Belastungsinduzierte veränderungen der kardialen marker troponin, ischämie-modifiziertes albumin und B-typ natriuretisches peptid

At present the risk of myocardial damage by endurance exercise is again under discussion because of reports on exercise-induced increases in cardiac markers troponin and B-type natriuretic peptide (BNP), since these markers are typically elevated in patients with acute myocardial infarction and chronic heart failure, respectively. Exercise-induced elevations of cardiac troponins can be present in professional as well as in recreational athletes, especially after prolonged and strenuous endurance exercise sessions (e.g. marathon, ultra-triathlon). But in contrast to acute myocardial infarction, exercise-induced elevations in cardiac troponins are only moderate and seem to represent reversible damage instead of infarction of cardiomyocytes. In healthy athletes, exercise-induced elevations usually reach normal reference values within 24 hours after exercise. BNP (and NT-proBNP) concentrations can also increase in professional and recreational athletes by sports activity and are found to be elevated especially after endurance exercise bouts. Nevertheless, these increases do not seem to be of pathological significance but may have cytoprotective and growth-regulating properties on the myocardium. For daily routine in the clinical setting, it is important to know that BNP and NT-proBNP concentrations are not elevated in healthy athletes under resting conditions. In patients with coronary artery disease or chronic heart failure it has to be considered that even moderate exercise can induce temporary minor increases in BNP or NT-proBNP.