 409, 436, 784, 939, 1034, 1559], 'based': [321, 738], 'several': [323, 696], 'lines': [324], 'evidence:': [326], 'clear': [328], 'health': [330], 'benefits': [331], 'exercise,': [334, 343, 1012, 1286], 'high': [336, 1444, 2629, 2707], 'frequency': [337], 'lack': [346], 'symptoms': [348], 'or': [349, 430, 596, 599, 756, 802, 805, 928, 1195, 1201, 1718], 'evidence': [351, 399], 'suggesting': [352, 378], 'disease.': [355, 517, 1453], 'However,': [356, 423], 'challenged': [361], 'by': [362, 669, 865, 945, 976, 1057, 1272, 1366, 1508, 1547, 1610, 2284, 2293], 'recent': [363, 854], 'observations:': [364], 'prevalence': [367, 1263, 1445, 1468], 'atherosclerotic': [369, 419, 1957], 'plaques': [370], 'former': [372], 'athletes': [373, 1953], 'than': [374, 678, 873], 'control': [376], 'subjects,': [377], 'over': [382], 'years': [383], 'be': [385, 667, 768, 809, 863, 915, 1021, 1044, 1088, 1338, 1400, 1506, 1568, 1621], 'atherogenesis5;': [388], 'cTnI': [390, 408, 518, 613, 646, 747, 1134, 1392], 'among': [394, 414, 2403], 'marathon': [395, 2000, 2151], 'runners': [396, 2149], 'CMR': [398], 'scar6;': [402], 'an': [404, 542, 620, 1047, 1067, 1849, 2672], 'exaggerated': [405], 'prolonged': [407, 782, 955, 2039], 'bicycle': [412], 'race': [413, 2627], 'participants': [415, 503, 563, 607, 627], 'occult': [417], 'obstructive': [418, 2032], 'disease.7': [422], 'definitive': [424], 'data': [425, 855, 1015, 1117, 1121, 1346], 'relating': [426], 'postexercise': [427, 612, 1421], 'magnitude': [432, 933, 995, 1072, 1142, 1265, 1556], 'outcomes': [442], 'lacking.In': [445], 'this': [446, 631, 1709], 'issue': [447], 'Circulation,': [449], 'Aengevaeren': [450, 692, 1058, 1273, 1435, 1601, 2058], 'et': [451, 693, 1059, 1274, 1436, 1602, 1761, 1808, 1890, 1942, 1985, 2279, 2822], 'al8': [452, 694, 1275, 1437, 1603], 'report': [453], 'observations': [454, 690], 'from': [455, 651, 917, 1646, 1653, 1659, 1670, 1673, 1676, 1681, 1692, 1698, 2113, 2299], 'first': [457], 'large-scale': [458], 'study': [459, 475, 683, 1056, 1150, 1271, 1432, 1599], 'investigates': [461], 'association': [463, 635, 664, 1283], 'between': [464, 1284, 2200], 'long-term': [471, 960, 964, 972, 1083, 1255, 1582, 1996], 'events.': [473], 'included': [476, 1152, 1438], '726': [477], 'middle-aged': [478, 1439], '(median': [480], '61': [481], 'years)': [482], 'who': [483], 'walked': [484], 'distance': [486], '30': [488], '55': [490], 'km': [491, 2625], 'nearly': [493], '70%': [494], 'predicted': [496], 'rate.': [498], 'Twenty-six': [499], 'percent': [500, 605], 'had': [504, 511, 1166], 'factors,': [507], 'additionally,': [509], '14%': [510], 'history': [513], 'previous': [515, 1451], 'was': [519, 1179], 'measured': [520], 'before': [521, 652, 1615], '10': [523, 2831], 'minutes': [524], 'completion': [526], 'using': [529, 2671], 'contemporary': [531], 'assay': [532, 1772, 1908], 'limit': [535, 545], 'detection': [537], '0.006': [539], 'μg/L': [540], 'upper': [543], 'reference': [544], '(ie,': [546], '99th': [548, 568, 617], 'percentile)': [549], '0.040': [551], 'μg/L.': [552], 'median': [555, 574], '8': [557], 'hours': [558], 'walking,': [560], '9%': [561], 'showed': [564], 'values': [565, 629, 1405, 1423], 'above': [566, 615], 'percentile': [569, 618], 'cTnI.': [571], 'During': [572], 'follow-up': [575], 'time': [576, 1329], '43': [578], 'months,': [579], '29': [580], 'deaths': [581], '33': [583], 'major': [584, 673, 2245], 'adverse': [585, 674], 'events': [587, 676], '(defined': [588], 'as': [589, 1106, 1238, 1250, 1252, 1848, 2676, 2711], 'infarction,': [591], 'stroke,': [592], 'failure,': [594], 'elective': [597], 'revascularization,': [598], 'sudden': [600], 'arrest)': [602], 'occurred.': [603], 'Twenty-seven': [604], 'group': [610], 'experienced': [619], 'end': [621], 'point': [622, 1330], 'compared': [623], '7%': [625], 'below': [630], 'level': [632], '(P<0.001).': [633], 'remained': [636], 'significant': [637, 1224], 'adjustment': [639], 'traditional': [641], 'factors': [643, 1236, 1449, 1472], 'baseline': [645, 991, 1063, 1374], 'concentrations.': [647], 'Moreover,': [648], 'larger': [649], 'changes': [650], 'were': [656], 'significantly': [657], 'primary': [661], 'outcome.': [662], 'seemed': [665], 'driven': [668], 'incidence': [671, 1533], 'rather': [677, 872], 'all-cause': [679], 'mortality.': [680], 'Although': [681, 1385], 'results': [684], 'seem': [685, 1504], 'robust': [686], 'convincing,': [688], 'raise': [695], 'questions,': [697], 'particular': [699], 'concerning': [700], 'underlying': [702, 722, 959, 1109], 'mechanisms': [703, 721, 898], 'release': [706, 736, 902, 998, 1218, 2291, 2402, 2493], 'strenuous': [708, 2044], 'physical': [709, 1513], 'activity': [710, 1514], 'potential': [713, 810, 1108], 'clinical': [714, 1292, 1307, 1480, 1579, 1854], 'implications': [715, 1293, 1580], 'exercise-associated': [717, 1112], 'elevation.The': [719], 'exercise-induced': [723, 734, 1267, 2203, 2248, 2492], 'remain': [726], 'incompletely': [727], 'understood.': [728], 'current': [730, 790, 1055, 1573], 'paradigm': [731], 'transient,': [733], 'concept': [741], 'small': [744, 2145], 'proportion': [745], 'cTnT': [749, 1185], 'molecules': [750, 2146], 'circulate': [751], 'freely': [752], 'cytosol': [755], 'weakly': [758], 'bound': [759], 'myofilaments': [762], 'cardiomyocyte': [765, 787], 'released': [769, 916, 2112], 'into': [770, 1281], 'extracellular': [772, 831, 929], 'space': [773], 'reversible': [775, 813, 858, 941], 'cell': [776, 797, 814, 834, 843, 852, 924], 'injury.9': [777], 'contrast': [779, 847], 'necrosis,': [788, 853], 'suggests': [792], 'stretching': [794], 'membrane,': [798], 'oxygen': [799], 'supply-demand': [800], 'mismatch,': [801], 'toxic': [803], 'neurohormonal': [804], 'inflammatory': [806], 'influences': [807], 'inducers': [811], 'leading': [816], 'during': [822, 1135, 1219, 1662], 'exercise.9': [825], 'Subsequent': [826], 'formation': [827, 922], 'membranous': [829, 926], 'blebs,': [830, 927], 'vesicles,': [832], 'wounds': [835], 'permit': [837], 'leakage': [838], 'through': [841], 'membrane': [844], '(Figure).': [845], 'case': [850], 'suggest': [856, 1016, 1061, 1122, 1347], 'preferentially': [862], 'characterized': [864, 975], 'fragments': [871], 'intact': [874], 'molecules.10': [876], 'Finally,': [877, 1478], 'reduction': [880, 1244, 1524, 1553], 'clearance': [882], 'could': [883], 'theoretically': [884], 'also': [885, 1029, 1103, 1382, 1544], 'contribute': [886, 1259], 'exercise.Download': [894], 'figureDownload': [895], 'PowerPointFigure.': [896], 'Potential': [897], 'expected': [904], 'dynamics': [907], 'exercise.': [910], 'A,': [911, 1750, 1752, 1799, 1803, 1841, 1923, 1941, 2133, 2382, 2421, 2429, 2435, 2439, 2475, 2521, 2525, 2610, 2614], 'troponins': [913], 'reversibly': [918], 'injured': [919, 2114], 'cardiomyocytes': [920], 'wounds,': [925], 'vesicles.': [930], 'B,': [931, 2022, 2091, 2230, 2368, 2374, 2743], 'induced': [944, 2283], 'given': [947], 'load': [949], 'likely': [951], 'greater': [952], 'more': [954, 1260], 'injury.Short-': [962], 'leads': [967], 'distinct': [969], 'patterns:': [971], 'concentrations,': [980], 'whereas': [981], 'shows': [984], 'rapid': [986, 2285], 'increasing/decreasing': [987], 'pattern': [988], 'returning': [989], 'within': [992], 'hours.': [993], 'seems': [1001], 'vary': [1003], 'according': [1004], 'intensity': [1008, 1019, 2175], 'duration': [1010, 1247, 2240], 'although': [1013, 1211, 1376], 'some': [1014, 1345], 'stronger': [1023], 'determinant.11': [1024], 'Accordingly,': [1025], 'cardiorespiratory': [1026, 1040], 'fitness': [1027, 1041], 'impact': [1030], 'appears': [1042], 'related': [1045], 'augmented': [1048], 'response.': [1050], 'Other': [1051], '(including': [1053], 'al8)': [1060], 'important': [1068], 'predictor': [1069], 'response8,12,13': [1076], '(Figure),': [1077], 'compatible': [1078], 'subclinical': [1084, 1254, 1856, 1946], 'less': [1091], 'tolerance': [1092], 'stress.The': [1096], 'asymptomatic': [1099], 'ischemia': [1101, 1213, 2282], 'proposed': [1105], 'mechanism': [1110], 'release,': [1114], 'but': [1115, 1172, 1990], 'existing': [1116], 'conflicting.': [1119], 'Some': [1120], 'suspected': [1127], 'disease,': [1130, 1160, 1227], 'stress': [1136, 2337], 'testing': [1137], 'ischemic': [1145], 'territory.': [1146], 'Conversely,': [1147], 'without': [1157], 'baseline,': [1171], 'pacing-induced': [1174], 'rate': [1178, 1240], 'similar': [1182], 'increments': [1183], 'sinus': [1190, 2302], 'regardless': [1191], 'absence': [1196], 'lactate': [1202], 'production,': [1203], 'surrogate': [1205], 'ischemia.14': [1208], 'summary,': [1210], 'cause': [1215], 'such': [1237], 'subsequent': [1243, 2341], 'diastole,': [1249], 'well': [1251], 'unrecognized': [1253], 'injury,': [1257, 2339], 'increase.Although': [1269], 'provides': [1276, 1631], 'novel': [1277], 'interesting': [1279], 'insights': [1280, 2298], 'increase,': [1288], 'outcomes,': [1290], 'unclear.': [1295, 1384, 1477], 'First,': [1296], '30-': [1298], '55-km': [1300], 'walking': [1301], 'test': [1302, 1625], 'obviously': [1304], 'impractical': [1305], 'practice,': [1308], 'future': [1310, 1397, 1571], 'should': [1312, 1399, 1567], 'aim': [1313], 'identifying': [1315], 'briefer,': [1316], 'standardized': [1317], 'protocols': [1319], 'provide': [1321, 1357, 1407], 'reproducible': [1322], 'results.': [1323], 'Second,': [1324], 'optimal': [1326, 1408], 'blood': [1327, 2242], 'sampling': [1328, 2303], 'diagnostic': [1332], 'prognostic': [1334, 1363, 1632], 'purposes': [1335], 'not': [1337, 1712, 1991], 'termination': [1341], 'exercise;': [1343], 'indeed,': [1344], 'samples': [1349], 'obtained': [1350], 'later': [1351], 'recovery': [1354], 'period': [1355], 'better': [1358], 'discrimination.7': [1359], 'Third,': [1360], 'whether': [1361, 1551], 'information': [1364, 1633], 'provided': [1365], 'adding': [1367], 'delta': [1369, 1404], 'value': [1371], 'value,': [1375], 'statistically': [1377], 'significant,': [1378], 'clinically': [1380], 'important,': [1381], 'remains': [1383, 1476], 'hazard': [1387], 'ratios': [1388], 'increased': [1389, 1512], 'deltas,': [1393], 'goal': [1395], 'determine': [1402], 'discrimination': [1409], 'different': [1411], 'investigate': [1416], 'how': [1417], 'addition': [1419], 'impacts': [1424], 'C-statistics': [1426], 'reclassification': [1428], 'statistics.': [1429], 'Fourth,': [1430], 'relatively': [1443], 'To': [1454], 'what': [1455], 'extent': [1456], 'generalizable': [1460], 'younger': [1463], 'lower': [1467, 1532], 'utility': [1481], 'biomarker': [1484, 1496], 'greatly': [1486], 'enhanced': [1487], 'if': [1488], 'its': [1489], 'modifiable': [1493, 1507, 1546], 'reflects': [1497], 'change': [1498, 2332], 'risk.': [1500], 'Long-term': [1501], 'lifestyle': [1509, 1548], 'intervention,': [1510, 1549], 'because': [1511], 'older': [1516, 2346], 'adults': [1517], 'age-related': [1527], 'failure.15': [1536], 'Whether': [1537], 'signals': [1560], 'reduced': [1561, 2563], 'risk,': [1563], 'unknown': [1565], 'addressed': [1569], 'studies.Our': [1572], 'understanding': [1574], 'causes': [1577, 2288], 'occurs': [1591], 'still': [1596], 'incomplete.': [1597], 'adds': [1604], 'another': [1605], 'piece': [1606], 'puzzle': [1609], 'showing': [1611], 'measurement': [1614], 'can': [1620], 'functional': [1624], 'system': [1629], 'independent': [1634], 'conventional': [1636], 'markers.DisclosuresDr': [1638], 'received': [1641], 'grants': [1642, 1649, 1669, 1672, 1675], 'personal': [1644, 1651, 1657, 1679, 1690, 1696], 'fees': [1645, 1652, 1658, 1680, 1691, 1697], 'Roche': [1647, 1693], 'Diagnostics,': [1648, 1655], 'Abbott': [1654], 'Siemens': [1660, 1699], 'Healthineers': [1661], 'conduct': [1664], 'study,': [1667], 'Novartis,': [1671], 'SomaLogic,': [1674], 'Singulex,': [1677], 'Bayer': [1682], 'outside': [1683, 1702], 'submitted': [1685, 1704], 'work.': [1686], 'Dr': [1687], 'reports': [1689], 'Diagnostics': [1694], 'Health': [1700], 'Care': [1701], 'work.FootnotesThe': [1705], 'opinions': [1706], 'expressed': [1707], 'necessarily': [1713], 'those': [1714], 'editors': [1717], 'American': [1721, 2461, 2837], 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