Srčani biomarkeri i sportska aktivnost

master's thesis

• Title (english): Cardiac biomarkers and sports
• Author: Luka Antolković
• Mentor: Mislav Vrsalović (mentor)
• Committee member: Matias Trbušić (predsjednik povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Committee member: Mislav Vrsalović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Occupational and Sports Medicine

Abstract

Srčani biomarkeri troponini i natriuretski peptidi postali su nezaobilazni u dijagnostičkoj obradi akutnog koronarnog sindroma i srčanog zatajenja. Korištenjem visoko osjetljivih troponina, nakon intenzivne tjelesne aktivnosti u djela sportaša, detektirane su vrijednosti koje prelaze prag za dijagnozu akutnog infarkta miokarda. Usprkos tako visokim vrijednostima troponina sportaši se nisu žalili na bolove u prsima niti su imali EKG promjene ST spojnice. U sportaša s visokim vrijednostima troponina kontrastna MR srca nije pronašla znakove nekroze miokarda. Također, kinetika porasta troponina ne odgovara onoj u akutnom infarktu miokarda. Sve više autora smatra da je porast troponina nakon intenzivne tjelesne aktivnosti posljedica povećanog mehaničkog opterećenja miokarda. Nije dokazana povezanost između prolaznog poremećaja srčane funkcije nakon intenzivne tjelesnih aktivnosti i porasta srčanih biomarkera. Prema preporukama SZO 150 minuta tjedno umjerene ili 75 minuta tjedno intenzivne aerobne aktivnosti u odraslih osoba smanjuju kardiovaskularni rizik i preuranjeni mortalitet. U osoba srednje i starije životne dobi koje su se bavile ili se bave intenzivnom tjelesnom aktivnošću uočena je ubrzana ateroskleroza koronarnih arterija, veći rizik razvoja fibrilacije atrija i
miokardijalne fibroze. Usprkos tim nalazima nema jasnih dokaza da intenzivna tjelesna aktivnost štetno utječe na zdravlje.

Abstract (english)

Cardiac biomarkers such as troponins and natriuretic peptides have become important in the diagnostic treatment of acute coronary syndrome and heart failure. With the appearance of high sensitive troponins, after intense physical activity in some athletes, values exceeding the threshold for the diagnosis of acute myocardial infarction were detected. Despite such high
troponin values, they did not complain on chest pain neither had ECG changes suggestive of an acute myocardial infarction. In athletes with high troponin values, contrast-enhanced magnetic resonance imaging of the heart found no signs of myocardial necrosis. Also, the kinetics of troponin increase did not correspond to that in acute myocardial infarction. So, it is supposed
that such increase in troponin is due to the increased mechanical load on the myocardium. There is no association between transient cardiac dysfunction after intense physical activity and an increase in cardiac biomarkers. Accelerated coronary artery atherosclerosis, a higher risk of atrial fibrillation and myocardial fibrosis have been observed in middle-aged and elderly people
who have been or are engaged in intense physical activity. Despite these findings, there is no clear evidence that intense physical activity is harmful to health.

• Keywords: srčani biomarkeri; visoko osjetljivi troponini; BNP; NT-proBNP; tjelesna aktivnost
• Keywords (english): cardiac biomarkers; high sensitive troponins; BNP; NT-proBNP; physical activity
• Language: croatian
• URN:NBN: urn:nbn:hr:105:864548
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-31 08:56:54