Markers of ventricular dysfunction and myocardial damage in ultra-endurance sports

Abstract

In recent years, ultra-endurance sports have become mass phenomena. Their growing popularity contrasts with epidemiological evidence that suggests that very intense or prolonged physical exercise may not be as beneficial as moderate one. On the other hand, it is known that markers of myocardial damage and ventricular dysfunction, such as troponins and natriuretic peptides, may rise soon after exhausting sports events, particularly in ultra-endurance disciplines. As might be expected, some authors have suggested that extremely intense or prolonged exercise could be harmful to athletes' health and that the presence of high levels of these markers in plasma may mean myocardial injury or ventricular dysfunction. This article aims to review and summarize the bibliography related to the topic, to describe the proposed mechanisms that try to explain how and why the physical exercise associated with other variables may trigger the values of these biomarkers. The factors proposed to be responsible for such elevation were also analyzed and we offer an interpretation of such phenomenon. Also, the experience of our working group on the subject is briefly commented, as we think the results may help in understanding this intriguing phenomenon, which should be known and recognized by the medical community to avoid clinical mismanagement before athletes with these laboratory findings.