Increased biochemical markers of myocardial damage and ventricular dysfunction after a mountain ultramarathon

Abstract

It has been reported that ultra-endurance races can raise markers of myocardial damage and ventricular dysfunction. We decided to study the behavior of these markers in young runners, with little experience and not used to the height, before and after a mountain ultramarathon. Method: Prospective observational study. Twenty athletes were evaluated before, immediately after and 24 hours after an ultramarathon, analyzing plasma levels of troponin T and NT Pro- BNP, age, sex, duration and length of the race, training, experience, and relative race intensity. Results: Twenty runners completed 55.19 ± 7.39 kilometers in 637.9 ± 197.53 minutes. Both
markers raised significantly (p <0.0001). 95% exceeded the cut-off point of NT Pro-BNP for heart failure. All runners presented values above the 99th percentile for troponin T and 80% exceeded the diagnostic threshold for AMI. The group with less experience, but more trained, presented higher values of NT Pro-BNP. Troponin levels were inversely proportional to weekly training (p =
0.042), where the group ran at a heart rate greater than 80% of the maximum, which significantly raised NT Pro-BNP values (p = 0.001). Conclusions: In this study, a significant increase in troponin and NT Pro-BNP levels were observed in all athletes. The characteristics of the race and the sample may have facilitated these results. The mechanisms of these findings are not yet defined, but the absence of clinical manifestations, and the uniformity of the responses, suggest that they could represent aspects of an
adaptive phenomenon.