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Kröpfl JM, Beltrami FG, Gruber H, Schmidt‐Trucksäss A, Dieterle T, Spengler CM. Circulating Gal-3 and sST2 are associated with acute exercise-induced sustained endothelial activation: Possible relevance for fibrosis development? Exp Physiol 2023; 108:1259-1267. [PMID: 37572028 PMCID: PMC10988490 DOI: 10.1113/ep091277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/17/2023] [Indexed: 08/14/2023]
Abstract
Long-term, intense endurance exercise training can occasionally induce endothelial micro-damage and cardiac fibrosis. The underlying mechanisms are incompletely understood. Twenty healthy, well-trained male participants (10 runners and 10 cyclists) performed a strenuous high-intensity interval training (HIIT) session matched by age, height, weight and maximal oxygen consumption. We assessed the acute exercise response of novel cardiac biomarkers of fibrosis [e.g., galectin-3 (Gal-3) and soluble suppression of tumorigenicity 2 (sST2)] per exercise modality and their relationship with haemodynamic contributors, such as preload, afterload and cardiac contractility index (CTi), in addition to endothelial damage by sustained activation and shedding of endothelial cells (ECs). Serum Gal-3 and sST2 concentrations were investigated by enzyme-linked immunosorbent assays; haemodynamics were analysed via impedance plethysmography and circulating ECs by flow cytometry. The Gal-3 and sST2 concentrations and ECs were elevated after exercise (P < 0.001), without interaction between exercise modalities. Circulating Gal-3 and sST2 concentrations both showed a positive relationship with ECs (rrm = 0.68, P = 0.001 and rrm = 0.57, P = 0.010, respectively, both n = 18). The EC association with Gal-3 was significant only in cyclists, but equally strong for both modalities. Gal-3 was also related to exercise-induced CTi (rrm = 0.57, P = 0.011, n = 18). Cardiac wall stress is increased after an acute HIIT session but does not differ between exercise modalities. Exercise-released Gal-3 from cardiac macrophages could very probably drive systemic endothelial damage, based on an enhanced CTi. The importance of acute exercise-induced vascular resistances and cardiac contractility for the release of fibrotic biomarkers and any long-term pathological endothelial adaptation should be investigated further, also relative to the exercise modality. NEW FINDINGS: What is the central question of this study? Circulating biomarkers of cardiac wall stress and fibrosis are influenced by physical exercise. The underlying mechanisms per exercise modality are still unclear. What is the main finding and its importance? We show that galectin-3 (Gal-3) and soluble suppression of tumorigenicity 2 (sST2) are increased after acute exercise but do not differ between running and cycling. One haemodynamic contributor to the secretion of Gal-3 is an enhanced cardiac contractility. Acute exercise-released Gal-3 and sST2 are linked to sustained endothelial activation and cell shedding. This could be relevant in the context of fibrosis development and could identify athletes at risk for pathological endothelial adaptations.
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Affiliation(s)
- Julia M. Kröpfl
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and HealthUniversity of BaselBaselSwitzerland
| | - Fernando G. Beltrami
- Exercise Physiology Lab, Institute of Human Movement Sciences and SportETH ZurichZurichSwitzerland
| | - Hans‐Jürgen Gruber
- Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical University of GrazGrazAustria
| | - Arno Schmidt‐Trucksäss
- Division of Sport and Exercise Medicine, Department of Sport, Exercise and HealthUniversity of BaselBaselSwitzerland
| | - Thomas Dieterle
- Foeldiklinik GmbH&Co KGHinterzartenGermany
- Department of Clinical ResearchUniversity Hospital BaselBaselSwitzerland
| | - Christina M. Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and SportETH ZurichZurichSwitzerland
- Zurich Center for Integrative Human Physiology (ZIHP)University of ZurichZurichSwitzerland
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Suehiro CL, Souza NTS, da Silva EB, Cruz MM, Laia RM, de Oliveira Santos S, Santana-Novelli FPR, de Castro TBP, Lopes FD, Pinheiro NM, de FátimaLopes Calvo Tibério I, Olivo CR, Alonso-Vale MI, Prado MAM, Prado VF, de Toledo-Arruda AC, Prado CM. Aerobic exercise training engages cholinergic signaling to improve emphysema induced by cigarette smoke exposure in mice. Life Sci 2022; 301:120599. [DOI: 10.1016/j.lfs.2022.120599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 04/16/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022]
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Abstract
Immunoassays are currently the methods of choice for the measurement of a large panel of complex and heterogenous molecules owing to full automation, short turnaround time, high specificity and sensitivity. Despite remarkable performances, immunoassays are prone to several types of interferences that may lead to harmful consequences for the patient (e.g., prescription of an inadequate treatment, delayed diagnosis, unnecessary invasive investigations). A systematic search is only performed for some interferences because of its impracticality in clinical laboratories as it would notably impact budget, turnaround time, and human resources. Therefore, a case-by-case approach is generally preferred when facing an aberrant result. Hereby, we review the current knowledge on immunoassay interferences and present an algorithm for interference workup in clinical laboratories, from suspecting their presence to using the appropriate tests to identify them. We propose an approach to rationalize the attitude of laboratory specialists when faced with a potential interference and emphasize the importance of their collaboration with clinicians and manufacturers to ensure future improvements.
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Affiliation(s)
- Loris Wauthier
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium
| | - Mario Plebani
- Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy
| | - Julien Favresse
- Department of Laboratory Medicine, Clinique St-Luc Bouge, Namur, Belgium
- Department of Pharmacy, Namur Research Institute for LIfes Sciences, University of Namur, Namur, Belgium
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Le Goff C, Viallon M, Kaux JF, Andonian P, Moulin K, Seidel L, Giardini G, Gergelé L, Croisille P, Cavalier E, Millet GP. Kinetics of Cardiac Remodeling and Fibrosis Biomarkers During an Extreme Mountain Ultramarathon. Front Cardiovasc Med 2022; 9:790551. [PMID: 35321109 PMCID: PMC8934929 DOI: 10.3389/fcvm.2022.790551] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives The effects of ultra-distance on cardiac remodeling and fibrosis are unclear. Moreover, there are no data reporting the kinetics of cardiac alterations throughout the event and during recovery. Our aim was to investigate the kinetics of biological markers including new cardiac fibrosis biomarkers suppression of tumorigenicity 2 (ST2) and galectin-3 (Gal-3) during and after an extreme mountain ultramarathon. Methods Fifty experienced runners participating in one of the most challenging mountain ultramarathons (330 km, D+ 25,000 m) were enrolled in our study. Blood samples were collected at four time points: before (Pre-), at 148 km (Mid-), at the finish line (Post-), and 3 days after the recovery period (Recov-). Results The cardiac fibrosis biomarkers (ST2 and Gal-3) increased from Pre- to Mid-. During the second half, ST2 remained higher than pre-values as opposed to Gal-3. Necrosis, ischemia, and myocyte injury biomarkers increased until Mid- then decreased but remained higher at Recov- than Pre-values. Oxidative stress appeared at Mid-. Lipid peroxides remained higher at Recov- compared to Pre-. The maximal value in most of these biomarkers was observed at Mid- and not at Post-. Conclusions The present study supports biphasic kinetics of cardiac fibrosis biomarkers, with a relative recovery during the second half of the event that seems specific to this extreme event. Overall, performing at such an extreme ultramarathon seems less deleterious for the heart than shorter events.
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Affiliation(s)
- Caroline Le Goff
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium
- *Correspondence: Caroline Le Goff
| | - Magalie Viallon
- Department of Radiology, University Hospital of Saint Etienne, Saint-Étienne, France
- CREATIS, CNRS (UMR 5220), INSERM (U1044), INSA Lyon, University of Lyon, Lyon, France
| | - Jean-François Kaux
- Physical Medicine and Sport Traumatology Department, SportS, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIFA Medical Centre of Excellence, FIMS Collaborative Centre of Sports Medicine, University Hospital of Liège, University of Liège, Liège, Belgium
| | - Pierre Andonian
- Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Kevin Moulin
- Department of Radiology, University Hospital of Saint Etienne, Saint-Étienne, France
- CREATIS, CNRS (UMR 5220), INSERM (U1044), INSA Lyon, University of Lyon, Lyon, France
| | - Laurence Seidel
- Biostatistics Department, University Hospital of Liège, Liège, Belgium
| | - Guido Giardini
- Neurology Department, Valle d'Aosta Regional Hospital, Aosta, Italy
| | - Laurent Gergelé
- Department of Anesthesiology, University Hospital of Saint Etienne, Saint-Étienne, France
| | - Pierre Croisille
- Department of Radiology, University Hospital of Saint Etienne, Saint-Étienne, France
- CREATIS, CNRS (UMR 5220), INSERM (U1044), INSA Lyon, University of Lyon, Lyon, France
| | - Etienne Cavalier
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium
| | - Gregoire P. Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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Martins da Costa A, Teixeira R, Vilela EM, Tavares A, Torres S, Sampaio F, Teixeira M, Fontes-Carvalho R, Pedro Nunes J. Suppression of tumorigenicity 2 after exercise: a systematic review. Monaldi Arch Chest Dis 2021; 92. [PMID: 34461703 DOI: 10.4081/monaldi.2021.1839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/12/2021] [Indexed: 11/23/2022] Open
Abstract
Exercise is a pivotal physiological activity, associated with benefits. Whilst the importance of physical activity is consensual along different steps of the cardiovascular (CV) continuum, there has been interest in assessing the CV adaptations to vigorous exercise. Indeed, exercise can be associated with increases in cardiac biomarkers, though the scope of this observation remains elusive. Interleukin 1 receptor related protein, Suppression of tumorigenicity 2 (ST2) is a biomarker related to the pathophysiology of fibrosis, having shown promise in the study of heart failure. Knowledge of ST2 kinetics could improve understanding of the mechanistic pathways related to CV adaptations to exercise. To assess the current state-of-the-art concerning ST2 levels after exercise in healthy individuals. A systematic review was carried out on three databases (Pubmed, ISI Web of Science and Scopus), up to October 2020, using the queries "ST2" or "ST-2" + "exercise" or "running". A total of six studies were included in the review, encompassing 349 subjects (73% male gender) in which ST2 was assessed. Most studies reported increases in ST2 levels after exercise. Three studies, encompassing a total of 219 individuals, described a cut-off level of 35 ng/dL for ST2. In these, 92.7% of subjects had ST2 levels above this cut-off after exercise (running in all studies). Most studies report increased levels of ST2 after exercise, with an important number of individuals exceeding the 35 ng/dL threshold. Given the small number of individuals represented and the lack of imaging data and long-term follow-up, further prospective larger studies should target this.
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Affiliation(s)
| | - Rafael Teixeira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Eduardo M Vilela
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Ana Tavares
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Susana Torres
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Francisco Sampaio
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Madalena Teixeira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho.
| | - Ricardo Fontes-Carvalho
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho; Cardiovascular Research Center (UniC), Faculty of Medicine, University of Porto.
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Kashef A, Nikoo AS. Effects of short duration high intensity competition on cardiac and cell damage biomarkers. Comparative Exercise Physiology 2021. [DOI: 10.3920/cep200047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to investigate the cardiac biomarkers like cardiac troponin T (cTnT), cardiac troponin I, and creatine kinase-MB (CK-MB) and the cell damage biomarkers including creatine phosphokinase (CPK), C-reactive protein (CRP), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in response to a short-duration high-intensity competition with correction of the post-exercise raw data with the plasma volume loss in trained athletes. Thirty-two male athletes (age, 26.9±4.7 years) competed in 8 min high-intensity competition. The competition items included: running for 400 meters; three-stage deadlifting; bar pulling up; and 30 kg kettlebell swinging. Venous blood samples were obtained before and immediately after the competition and biomarkers analysed. Plasma volume changes were estimated from haemoglobin and haematocrit readings before and after the competition. A significant increase was shown immediately after the competition compared to resting in cTnT, AST, ALT, CPK, and CRP (P<0/001). CK-MB showed no significant difference. When raw data were corrected for plasma volume loss, CPK showed a significant increase (P<0.001), and LDH and CK-MB a significant decrease (P<0.001), however cTnT, AST, ALT and CRP showed no significant difference. The plasma volume loss can affect the response of cardiac and cellular damage biomarkers to exercise. High-intensity competition for 8 min did not elevate the cardiac biomarkers, but elevated the muscle biomarkers.
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Affiliation(s)
- A. Kashef
- Exercise Physiology Department, Shahid Rajaee Teacher Training University, Lavizan St., Tehran, 1678815811, Iran
| | - A. Sadeghi Nikoo
- Oxygen Medical and Research Center, Seoul St., Tehran, 1468973141, Iran
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Li F, Hopkins WG, Wang X, Baker JS, Nie J, Qiu J, Quach B, Wang K, Yi L. Kinetics, Moderators and Reference Limits of Exercise-Induced Elevation of Cardiac Troponin T in Athletes: A Systematic Review and Meta-Analysis. Front Physiol 2021; 12:651851. [PMID: 33841187 PMCID: PMC8033011 DOI: 10.3389/fphys.2021.651851] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/01/2021] [Indexed: 01/26/2023] Open
Abstract
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.
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Affiliation(s)
- Feifei Li
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Will G Hopkins
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Xuejing Wang
- Clinical Laboratory, Civil Aviation General Hospital, Beijing, China
| | - Julien S Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.,Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China
| | - Jinlei Nie
- School of Health Sciences and Sports, Macao Polytechnic Institute, Macao, China
| | - Junqiang Qiu
- College of Sport Science School, Beijing Sport University, Beijing, China
| | - Binh Quach
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Kun Wang
- College of Physical Education, Hebei Normal University, Shijiazhuang, China
| | - Longyan Yi
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
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Benedetti S, Gemma Nasoni M, Palma F, Citarella R, Luchetti F. Serum changes in sTWEAK and its scavenger receptor sCD163 in ultramarathon athletes running the 24-h race. Cytokine 2020; 137:155315. [PMID: 33011401 DOI: 10.1016/j.cyto.2020.155315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/28/2020] [Accepted: 09/22/2020] [Indexed: 11/17/2022]
Abstract
In the present investigation, the serum changes of sTWEAK levels, a multifunctional cytokine involved in tissue response to acute injury and inflammation, and of its scavenger receptor sCD163, were monitored for the first time in ultramarathon athletes running the 24-h competition, an extremely demanding race in terms of muscular and physiological exertion. To this aim, venous blood samples were collected from each participant (n = 22, M = 12, F = 10) both before and immediately after the 24-h running. Other than sTWEAK and sCD163, the common serum biomarkers of inflammation (namely CRP and IL-6) and tissue injury (such as CPK, LDH, CPK-MB, troponin-I, and NT-proBNP) were evaluated. All parameters were within the reference ranges at baseline, indicating no alterations of the normal physiological processes before the competition; on the contrary, most biomarkers of tissue damage and inflammation strongly increased after the ultramarathon race. Interestingly, a significant decrement of sTWEAK levels associated with an increment of its scavenger receptor sCD163 was observed at post-race. Positive relationships were evidenced between IL-6 and sCD163 levels and the markers of cardiac damage troponin-I and NT-proBNP. On the contrary, sTWEAK showed an inverse correlation with IL-6 and NT-proBNP. This study opens the way to further investigations aimed at clarifying the role of TWEAK pathway during the prolonged ultraendurance activity, paying particular attention to the link of IL-6, CD163 and TWEAK with the cardiac function.
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Affiliation(s)
- Serena Benedetti
- Department of Biomolecular Sciences, Section of Biochemistry and Biotechnology, University of Urbino Carlo Bo, Urbino, Italy.
| | - Maria Gemma Nasoni
- Department of Biomolecular Sciences, Section of Morphology, Physiology and Environmental Biology, University of Urbino Carlo Bo, Urbino, Italy
| | - Francesco Palma
- Department of Biomolecular Sciences, Section of Biochemistry and Biotechnology, University of Urbino Carlo Bo, Urbino, Italy
| | | | - Francesca Luchetti
- Department of Biomolecular Sciences, Section of Morphology, Physiology and Environmental Biology, University of Urbino Carlo Bo, Urbino, Italy
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Mahanty A, Xi L. Utility of cardiac biomarkers in sports medicine: Focusing on troponin, natriuretic peptides, and hypoxanthine. Sports Medicine and Health Science 2020; 2:65-71. [PMID: 35784176 PMCID: PMC9219314 DOI: 10.1016/j.smhs.2020.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 01/20/2023] Open
Abstract
Evidence-based consensus suggests that physical activity and regular exercise training can reduce modifiable risk factors as well as rate of mortality and morbidity in patients with chronic diseases, such as cardiovascular disease (CVD), diabetes, obesity and cancer. Conversely, long-term exercise training and drastic increase in vigorous physical activity may also cause acute cardiovascular events (e.g. acute myocardial infarction) and deleterious cardiac remodeling, particularly when exercise is performed by unfit or susceptible individuals. There is a reversed J-shaped hormesis-like curve between the duration and intensity of exercise and level of CVD risks. Therefore, it is important for an early detection of cardiac injuries in professional and amateur athletes. Under this context, this article focuses on the use of biomarker testing, an indispensable component in the current clinical practices especially in Cardiology and Oncology. We attempt to justify the importance of using circulating biomarkers in routine practices of Sports Medicine for an objective assessment of CVD events following exercise. Special attentions are dedicated to three established or emerging cardiac biomarkers (i.e. cardiac troponins, natriuretic peptides, hypoxanthine) for myocardial tissue hypoxia/ischemia events, muscle stress, and the consequent cellular necrotic injury. Based on these focused analyses, we propose use of circulating biomarker testing in both laboratory and point-of-care settings with an increasingly broader involvement or participation of team physicians, trainers, coaches, primary care doctors, as well as educated athlete community. This diagnostic approach may improve the quality of medical surveillance and preventive measures on exercise-related CVD risks/outcomes.
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Affiliation(s)
| | - Lei Xi
- Corresponding author. Division of Cardiology, Box 980204, Virginia Commonwealth University, 1101 East Marshall Street, Room 7-020C, Richmond, VA, 23298-0204, USA.
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