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Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis
Background: Kinetics, moderators and reference limits for exercise-induced cardiac troponin T (cTnT) elevations are still unclear. Methods: A systematic review of published literature was conducted adhering to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines....
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033011/ https://www.ncbi.nlm.nih.gov/pubmed/33841187 http://dx.doi.org/10.3389/fphys.2021.651851 |
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author | Li, Feifei Hopkins, Will G. Wang, Xuejing Baker, Julien S. Nie, Jinlei Qiu, Junqiang Quach, Binh Wang, Kun Yi, Longyan |
author_facet | Li, Feifei Hopkins, Will G. Wang, Xuejing Baker, Julien S. Nie, Jinlei Qiu, Junqiang Quach, Binh Wang, Kun Yi, Longyan |
author_sort | Li, Feifei |
collection | PubMed |
description | Background: Kinetics, moderators and reference limits for exercise-induced cardiac troponin T (cTnT) elevations are still unclear. Methods: A systematic review of published literature was conducted adhering to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies reporting high-sensitivity cardiac troponin T (hs-cTnT) concentrations before and after a bout of exercise in athletes were included and analyzed. The final dataset consisted of 62 estimates from 16 bouts in 13 studies of 5–1,002 athletes (1,421 in total). Meta-analysis was performed using general linear mixed modeling and Bayesian inferences about effect magnitudes. Modifying fixed-effect moderators of gender, age, baseline level, exercise duration, intensity and modalities were investigated. Simulation was used to derive 99th percentile with 95% limits of upper reference ranges for hs-cTnT of athletic populations. Results: The mean and upper reference limits of hs-cTnT before exercise were 4.4 and 19 ng.L(−1). Clear increases in hs-cTnT ranging from large to very large (factor changes of 2.1–7.5, 90% compatibility limits, ×/÷1.3) were evident from 0.7 through 25 h, peaking at 2.9 h after the midpoint of a 2.5-h bout of running, when the mean and upper reference limit for hs-cTnT were 33 and 390 ng L(−1). A four-fold increase in exercise duration produced a large clear increase (2.4, ×/÷1.7) in post-exercise hs-cTnT. Rowing exercise demonstrated an extremely large clear reduction (0.1 ×/÷2.4). Conclusions: The kinetics of cTnT elevation following exercise, the positive effect of exercise duration, the impact of exercise modality and 99th upper reference limits for athletic populations were reasonably well defined by this meta-analysis. |
format | Online Article Text |
id | pubmed-8033011 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80330112021-04-10 Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis Li, Feifei Hopkins, Will G. Wang, Xuejing Baker, Julien S. Nie, Jinlei Qiu, Junqiang Quach, Binh Wang, Kun Yi, Longyan Front Physiol Physiology Background: Kinetics, moderators and reference limits for exercise-induced cardiac troponin T (cTnT) elevations are still unclear. Methods: A systematic review of published literature was conducted adhering to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies reporting high-sensitivity cardiac troponin T (hs-cTnT) concentrations before and after a bout of exercise in athletes were included and analyzed. The final dataset consisted of 62 estimates from 16 bouts in 13 studies of 5–1,002 athletes (1,421 in total). Meta-analysis was performed using general linear mixed modeling and Bayesian inferences about effect magnitudes. Modifying fixed-effect moderators of gender, age, baseline level, exercise duration, intensity and modalities were investigated. Simulation was used to derive 99th percentile with 95% limits of upper reference ranges for hs-cTnT of athletic populations. Results: The mean and upper reference limits of hs-cTnT before exercise were 4.4 and 19 ng.L(−1). Clear increases in hs-cTnT ranging from large to very large (factor changes of 2.1–7.5, 90% compatibility limits, ×/÷1.3) were evident from 0.7 through 25 h, peaking at 2.9 h after the midpoint of a 2.5-h bout of running, when the mean and upper reference limit for hs-cTnT were 33 and 390 ng L(−1). A four-fold increase in exercise duration produced a large clear increase (2.4, ×/÷1.7) in post-exercise hs-cTnT. Rowing exercise demonstrated an extremely large clear reduction (0.1 ×/÷2.4). Conclusions: The kinetics of cTnT elevation following exercise, the positive effect of exercise duration, the impact of exercise modality and 99th upper reference limits for athletic populations were reasonably well defined by this meta-analysis. Frontiers Media S.A. 2021-03-26 /pmc/articles/PMC8033011/ /pubmed/33841187 http://dx.doi.org/10.3389/fphys.2021.651851 Text en Copyright © 2021 Li, Hopkins, Wang, Baker, Nie, Qiu, Quach, Wang and Yi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Physiology Li, Feifei Hopkins, Will G. Wang, Xuejing Baker, Julien S. Nie, Jinlei Qiu, Junqiang Quach, Binh Wang, Kun Yi, Longyan Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis |
title | Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis |
title_full | Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis |
title_fullStr | Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis |
title_full_unstemmed | Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis |
title_short | Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis |
title_sort | kinetics, moderators and reference limits of exercise-induced elevation of cardiac troponin t in athletes: a systematic review and meta-analysis |
topic | Physiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033011/ https://www.ncbi.nlm.nih.gov/pubmed/33841187 http://dx.doi.org/10.3389/fphys.2021.651851 |
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