Troponin release following endurance exercise: is inflammation the cause? a cardiovascular magnetic resonance study.

BACKGROUND: The aetiology and clinical significance of troponin release following endurance exercise is unclear but may be due to transient myocardial inflammation. Cardiovascular magnetic resonance (CMR) affords us the opportunity to evaluate the presence of myocardial inflammation and focal fibrosis and is the ideal imaging modality to study this hypothesis. We sought to correlate the relationship between acute bouts of ultra endurance exercise leading to cardiac biomarkers elevation and the presence of myocardial inflammation and fibrosis using CMR. METHODS: 17 recreation athletes (33.5 +/- 6.5 years) were studied before and after a marathon run with troponin, NTproBNP, and CMR. Specific imaging parameters to look for inflammation included T2 weighted images, and T1 weighted spin-echo images before and after an intravenous gadolinium-DTPA to detect myocardial hyperemia secondary to inflammation. Late gadolinium imaging was performed (LGE) to detect any focal regions of replacement fibrosis. RESULTS: Eleven of the 17 participant had elevations of TnI above levels of cut off for myocardial infarction 6 hrs after the marathon (0.075 +/- 0.02, p = 0.007). Left ventricular volumes were reduced post marathon and a small increase in ejection fraction was noted (64+/- 1% pre, 67+/- 1.2% post, P = 0.014). Right ventricular volumes, stroke volume, and ejection fraction were unchanged post marathon. No athlete fulfilled criteria for myocardial inflammation based on current criteria. No regions of focal fibrosis were seen in any of the participants. CONCLUSION: Exercise induced cardiac biomarker release is not associated with any functional changes by CMR or any detectable myocardial inflammation or fibrosis.

Association of physical inactivity with increased cardiovascular risk in patients with rheumatoid arthritis.

OBJECTIVE: Patients with rheumatoid arthritis (RA) are characterized by reduced physical activity and increased morbidity and mortality from cardiovascular disease (CVD). The aim of this study was to investigate associations between levels of physical activity and CVD risk profile in RA patients. METHODS: Levels of physical activity were assessed in 65 RA patients (43 females). Using the International Physical Activity Questionnaire, patients were allocated into three groups: active, moderately active and inactive. Anthropometric characteristics, RA activity/severity, multiple classical and novel CVD risk factors and 10-year CVD event probability were assessed and compared among the three groups. RESULTS: Significant differences were detected among groups in systolic blood pressure (P=0.006), cholesterol (P<0.001), low-density lipoprotein (P=0.01), homeostasis model assessment (P=0.001), type-I plasminogen activator inhibitor antigen (P<0.001), tissue-type plasminogen activator antigen (P=0.019), homocysteine (P=0.027), fibrinogen (P=0.001), apolipoprotein B (P=0.002) and von Willebrand Factor (P=0.001), with a consistent deterioration from the physically active to the physically inactive group. Multivariate analysis of variance revealed that levels of physical activity were significantly associated with the differences in all of the above variables (P<0.05) after adjustment for age, weight, sex, smoking status, as well as RA disease activity and severity. CONCLUSION: This cross-sectional study suggests that physically inactive RA patients have significantly worse CVD risk profile compared with physically active patients. The possible beneficial impact of increased physical activity, including structured exercise, to the CVD risk of RA patients needs to be accurately assessed in prospective studies.

Validity of the emotional intelligence scale for use in sport.

This study investigated the factorial validity of the 33-item self-rated Emotional Intelligence Scale (EIS: Schutte et al., 1998) for use with athletes. In stage 1, content validity of the EIS was assessed by a panel of experts (n = 9). Items were evaluated in terms of whether they assessed EI related to oneself and EI focused on others. Content validity further examined items in terms of awareness, regulation, and utilization of emotions. Content validity results indicated items describe 6-factors: appraisal of own emotions, regulation of own emotions, utilization of own emotions, optimism, social skills, and appraisal of others emotions. Results highlighted 13-items which make no direct reference to emotional experiences, and therefore, it is questionable whether such items should be retained. Stage 2 tested two competing models: a single factor model, which is the typical way researchers use the EIS and the 5-factor model (optimism was discarded as it become a single-item scale fiolliwng stage 1) identified in stage 1. Confirmatory factor analysis (CFA) results on EIS data from 1,681 athletes demonstrated unacceptable fit indices for the 33-item single factor model and acceptable fit indices for the 6-factor model. Data were re-analyzed after removing the 13-items lacking emotional content, and CFA results indicate partial support for single factor model, and further support for a five-factor model (optimism was discarded as a factor during item removal). Despite encouraging results for a reduced item version of the EIS, we suggest further validation work is needed. Key pointsGiven the inherent link between construct measurement and theory testing, it is imperative for researchers to pay close attention to measurement issues showed poor fit indices. The present study investigated a self-report emotional intelligence for use in sportResults indicate that a single-item model shows poor fit with acceptable fit indices for a 6-factor model.A revised 5-factor and 19-item model showed improved model fit.Despite encouraging results, we suggest further validation work is needed.

Changes in vascular and cardiac function after prolonged strenuous exercise in humans.

Prolonged exercise has been shown to result in an acute depression in cardiac function. However, little is known about the effect of this type of exercise on vascular function. Therefore, the purpose of the present study was to investigate the impact of an acute bout of prolonged strenuous exercise on vascular and cardiac function and the appearance of biomarkers of cardiomyocyte damage in 15 male (32 +/- 10 yr) nonelite runners. The subjects were tested on two occasions, the day before and within an hour of finishing the London marathon (229 +/- 38 min). Function of the brachial and femoral arteries was determined using flow-mediated dilatation (FMD). Echocardiographic assessment of cardiac strain, strain rate, tissue velocities, and flow velocities during diastole and systole were also obtained. Venous blood samples were taken for later assessment of cardiac troponin I (cTnI), a biomarker of cardiomyocyte damage. Completion of the marathon resulted in a depression in femoral (P = 0.04), but not brachial (P = 0.96), artery FMD. There was no change, pre- vs. postmarathon, in vascular shear, indicating that the impaired femoral artery function was not related to hemodynamic changes. The ratio of peak early to atrial radial strain rate, a measure of left ventricular diastolic function, was reduced postmarathon (P = 0.006). Postrace cTnI was elevated in 12 of 13 runners, with levels above the recognized clinical threshold for damage in 7 of these. In conclusion, when taken together, these data suggest a transient depression in cardiac and leg vascular function following prolonged intensive exercise.