PHYSIOLOGICAL RESEARCH, vol.72, no.6, pp.707-717, 2023 (SCI-Expanded)
Sudden cardiac death (SCD) in athletes is generally rare, but
a serious complication of cardiovascular events during exercise.
Although regular intensive physical exercise is thought to be a key
to a healthy life, unsuspected pathologies might lead to SCD during
or after physical activity. Cardiac dysfunction and elevated cardiac
markers have been reported after prolonged exercise. We sought
to clarify the cardiac marker levels and hydration status in healthy,
middle-aged male subjects for 24 hours after running sixty-minute
at race-pace. The participants were 47.4±1.7 years old, had peak
oxygen consumption of 47.1±1.2ml/kg/min, and regularly running
70.5±6.4km/week. Blood biomarkers were performed before,
immediately after, at the fourth and twenty-fourth hours after
running. Compared to initial values, creatine kinase
(before:161.2±22.5U/L, 24 hours after:411.9±139.7U/L,
p<0.001) and CK-MB (before:4.3±0.7ng/ml, 24 hours
after:10.1±3.0ng/ml, p<0.001) were significantly elevated
immediately after running and remained significantly high for 24
hours. In addition, Troponin-I (before:5.0±1.1ng/l, 4 hours
after:81.5±29.9ng/l, p<0.001) and NT-proBNP (before:
31.2±5.3pg/ml, immediately after: 64.4±8.5pg/ml, p<0.01) were
significantly elevated immediately after running and returned to
baseline levels in 24 hours. The sixty-minute running caused
significant dehydration, but athletes were rehydrated at the 4th
hour in their voluntary hydration behavior. As the individual data
were analyzed, it was interesting to see that some of the athletes
had critical biomarker levels without any cardiac symptom. Our
findings indicate that race-pace sixty-minute running may induce
a possible transient silent myocardial injury in apparently healthy
master runners. Detailed pre-participation screening of these
athletes may be necessary to reduce the risk of SCD.