Title Srčani troponini u profesionalnih i rekreativnih sportaša Title (english) Cardiac troponins in competitive and recreational sport Author Zvonimir Vukadin Mentor Mislav Vrsalović (mentor)Committee member Matias Trbušić (predsjednik povjerenstva)Committee member Martina Lovrić Benčić (član povjerenstva)Committee member Mislav Vrsalović (član povjerenstva)Granter University of Zagreb Defense date and country 2021-07-16, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Srčani troponini T i I su zbog svoje kardiospecifičnosti osnovna laboratorijska pretraga za detekciju nekroze kardiomiocita. Osim svakodnevne upotrebe u dijagnostici akutnog infarkta miokarda, povišene vrijednosti srčanih troponina opažene su i u drugim kardiološkim i nekardiološkim stanjima (miokarditis, plućna embolija, hipotireoza, citostatska kardiotoksičnost), pa čak i u zdravoj populaciji. Osim porasta u patološkim stanjim, porast troponina zamijećen je i u zdravih pojedinaca, naročito nakon fizičke aktivnosti. Mnoga istraživanja i metaanalize su provedene kako bi se pokušalo odgovoriti na pitanja koji je mehanizam uzrok porasta srčanih troponina nakon fizičke aktivnosti te je li porast troponina nakon fizičke aktivnosti fiziološki ili patološki fenomen. Sve je više dokaza kako porast troponina nije posljedica ireverzibilne nekroze kardiomiocita. Kao mehanizam porasta se sve češće spominje „fiziološko“ curenje kroz tranzitorno propusnu staničnu membranu. Dinamika porasta i pada troponina nakon fizičke aktivnosti ne odgovara onoj nakon akutnog koronarnog sindroma te apsolutne vrijednosti su nekoliko tisuća puta manje. Intenzitet fizičke aktivnosti je najkonzistentniji prediktor apsolutnog i relativnog porasta troponina nakon fizičke aktivnosti. Osim navedenog, vjerojatno barem djelomičan utjecaj imaju srčana frekvencija i bazalna vrijednost troponina. Iako rezultati studija pokazuju kako profesionalni sportaši imaju veća odstupanja troponina od gornjeg referentnog intervala od rekreativaca, vjerojatnije je navedeno posljedica intenzivnije aktivnosti koje profesionalni sport zahtjeva a ne rezultat dugotrajnijeg i učestalijeg izlaganja fizičkoj aktivnosti. S kliničkog stajališta, važno je prepoznati ovaj fenomen, jer može unijeti zabunu u svakodnevnu kliničku praksu. Potrebne su veće i dulje studije kako bi se razjasnila i potvrdila benigna narav navedenog fenomena i istražio eventualni dugoročni utjecaj navedenog fenomena na kardiovaskularno zdravlje.
Abstract (english) Cardiac troponins T and I, due to their cardiospecificity, are the basic laboratory test for the detection of cardiomyocyte necrosis. In addition to daily use in the diagnosis of acute myocardial infarction, elevated cardiac troponin values have been observed in other cardiac and noncardiac conditions (myocarditis, pulmonary embolism, hypothyroidism, cytostatic cardiotoxicity) and even in a healthy population. The impact of physical activity on troponin increase in healthy individuals was lately intensively investigated. Many studies and meta-analyzes have been conducted with the intention to detect the underlying mechanism of cardiac troponin increase after physical activity and whether troponin increase after physical activity is a physiological or pathological phenomenon. There is growing evidence that troponin rise after physical activity is not due to irreversible necrosis, and a "physiological" leakage through the transient permeable cell membrane is increasingly mentioned as a underlying mechanism. The dynamics of increase and decrease of troponin after physical activity does not correspond to the dynamic observed after acute coronary syndrome and the absolute values are several thousand times lower. The intensity of physical activity is currently the most consistent predictor of absolute and relative increase in troponin after physical activity. Also, heart rate and basal troponin value are likely to have at least a partial impact. Professional athletes have higher deviations of troponin than recreational athletes but this observation is more likely a consequence of more intense activity required by professional sports and not the result of longer and more frequent physical activity. From a clinical point of view, it is important to recognize this phenomenon, as it can easily lead to misdiagnosis into everyday clinical practice. Larger and longer studies are needed to clarify and confirm the benign nature of this phenomenon and to investigate the possible long-term impact on cardiovascular health.
Keywords
srčani troponin
sport
tjelesna aktivnost
srčani biomarkeri
zdravi pojedinci
fiziološki
Keywords (english)
cardiac troponins
sport
exercise
cardiac biomarkers
healthy subjects
physiologic
Language croatian URN:NBN urn:nbn:hr:105:975149 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2022-05-20 08:41:36
