Assessment of cardiovascular risk and physical activity: the role of cardiac-specific biomarkers in the general population and athletes
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Aldo Clerico
, Martina Zaninotto
, Alberto Aimo , Claudio Galli, Maria Teresa Sandri
, Mario Correale , Ruggero Dittadi , Marco Migliardi , Antonio Fortunato , Lucia Belloni and Mario Plebani
Abstract
The first part of this Inter-Society Document describes the mechanisms involved in the development of cardiovascular diseases, particularly arterial hypertension, in adults and the elderly. It will also examine how consistent physical exercise during adolescence and adulthood can help maintain blood pressure levels and prevent progression to symptomatic heart failure. The discussion will include experimental and clinical evidence on the use of specific exercise programs for preventing and controlling cardiovascular diseases in adults and the elderly. In the second part, the clinical relevance of cardiac-specific biomarkers in assessing cardiovascular risk in the general adult population will be examined, with a focus on individuals engaged in sports activities. This section will review recent studies that suggest a significant role of biomarkers in assessing cardiovascular risk, particularly the presence of cardiac damage, in athletes who participate in high-intensity sports. Finally, the document will discuss the potential of using cardiac-specific biomarkers to monitor the effectiveness of personalized physical activity programs (Adapted Physical Activity, APA). These programs are prescribed for specific situations, such as chronic diseases or physical disabilities, including cardiovascular diseases. The purposes of this Inter-Society Document are the following: 1) to discuss the close pathophysiological relationship between physical activity levels (ranging from sedentary behavior to competitive sports), age categories (from adolescence to elderly age), and the development of cardiovascular diseases; 2) to review in detail the experimental and clinical evidences supporting the role of cardiac biomarkers in identifying athletes and individuals of general population at higher cardiovascular risk; 3) to stimulate scientific societies and organizations to develop specific multicenter studies that may take into account the role of cardiac biomarkers in subjects who follow specific exercise programs in order to monitor their cardiovascular risk.
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Research ethics: Not applicable.
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Informed consent: Not applicable.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: The authors state no conflict of interest.
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Research funding: None declared.
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Data availability: Not applicable.
References
1. Goff, DCJr, Lloyd-Jones, DM, Bennett, G, Coady, S, D’Agostino, RB, Gibbons, R, et al.. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:2935–59. https://doi.org/10.1016/j.jacc.2013.11.005.Search in Google Scholar PubMed PubMed Central
2. Piepoli, MF, Hoes, AW, Agewall, S, Albus, C, Brotons, C, Catapano, AL, et al.. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2016;37:2315–81. https://doi.org/10.1093/eurheartj/ehw106.Search in Google Scholar PubMed PubMed Central
3. West, G, editor. Scale. New York: Penguin Press; 2017:182–94 pp.Search in Google Scholar
4. ISTAT anno 2020. Report. Cause di morte in Italia; 2023. Available from: https://www.istat.it/it/files//2023/05/Report_Cause-di-morte-2020.pdf.Search in Google Scholar
5. Lim, SS, Vos, T, Flaxman, AD, Danaei, G, Shibuya, K, Adair-Rohani, H, et al.. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2224–60. https://doi.org/10.1016/s0140-6736(12)61766-8.Search in Google Scholar
6. Murray, CJL, Aravkin, AY, Zheng, P, Abbafati, C, Abbas, AM, Abbasi-Kangevari, M, et al.. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396:1223–49. https://doi.org/10.1016/s0140-6736(20)30752-2.Search in Google Scholar PubMed PubMed Central
7. Yusuf, S, Joseph, P, Rangarajan, S, Islam, S, Mente, A, Hystad, P, et al.. Modifiable risk factors, cardiovascular disease, and mortality in 155,722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet 2020;395:795–808. https://doi.org/10.1016/s0140-6736(19)32008-2.Search in Google Scholar PubMed PubMed Central
8. Whelton, PK, Carey, RM, Aronow, WS, Casey, DEJr, Collins, KJ, Dennison Himmelfarb, C, et al.. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Soc Hypertens 2018;12:579.e1–579.e73.Search in Google Scholar
9. Williams, B, Mancia, G, Spiering, W, Agabiti Rosei, E, Azizi, M, Burnier, M, et al.. ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J 2018;39:3021–104. https://doi.org/10.1093/eurheartj/ehy339.Search in Google Scholar PubMed
10. Bundy, JD, Li, C, Stuchlik, P, Kelly, TN, Mills, KT, He, H, et al.. Systolic blood pressure reduction and risk of cardiovascular disease and mortality a systematic review and network meta-analysis. JAMA Cardiol 2017;2:775–81. https://doi.org/10.1001/jamacardio.2017.1421.Search in Google Scholar PubMed PubMed Central
11. Mills, KT, Stefanescu, A, He, J. The global epidemiology of hypertension. Nat Rev Nephrol 2020;16:223–37. https://doi.org/10.1038/s41581-019-0244-2.Search in Google Scholar PubMed PubMed Central
12. Zhou, B, Carrillo-Larco, RM, Danaei, G, Riley, LM, Paciorek, CJ, Stevens, GA, et al.. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1,201 population-representative studies with 104 million participants. Lancet 2021;398:957–80. https://doi.org/10.1016/s0140-6736(21)01330-1.Search in Google Scholar PubMed PubMed Central
13. Hunt, SA, Abraham, WT, Chin, MH, Feldman, AM, Francis, GS, Ganiats, TG, et al.. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation 2005;112:e154–235. https://doi.org/10.1161/circulationaha.105.167586.Search in Google Scholar PubMed
14. Braunwald, E. The war against heart failure: the Lancet lecture. Lancet 2015;385:812–24. https://doi.org/10.1016/s0140-6736(14)61889-4.Search in Google Scholar PubMed
15. Rahimi, K, Bidel, Z, Nazarzadeh, M, Copland, E, Canoy, D, Ramakrishnan, R, et al.. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet 2021;397:1625–36. https://doi.org/10.1016/s0140-6736(21)00590-0.Search in Google Scholar PubMed PubMed Central
16. Vrijens, B, Vincze, G, Kristanto, P, Urquhart, J, Burnier, M. Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories. BMJ 2008;336:1114–7. https://doi.org/10.1136/bmj.39553.670231.25.Search in Google Scholar PubMed PubMed Central
17. Choudhry, NK, Kronish, IM, Vongpatanasin, W, Ferdinand, KC, Pavlik, VN, Egan, BM, et al.. Medication adherence and blood pressure control: a scientific statement from the American Heart Association. Hypertension 2022;79:e1–14. https://doi.org/10.1161/hyp.0000000000000203.Search in Google Scholar
18. Burnier, M, Egan, BM. Adherence in hypertension. Circ Res 2019;124:1124–40. https://doi.org/10.1161/circresaha.118.313220.Search in Google Scholar PubMed
19. Cohen, JS. Adverse drug effects, compliance, and initial doses of antihypertensive drugs recommended by the joint national committee vs. the physicians’ desk reference. Arch Intern Med 2001;161:880. https://doi.org/10.1001/archinte.161.6.880.Search in Google Scholar PubMed
20. Wang, G, Grosse, SD, Schooley, MW. Conducting research on the economics of hypertension to improve cardiovascular health. Am J Prev Med 2017;53:S115–7. https://doi.org/10.1016/j.amepre.2017.08.005.Search in Google Scholar PubMed PubMed Central
21. Hanssen, H, Boardman, H, Deiseroth, A, Moholdt, T, Simonenko, M, Kränkel, N, et al.. Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension. Eur J Prev Cardiol 2022;29:205–15. https://doi.org/10.1093/eurjpc/zwaa141.Search in Google Scholar PubMed
22. Cernota, M, Kroeber, ES, Demeke, T, Frese, T, Getachew, S, Kantelhardt, EJ, et al.. Non-pharmacological interventions to achieve blood pressure control in African patients: a systematic review. BMJ Open 2022;12:e048079. https://doi.org/10.1136/bmjopen-2020-048079.Search in Google Scholar PubMed PubMed Central
23. Valenzuela, PL, Carrera-Bastos, P, Gálvez, BG, Ruiz-Hurtado, G, Ordovas, JM, Ruilope, LM, et al.. Lifestyle interventions for the prevention and treatment of hypertension. Nat Rev Cardiol 2021;18:251–75. https://doi.org/10.1038/s41569-020-00437-9.Search in Google Scholar PubMed
24. Lear, SA, Hu, W, Rangarajan, S, Leong, D, Iqbal, R, Casanova, A, et al.. The effect of physical activity on mortality and cardiovascular disease in 130,000 people from 17 high-income, middle-income, and low-income countries: the PURE study. Lancet 2017;390:2643–54. https://doi.org/10.1016/s0140-6736(17)31634-3.Search in Google Scholar PubMed
25. Leitzmann, MF, Park, Y, Blair, A, Ballard-Barbash, R, Mouw, T, Hollenbeck, AR, et al.. Physical activity recommendations and decreased risk of mortality. Arch Intern Med 2007;167:2453–60. https://doi.org/10.1001/archinte.167.22.2453.Search in Google Scholar PubMed
26. Wang, Y, Nie, J, Ferrari, G, Rey-Lopez, JP, Rezende, LFM. Association of physical activity intensity with mortality: a national cohort study of 403,681 US adults. JAMA Intern Med 2021;181:203–11. https://doi.org/10.1001/jamainternmed.2020.6331.Search in Google Scholar PubMed PubMed Central
27. Blond, K, Brinkløv, CF, Ried-Larsen, M, Crippa, A, Grøntved, A. Association of high amounts of physical activity with mortality risk: a systematic review and meta-analysis. Br J Sports Med 2020;54:1195–201. https://doi.org/10.1136/bjsports-2018-100393.Search in Google Scholar PubMed
28. Cornelissen, VA, Smart, NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc 2013;2:e004473. https://doi.org/10.1161/jaha.112.004473.Search in Google Scholar
29. Naci, H, Salcher-Konrad, M, Dias, S, Blum, MR, Sahoo, SA, Nunan, D, et al.. How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. Br J Sports Med 2019;53:859–69. https://doi.org/10.1136/bjsports-2018-099921.Search in Google Scholar PubMed
30. Whelton, SP, Chin, A, Xin, X, He, J. Effect of aerobic exercise on blood pressure: a meta-analysis of randomized, controlled trials. Ann Intern Med 2002;136:493–503. https://doi.org/10.7326/0003-4819-136-7-200204020-00006.Search in Google Scholar PubMed
31. Edwards, J, De Caux, A, Donaldson, J, Wiles, J, O’Driscoll, J. Isometric exercise vs. high-intensity interval training for the management of blood pressure: a systematic review and meta-analysis. Br J Sports Med 2022;56:506–14. https://doi.org/10.1136/bjsports-2021-104642.Search in Google Scholar PubMed
32. Cornelissen, VA, Fagard, RH, Coeckelberghs, E, Vanhees, L. Impact of resistance training on blood pressure and other cardiovascular risk factors. Hypertension 2011;58:950–8. https://doi.org/10.1161/hypertensionaha.111.177071.Search in Google Scholar PubMed
33. Lee, L-L, Mulvaney, CA, Wong, YKY, Chan, ES, Watson, MC, Lin, HH. Walking for hypertension. Cochrane Database Syst Rev 2021;2:CD008823. https://doi.org/10.1002/14651858.CD008823.pub2.Search in Google Scholar PubMed PubMed Central
34. Costa, EC, Hay, JL, Kehler, DS, Boreskie, KF, Arora, RC, Umpierre, D, et al.. Effects of high-intensity interval training vs. moderate-intensity continuous training on blood pressure in adults with pre- to established hypertension: a systematic review and meta-analysis of randomized trials. Sports Med 2018;48:2127–42. https://doi.org/10.1007/s40279-018-0944-y.Search in Google Scholar PubMed
35. Ashton, RE, Tew, GA, Aning, JJ, Gilbert, SE, Lewis, L, Saxton, JM. Effects of short-term, medium-term and long-term resistance exercise training on cardiometabolic health outcomes in adults: systematic review with meta-analysis. Br J Sports Med 2020;54:341–8. https://doi.org/10.1136/bjsports-2017-098970.Search in Google Scholar PubMed
36. Xi, H, He, Y, Niu, Y, Sui, X, Zhang, J, Zhu, R, et al.. Effect of combined aerobic and resistance exercise on blood pressure in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Exp Gerontol 2021;155:111560. https://doi.org/10.1016/j.exger.2021.111560.Search in Google Scholar PubMed
37. Schroeder, EC, Franke, WD, Sharp, RL, Lee, DC. Comparative effectiveness of aerobic, resistance, and combined training on cardiovascular disease risk factors: a randomized controlled trial. PLoS One 2019;14:e0210292. https://doi.org/10.1371/journal.pone.0210292.Search in Google Scholar PubMed PubMed Central
38. Edwards, JJ, Deenmamode, AHP, Griffiths, M, Arnold, O, Cooper, NJ, Wiles, JD, et al.. Exercise training and resting blood pressure: a large-scale pairwise and network meta-analysis of randomised controlled trials. Br J Sports Med 2023;57:1317–26. https://doi.org/10.1136/bjsports-2022-106503.Search in Google Scholar PubMed
39. Carlson, DJ, Dieberg, G, Hess, NC, Millar, PJ, Smart, NA. Isometric exercise training for blood pressure management: a systematic review and meta-analysis. Mayo Clin Proc 2014;89:327–34. https://doi.org/10.1016/j.mayocp.2013.10.030.Search in Google Scholar PubMed
40. Williams, B, Mancia, G, Spiering, W, Agabiti Rosei, E, Azizi, M, Burnier, M, et al.. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 2018;36:1953–2041. https://doi.org/10.1097/HJH.0000000000001940.Search in Google Scholar PubMed
41. Mancia, G, Kreutz, R, Brunström, M, Burnier, M, Grassi, G, Januszewicz, A, et al.. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH). J Hypertens 2023;41:1874–2071. https://doi.org/10.1097/hjh.0000000000003480.Search in Google Scholar
42. Piepoli, MF, Abreu, A, Albus, C, Ambrosetti, M, Brotons, C, Catapano, AL, et al.. Update on cardiovascular prevention in clinical practice: a position paper of the European Association of Preventive Cardiology of the European Society of Cardiology. Eur J Prev Cardiol 2020;27:181–205. https://doi.org/10.1177/2047487319893035.Search in Google Scholar PubMed
43. Brook, RD, Appel, LJ, Rubenfire, M, Ogedegbe, G, Bisognano, JD, Elliott, WJ, et al.. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American Heart Association. Hypertension 2013;61:1360–83. https://doi.org/10.1161/hyp.0b013e318293645f.Search in Google Scholar PubMed
44. Pescatello, LS, Buchner, DM, Jakicic, JM, Powell, KE, Kraus, WE, Bloodgood, B, et al.. Physical activity to prevent and treat hypertension: a systematic review. Med Sci Sports Exerc 2019;51:1314–23. https://doi.org/10.1249/mss.0000000000001943.Search in Google Scholar
45. Pelliccia, A, Sharma, S, Gati, S, Bäck, M, Börjesson, M, Caselli, S, et al.. ESC Scientific Document Group. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J 2021;42:17–96. https://doi.org/10.1093/eurheartj/ehaa605.Search in Google Scholar PubMed
46. Marijon, E, Uy-Evanado, A, Reinier, K, Teodorescu, C, Narayanan, K, Jouven, X, et al.. Sudden cardiac arrest during sports activity in middle age. Circulation 2015;131:1384–91. https://doi.org/10.1161/circulationaha.114.011988.Search in Google Scholar PubMed PubMed Central
47. Chugh, SS, Weiss, JB. Sudden cardiac death in the older athlete. J Am Coll Cardiol 2015;65:493–502. https://doi.org/10.1016/j.jacc.2014.10.064.Search in Google Scholar PubMed
48. Minder, CM, Shaya, GE, Michos, ED, Keenan, TE, Blumenthal, RS, Nasir, K, et al.. Relation between self-reported physical activity level, fitness, and cardiometabolic risk. Am J Cardiol 2014;113:637–43. https://doi.org/10.1016/j.amjcard.2013.11.010.Search in Google Scholar PubMed
49. Bradley, SM, Michos, ED, Miedema, MD. Physical activity, fitness, and cardiovascular health: insights from publications in JAMA Network Open. JAMA Netw Open 2019;2:e198343. https://doi.org/10.1001/jamanetworkopen.2019.8343.Search in Google Scholar PubMed
50. Mandsager, K, Harb, S, Cremer, P, Phelan, D, Nissen, SE, Jaber, W. Association of cardiorespiratory fitness with longterm mortality among adults undergoing exercise treadmill testing. JAMA Netw Open 2018;1:e183605. https://doi.org/10.1001/jamanetworkopen.2018.3605.Search in Google Scholar PubMed PubMed Central
51. Accademia della Crusca. Il troppo stroppia o storpia? Firenze, Italy: Academia della Crusca; 2024. Available from: https://accademiadellacrusca.it/.Search in Google Scholar
52. Valenzuela, PL, Baggish, A, Castillo-Garcia, A, Santos-Lozano, A, Boraita, A, Lucia, A. Strenuous endurance exercise and the heart: physiological vs. pathological adaptations. Compr Physiol 2022;12:4067–85. https://doi.org/10.1002/cphy.c210045.Search in Google Scholar PubMed
53. Garatachea, N, Santos-Lozano, A, Sanchis-Gomar, F, Fiuza-Luces, C, Pareja-Galeano, H, Emanuele, E, et al.. Elite athletes live longer than the general population: a meta-analysis. Mayo Clin Proc 2014;89:1195–200. https://doi.org/10.1016/j.mayocp.2014.06.004.Search in Google Scholar PubMed
54. Antero-Jacquemin, J, Rey, G, Marc, A, Dor, F, Haida, A, Marck, A, et al.. Mortality in female and male French Olympians: a 1948–2013 cohort study. Am J Sports Med 2015;43:1505–12. https://doi.org/10.1177/0363546515574691.Search in Google Scholar PubMed
55. Antero, J, Tanaka, H, De Larochelambert, Q, Pohar-Perme, M, Toussaint, JF. Female and male US Olympic athletes live five years longer than their general population counterparts: a study of 8,124 former US Olympians. Br J Sports Med 2021;55:206–12. https://doi.org/10.1136/bjsports-2019-101696.Search in Google Scholar PubMed
56. CONI 1°. Rapporto Sport & Società. Roma: Censis Servizi; 2009.Search in Google Scholar
57. CONI. Sport – Italia 2020. Roma: Il Libro Bianco dello Sport Italiano; 2012.Search in Google Scholar
58. McArdle, WD, Katch, FI, Katch, VL. Exercise physiology, nutrition, energy, and human performance, 9th ed. Chapter 31. Philadelphia: Wolters Kluwer; 2023:910–51 pp.Search in Google Scholar
59. ISTAT. Sport, attività fisica, sedentarietà. Rome, Italy: Ufficio Stampa; 2022. Available from: ufficiostampa@istat.it.Search in Google Scholar
60. Harvey, JA, Chastin, SF, Skelton, DA. Prevalence of sedentary behavior in older adults: a systematic review. Int J Environ Res Publ Health 2013;10:6645–61. https://doi.org/10.3390/ijerph10126645.Search in Google Scholar PubMed PubMed Central
61. Dai, H, Jia, G, Liu, K. Health-related quality of life and related factors among elderly people in Jinzhou, China: a cross-sectional study. Publ Health 2015;129:667–73. https://doi.org/10.1016/j.puhe.2015.02.022.Search in Google Scholar PubMed
62. Kim, Y, Lee, E. The association between elderly people’s sedentary behaviors and their health-related quality of life: focusing on comparing the young-old and the old-old. Health Qual Life Outcome 2019;17:131. https://doi.org/10.1186/s12955-019-1191-0.Search in Google Scholar PubMed PubMed Central
63. McGowan, LJ, Powell, R, French, DP. Older adults’ construal of sedentary behaviour: implications for reducing sedentary behaviour in older adult populations. J Health Psychol 2021;26:2186–99. https://doi.org/10.1177/1359105320909870.Search in Google Scholar PubMed PubMed Central
64. Lees, SJ, Booth, FW. Sedentary death syndrome. Can J Appl Physiol 2004;29:447–60. https://doi.org/10.1139/h04-029.Search in Google Scholar PubMed
65. Booth, FW, Roberts, CK, Laye, MJ. Lack of exercise is a major cause of chronic diseases. Compr Physiol 2012;2:1143–211. https://doi.org/10.1002/cphy.c110025.Search in Google Scholar PubMed PubMed Central
66. Booth, FW, Roberts, CK, Thyfault, JP, Ruegsegger, GN, Toedebusch, RG. Role of inactivity in chronic diseases: evolutionary insight and pathophysiological mechanisms. Physiol Rev 2017;97:1351–402. https://doi.org/10.1152/physrev.00019.2016.Search in Google Scholar PubMed PubMed Central
67. Franceschi, C, Bonafè, M, Valensin, S, Olivieri, F, De Luca, M, Ottaviani, E, et al.. Inflammaging. An evolutionary perspective on immunosenescence. Ann N Y Acad Sci 2000;908:244–54. https://doi.org/10.1111/j.1749-6632.2000.tb06651.x.Search in Google Scholar PubMed
68. Ferrucci, L, Fabbri, E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol 2018;15:505–22. https://doi.org/10.1038/s41569-018-0064-2.Search in Google Scholar PubMed PubMed Central
69. Pietri, P, Stefanidis, C. Cardiovascular aging and longevity: JACC state-of-the-art review. J Am Coll Cardiol 2021;77:189–204. https://doi.org/10.1016/j.jacc.2020.11.023.Search in Google Scholar PubMed
70. Yan, M, Sun, S, Xu, K, Huang, X, Dou, L, Pang, J, et al.. Cardiac aging: from basic research to therapeutics. Oxid Med Cell Longev 2021:9570325. https://doi.org/10.1155/2021/9570325.Search in Google Scholar PubMed PubMed Central
71. Perrone, MA, Aimo, A, Bernardini, S, Clerico, A. Inflammageing and cardiovascular system: focus on cardiokines and cardiac-specific biomarkers. J Mol Sci 2023;24:844. https://doi.org/10.3390/ijms24010844.Search in Google Scholar PubMed PubMed Central
72. Yan, C, Xu, Z, Huang, W. Cellular senescence affects cardiac regeneration and repair in ischemic heart disease. Aging Dis 2021;12:552–69. https://doi.org/10.14336/ad.2020.0811.Search in Google Scholar PubMed PubMed Central
73. Suda, M, Paul, KH, Minamino, T, Miller, JD, Lerman, A, Ellison-Hughes, GM, et al.. Senescent cells: a therapeutic target in cardiovascular diseases. Cells 2023;12:1296. https://doi.org/10.3390/cells12091296.Search in Google Scholar PubMed PubMed Central
74. Mapelli, M, Salvioni, E, Mattavelli, I, Gugliandolo, P, Bonomi, A, Palermo, P, et al.. Activities of daily living in heart failure patients and healthy subjects: when the cardiopulmonary assessment goes beyond traditional exercise test protocols. Eur J Prev Cardiol 2023;30(2 Suppl):ii47–53. https://doi.org/10.1093/eurjpc/zwad155.Search in Google Scholar PubMed
75. Bhattacharjee, P, Khan, Z. Sacubitril/valsartan in the treatment of Heart Failure with Reduced Ejection Fraction focusing on the impact on the quality of life: a systematic review and meta-analysis of randomized clinical trials. Cureus 2023;15:e48674. https://doi.org/10.7759/cureus.48674.Search in Google Scholar PubMed PubMed Central
76. Fujimoto, Y, Maeda, D, Kagiyama, N, Sunayama, T, Dotare, T, Jujo, K, et al.. Prognostic implications of six-minute walking distance in patients with heart failure with preserved ejection fraction. Int J Cardiol 2023;379:76–81. https://doi.org/10.1016/j.ijcard.2023.03.025.Search in Google Scholar PubMed
77. Nederend, M, Kiès, P, Regeer, MV, Vliegen, HW, Mertens, BJ, Robbers-Visser, D, et al.. Tolerability and beneficial effects of sacubitril/valsartan on systemic right ventricular failure. Heart 2023;109:1525–32. https://doi.org/10.1136/heartjnl-2022-322332.Search in Google Scholar PubMed
78. Vetrovsky, T, Siranec, M, Frybova, T, Gant, I, Svobodova, I, Linhart, A, et al.. Lifestyle walking intervention in patients with heart failure with reduced ejection fraction: the WATCHFUL trial. Circulation 2023;149:177–88. https://doi.org/10.1161/circulationaha.123.067395.Search in Google Scholar PubMed PubMed Central
79. Benda, NM, Hopman, MT, van Dijk, AP, Oxborough, D, George, KP, Thijssen, DH, et al.. Impact of prolonged walking exercise on cardiac structure and function in cardiac patients vs. healthy controls. Eur J Prev Cardiol 2016;23:1252–60. https://doi.org/10.1177/2047487316631389.Search in Google Scholar PubMed
80. Hua, CY, Huang, Y, Su, YH, Bu, JY, Tao, HM. Collaborative care model improves self-care ability, quality of life and cardiac function of patients with chronic heart failure. Braz J Med Biol Res 2017;50:e6355. https://doi.org/10.1590/1414-431x20176355.Search in Google Scholar PubMed PubMed Central
81. Scardovi, AB, De Maria, R, Galeotti, GG, Faggiano, P, Arcari, L, Ghio, S, et al.. Similar predictive value of six-minute walking distance and B-type natriuretic peptide in heart failure with reduced to mid-range ejection fraction. Monaldi Arch Chest Dis 2019;89. https://doi.org/10.4081/monaldi.2019.1045.Search in Google Scholar PubMed
82. Grundtvig, M, Eriksen-Volnes, T, Ørn, S, Slind, EK, Gullestad, L. 6 min walk test is a strong independent predictor of death in outpatients with heart failure. ESC Heart Fail 2020;7:2904–11. https://doi.org/10.1002/ehf2.12900.Search in Google Scholar PubMed PubMed Central
83. Pierobon, A, Granata, N, Torlaschi, V, Vailati, C, Radici, A, Maestri, R, et al.. Psychomotor speed as a predictor of functional status in older chronic heart failure (CHF) patients attending cardiac rehabilitation. PLoS One 2020;15:e0235570. https://doi.org/10.1371/journal.pone.0235570.Search in Google Scholar PubMed PubMed Central
84. Farmakis, D, Mueller, C, Apple, FS. High-sensitivity cardiac troponin assays for cardiovascular risk stratification in the general population. Eur Heart J 2020;41:4050–6. https://doi.org/10.1093/eurheartj/ehaa083.Search in Google Scholar PubMed
85. Clerico, A, Zaninotto, M, Passino, C, Aspromonte, N, Piepoli, MF, Migliardi, M, et al.. Evidence on clinical relevance of cardiovascular risk evaluation in the general population using cardio-specific biomarkers. Clin Chem Lab Med 2020;59:79–90. https://doi.org/10.1515/cclm-2020-0310.Search in Google Scholar PubMed
86. Clerico, A, Recchia, FA, Passino, C, Emdin, M. Cardiac endocrine function is an essential component of the homeostatic regulation network: physiological and clinical implications. Am J Physiol Heart Circ Physiol 2006;290:H17–29. https://doi.org/10.1152/ajpheart.00684.2005.Search in Google Scholar PubMed
87. Brauwald, E. Biomarkers in heart failure. N Engl J Med 2008;358:2148–59. https://doi.org/10.1056/nejmra0800239.Search in Google Scholar PubMed
88. Vittorini, S, Clerico, A. Cardiovascular biomarkers: increasing impact of laboratory medicine in cardiology practice. Clin Chem Lab Med 2008;46:748–63. https://doi.org/10.1515/cclm.2008.188.Search in Google Scholar PubMed
89. Clerico, A, Giannoni, A, Vittorini, S, Passino, C. Thirty years of the heart as an endocrine organ: physiological role and clinical utility of cardiac natriuretic hormones. Am J Physiol Heart Circ Physiol 2011;301:H12–20. https://doi.org/10.1152/ajpheart.00226.2011.Search in Google Scholar PubMed
90. Clerico, A, Passino, C, Franzini, M, Emdin, M. Natriuretic peptides as biomarkers of cardiac endocrine function in heart failure: new challenges and perspectives. Future Cardiol 2016;12:573–84. https://doi.org/10.2217/fca-2016-0013.Search in Google Scholar PubMed
91. Giannoni, A, Giovannini, S, Clerico, A. Measurement of circulating concentration of cardiac troponin I and T in healthy subjects: a tool for monitoring myocardial tissue renewal? Clin Chem Lab Med 2009;47:1167–77. https://doi.org/10.1515/cclm.2009.320.Search in Google Scholar PubMed
92. Clerico, A, Zaninotto, M, Padoan, A, Masotti, S, Musetti, V, Prontera, C, et al.. Evaluation of analytical performance of immunoassay methods for cTnI and cTnT: from theory to practice. Adv Clin Chem 2019;93:239–62. https://doi.org/10.1016/bs.acc.2019.07.005.Search in Google Scholar PubMed
93. McDonagh, TA, Metra, M, Adamo, M, Gardner, RS, Baumbach, A, Böhm, M, et al.. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2022;24:4–21. https://doi.org/10.1002/ejhf.2333.Search in Google Scholar PubMed
94. Tsutsui, H, Albert, NM, Coats, AJS, Anker, SD, Bayes-Genis, A, Butler, J, et al.. Natriuretic peptides: role in the diagnosis and management of heart failure: a scientific statement from the Heart Failure Association of the European Society of Cardiology, Heart Failure Society of America and Japanese Heart Failure Society. Eur J Heart Fail 2023;25:616–31. https://doi.org/10.1002/ejhf.2848.Search in Google Scholar PubMed
95. Clerico, A, Padoan, A, Zaninotto, M, Passino, C, Plebani, M. Clinical relevance of biological variation of cardiac troponins. Clin Chem Lab Med 2020;59:641–52. https://doi.org/10.1515/cclm-2020-1433.Search in Google Scholar PubMed
96. Clerico, A, Zaninotto, M, Aimo, A, Cardinale, DM, Dittadi, R, Sandri, MT, et al.. Variability of cardiac troponin levels in normal subjects and in patients with cardiovascular diseases: analytical considerations and clinical relevance. Clin Chem Lab Med 2023;61:1209–29. https://doi.org/10.1515/cclm-2022-1285.Search in Google Scholar PubMed
97. Clerico, A, Masotti, S, Musetti, V, Passino, C. Pathophysiological mechanisms determining sex differences in circulating levels of cardiac natriuretic peptides and cardiac troponins. J Lab Precis Med 2019;4:1–18. https://doi.org/10.21037/jlpm.2019.01.03.Search in Google Scholar
98. Perrone, MA, Zaninotto, M, Masotti, S, Musetti, V, Padoan, A, Prontera, C, et al.. The combined measurement of high-sensitivity cardiac troponins and natriuretic peptides: a useful tool for clinicians? J Cardiovasc Med (Hagerstown) 2020;21:593–63. https://doi.org/10.2459/jcm.0000000000001022.Search in Google Scholar
99. Middleton, N, George, K, Whyte, G, Gaze, D, Collinson, P, Shave, RR. Cardiac troponin T release is stimulated by endurance exercise in healthy humans. J Am Coll Cardiol 2008;52:1813–4. https://doi.org/10.1016/j.jacc.2008.03.069.Search in Google Scholar PubMed
100. Hamasaki, H. The effects of exercise on natriuretic peptides in individuals without heart failure. Sports 2016;4:32. https://doi.org/10.3390/sports4020032.Search in Google Scholar PubMed PubMed Central
101. Krupicka, J, Janota, T, Kasalová, Z, Hradec, J. Effect of short-term maximal exercise on BNP plasma levels in healthy individuals. Physiol Res 2010;59:625–8. https://doi.org/10.33549/physiolres.931773.Search in Google Scholar PubMed
102. Sheikhani, H, Babaee Beygi, MA, Daryanoosh, F, Jafari, B. Alteration of plasma brain natriuretic peptide level after acute moderate exercise in professional athletes. Int Cardiovasc Res J 2011;5:148–50. https://doi.org/10.5812/icrj.4648.Search in Google Scholar
103. Franklin, BA, Thompson, PD, Al-Zaiti, SS, Albert, CM, Hivert, MF, Levine, BD, et al.. Exercise-related acute cardiovascular events and potential deleterious adaptations following long-term exercise training: placing the risks into perspective-an update: a scientific statement from the American Heart Association. Circulation 2020;141:e705–36. https://doi.org/10.1161/cir.0000000000000749.Search in Google Scholar
104. Santoso, A, Maulana, R, Alzahra, F, Prameswari, HS, Ambari, AM, Hartopo, AB, et al.. The effects of aerobic exercise on N-terminal pro-B-type natriuretic peptide and cardiopulmonary function in patients with heart failure: a meta-analysis of randomised clinical trials. Heart Lung Circ 2020;29:1790–8. https://doi.org/10.1016/j.hlc.2020.05.098.Search in Google Scholar PubMed
105. Mueller, S, Winzer, EB, Duvinage, A, Gevaert, AB, Edelmann, F, Haller, B, et al.. Effect of high-intensity interval training, moderate continuous training, or guideline-based physical activity advice on peak oxygen consumption in patients with heart failure with preserved ejection fraction: a randomized clinical trial. JAMA 2021;325:542–51. https://doi.org/10.1001/jama.2020.26812.Search in Google Scholar PubMed PubMed Central
106. Yamamoto, S, Okamura, M, Akashi, YJ, Tanaka, S, Shimizu, M, Tsuchikawa, Y, et al.. Impact of long-term exercise-based cardiac rehabilitation in patients with chronic heart failure – a systematic review and meta-analysis. Circ J 2024 Jan 12. https://doi.org/10.1253/circj.CJ-23-0820 [Epub ahead of print].Search in Google Scholar PubMed
107. Hickman, PE, Potter, JM, Aroney, C, Koerbin, G, Southcott, E, Wu, AH, et al.. Cardiac troponin may be released by ischemia alone, without necrosis. Clin Chim Acta 2010;411:318–23. https://doi.org/10.1016/j.cca.2009.12.009.Search in Google Scholar PubMed
108. Baker, P, Leckie, T, Harrington, D, Richardson, A. Exercise-induced cardiac troponin elevation: an update on the evidence, mechanism and implications. Int J Cardiol Heart Vasc 2019;22:181–6. https://doi.org/10.1016/j.ijcha.2019.03.001.Search in Google Scholar PubMed PubMed Central
109. Skadberg, Ø, Kleiven, Ø, Ørn, S, Bjørkavoll-Bergseth, MF, Melberg, TH, Omland, T, et al.. The cardiac troponin response following physical exercise in relation to biomarker criteria for acute myocardial infarction; the North Sea Race Endurance Exercise Study (NEEDED) 2013. Clin Chim Acta 2018;479:155–9. https://doi.org/10.1016/j.cca.2018.01.033.Search in Google Scholar PubMed
110. Cantinotti, M, Clerico, A, Giordano, R, Assanta, N, Franchi, E, Koestenberger, M, et al.. Cardiac troponin-T release after sport and differences by age, sex, training type, volume, and intensity: a critical review. Clin J Sport Med 2022;32:e230–40. https://doi.org/10.1097/jsm.0000000000000940.Search in Google Scholar PubMed
111. Aengevaeren, VL, Baggish, AL, Chung, EH, George, K, Kleiven, Ø, Mingels, AMA, et al.. Exercise-induced cardiac troponin elevations: from underlying mechanisms to clinical relevance. Circulation 2021;144:1955–72. https://doi.org/10.1161/circulationaha.121.056208.Search in Google Scholar PubMed PubMed Central
112. Vroemen, WHM, Mezger, STP, Masotti, S, Clerico, A, Bekers, O, de Boer, D, et al.. Cardiac troponin T: only small molecules in recreational runners after marathon completion. J Appl Lab Med 2019;3:909–11. https://doi.org/10.1373/jalm.2018.027144.Search in Google Scholar PubMed
113. Aengevaeren, VL, Froeling, M, Hooijmans, MT, Monte, JR, van den Berg-Faay, S, Hopman, MT, et al.. Myocardial injury and compromised cardiomyocyte integrity following a marathon run. JACC Cardiovasc Imag 2020;13:1445–7. https://doi.org/10.1016/j.jcmg.2019.12.020.Search in Google Scholar PubMed
114. Neumayr, G, Pfister, R, Mitterbauer, G, Eibl, G, Hoertnagl, H. Effect of competitive marathon cycling on plasma N-terminal pro-brain natriuretic peptide and cardiac troponin T in healthy recreational cyclists. Am J Cardiol 2005;96:732–5. https://doi.org/10.1016/j.amjcard.2005.04.054.Search in Google Scholar PubMed
115. Leers, MP, Schepers, R, Baumgarten, R. Effects of a long-distance run on cardiac markers in healthy athletes. Clin Chem Lab Med 2006;44:999–1003. https://doi.org/10.1515/cclm.2006.179.Search in Google Scholar PubMed
116. Scharhag, J, Urhausen, A, Schneider, G, Herrmann, M, Schumacher, K, Haschke, M, et al.. Reproducibility and clinical significance of exercise-induced increases in cardiac troponins and N-terminal pro brain natriuretic peptide in endurance athletes. Eur J Cardiovasc Prev Rehabil 2006;13:388–97. https://doi.org/10.1097/00149831-200606000-00015.Search in Google Scholar
117. Bordbar, S, Bigi, MA, Aslani, A, Rahimi, E, Ahmadi, N. Effect of endurance and strength exercise on release of brain natriuretic peptide. J Cardiovasc Dis Res 2012;3:22–5. https://doi.org/10.4103/0975-3583.91599.Search in Google Scholar PubMed PubMed Central
118. Roberts, E, Ludman, AJ, Dworzynski, K, Al-Mohammad, A, Cowie, MR, McMurray, JJ, et al.. The diagnostic accuracy of the natriuretic peptides in heart failure: systematic review and diagnostic meta-analysis in the acute care setting. Br Med J 2015;350:h910. https://doi.org/10.1136/bmj.h910.Search in Google Scholar PubMed PubMed Central
119. Goyder, CR, Roalfe, AK, Jones, NR, Taylor, KS, Plumptre, CD, James, O, et al.. Diagnostic accuracy of natriuretic peptide screening for left ventricular systolic dysfunction in the community: systematic review and meta-analysis. ESC Heart Fail 2023;10:1643–55. https://doi.org/10.1002/ehf2.14314.Search in Google Scholar PubMed PubMed Central
120. Sze, J, Mooney, J, Barzi, F, Hillis, GS, Chow, CK. Cardiac troponin and its relationship to cardiovascular outcomes in community populations – a systematic review and meta-analysis. Heart Lung Circ 2016;25:217–28. https://doi.org/10.1016/j.hlc.2015.09.001.Search in Google Scholar PubMed
121. Van der Lindel, N, Klinkenberg, LJJ, Bekers, O, Loon, LJCV, Dieijen-Visser, MPV, Zeegers, MP, et al.. Prognostic value of basal high-sensitive cardiac troponin levels on mortality in the general population: a meta-analysis. Medicine 2016;95:e5703. https://doi.org/10.1097/md.0000000000005703.Search in Google Scholar PubMed PubMed Central
122. Hughes, MF, Ojeda, F, Saarela, O, Jørgensen, T, Zeller, T, Palosaari, T, et al.. Association of repeatedly measured high-sensitivity-assayed troponin I with cardiovascular disease events in a general population from the MORGAM/BiomarCaRE Study. Clin Chem 2017;63:334–42. https://doi.org/10.1373/clinchem.2016.261172.Search in Google Scholar PubMed
123. Sigurdardottir, FD, Lynbakken, MN, Holmen, OL, Dalen, H, Hveem, K, Røsjø, H, et al.. Relative prognostic value of cardiac troponin I and C-reactive protein in the general population (from the North-Trøndelag Health [HUNT] Study). Am J Cardiol 2018;121:949–55. https://doi.org/10.1016/j.amjcard.2018.01.004.Search in Google Scholar PubMed
124. Willeit, P, Welsh, P, Evans, JDW, Tschiderer, L, Boachie, C, Jukema, JW, et al.. High-sensitivity cardiac troponin concentration and risk of first-ever cardiovascular outcomes in 154,052 participants. J Am Coll Cardiol 2017;70:558–68. https://doi.org/10.1016/j.jacc.2017.05.062.Search in Google Scholar PubMed PubMed Central
125. Welsh, P, Preiss, D, Shah, ASV, McAllister, D, Briggs, A, Boachie, C, et al.. Comparison between high-sensitivity cardiac troponin T and cardiac troponin I in a large general population cohort. Clin Chem 2018;64:1607–16. https://doi.org/10.1373/clinchem.2018.292086.Search in Google Scholar PubMed PubMed Central
126. Lam, CSP, Castillo, R, Ho, DT, Kasliwal, RR, Khurana, R, et al.. High-sensitivity troponin I for cardiovascular risk stratification in the general asymptomatic population: perspectives from Asia-Pacific. Int J Cardiol 2019;282:93–8. https://doi.org/10.1016/j.ijcard.2019.01.107.Search in Google Scholar PubMed
127. Welsh, P, Preiss, D, Hayward, C, Shah, ASV, McAllister, D, Briggs, A, et al.. Cardiac troponin T and troponin I in the general population. Comparing and contrasting their genetic determinants and associations with outcomes. Circulation 2019;139:2754–64. https://doi.org/10.1161/circulationaha.118.038529.Search in Google Scholar
128. Lippi, G, Cervellin, G, Sanchis-Gomar, F. Predicting mortality with cardiac troponins: recent insights from meta-analyses. Diagnosis 2019;8:37–49. https://doi.org/10.1515/dx-2019-0061.Search in Google Scholar PubMed
129. Li, Y, Pei, H, Zhou, C. Cardiac troponins predict adverse clinical outcomes in stable coronary artery disease: a dose-response meta-analysis of prospective studies. Biomarkers 2019;24:556–65. https://doi.org/10.1080/1354750x.2019.1606277.Search in Google Scholar
130. Aimo, A, Januzzi, JLJr, Vergaro, G, Ripoli, A, Latini, R, Masson, S, et al.. High-sensitivity troponin T, NT-proBNP and glomerular filtration rate: a multimarker strategy for risk stratification in chronic heart failure. Int J Cardiol 2019;277:166–72. https://doi.org/10.1016/j.ijcard.2018.10.079.Search in Google Scholar PubMed
131. Aimo, A, Georgiopoulos, G, Panichella, G, Vergaro, G, Passino, C, Emdin, M, et al.. High-sensitivity troponins for outcome prediction in the general population: a systematic review and meta-analysis. Eur J Intern Med 2022;98:61–8. https://doi.org/10.1016/j.ejim.2022.01.012.Search in Google Scholar PubMed
132. Conesa-Milian, E, Cirer-Sastre, R, Hernández-González, V, Legaz-Arrese, A, Corbi, F, Reverter-Masia, J. Cardiac troponin release after exercise in healthy young athletes: a systematic review. Healthcare (Basel) 2023;11:2342. https://doi.org/10.3390/healthcare11162342.Search in Google Scholar PubMed PubMed Central
133. Thygesen, K, Alpert, JS, Jaffe, AS, Chaitman, BR, Bax, JJ, Morrow, DA, et al.. Fourth universal definition of myocardial infarction (2018). Eur Heart J 2019;40:237–69. https://doi.org/10.1093/eurheartj/ehy462.Search in Google Scholar PubMed
134. Collet, JP, Thiele, H, Barbato, E, Barthélémy, O, Bauersachs, J, Bhatt, DL, et al.. The Task Force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2021;42:1289–387.10.1093/eurheartj/ehaa909Search in Google Scholar PubMed
135. Clerico, A, Zaninotto, M, Aimo, A, Dittadi, R, Cosseddu, D, Perrone, M, et al.. Use of high-sensitivity cardiac troponins in the emergency department for the early rule-in and rule-out of acute myocardial infarction without persistent ST-segment elevation (NSTEMI) in Italy. Clin Chem Lab Med 2021;60:169–82. https://doi.org/10.1515/cclm-2021-1085.Search in Google Scholar PubMed
136. Byrne, RA, Rossello, X, Coughlan, JJ, Barbato, E, Berry, C, Chieffo, A, et al.. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J 2023;44:3720–826. https://doi.org/10.1093/eurheartj/ehad191.Search in Google Scholar PubMed
137. Lee, DH, Rezende, LFM, Joh, HK, Keum, N, Ferrari, G, Rey-Lopez, JP, et al.. Long-term leisure-time physical activity intensity and all-cause and cause-specific mortality: a prospective cohort of US adults. Circulation 2022;146:523–34. https://doi.org/10.1161/circulationaha.121.058162.Search in Google Scholar
138. Gresslien, T, Agewall, S. Troponin and exercise. Int J Cardiol 2016;221:609–21. https://doi.org/10.1016/j.ijcard.2016.06.243.Search in Google Scholar PubMed
139. Marjot, J, Kaier, TE, Martin, ED, Reji, SS, Copeland, O, Iqbal, M, et al.. Quantifying the release of biomarkers of myocardial necrosis from cardiac myocytes and intact myocardium. Clin Chem 2017;63:990–6. https://doi.org/10.1373/clinchem.2016.264648.Search in Google Scholar PubMed PubMed Central
140. Hammarsten, O, Mair, J, Möckel, M, Lindahl, B, Jaffe, AS. Possible mechanisms behind cardiac troponin elevations. Biolmarkers 2018;23:725–34. https://doi.org/10.1080/1354750x.2018.1490969.Search in Google Scholar
141. Mair, J, Lindahl, B, Hammarsten, O, Müller, C, Giannitsis, E, Huber, K, et al.. How is cardiac troponin released from injured myocardium? Eur Heart J Acute Cardiovasc Care 2018;7:553–60. https://doi.org/10.1177/2048872617748553.Search in Google Scholar PubMed
142. Aakre, KM, Omland, T. Physical activity, exercise and cardiac troponins: clinical implications. Prog Cardiovasc Dis 2019;62:108–15. https://doi.org/10.1016/j.pcad.2019.02.005.Search in Google Scholar PubMed
143. Ragusa, R, Masotti, S, Musetti, V, Rocchiccioli, S, Prontera, C, Perrone, M, et al.. Cardiac troponins: mechanisms of release and role in healthy and diseased subjects. Biomolecules 2023;49:351–64. https://doi.org/10.1002/biof.1925.Search in Google Scholar PubMed
144. Sandoval, Y, Apple, FS, Mahler, SA, Body, R, Collinson, PO, Jaffe, AS. International Federation of Clinical Chemistry and Laboratory Medicine Committee on the Clinical Application of Cardiac Biomarkers. High-Sensitivity Cardiac Troponin and the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guidelines for the Evaluation and Diagnosis of Acute Chest Pain. Circulation 2022;146:569–81. https://doi.org/10.1161/circulationaha.122.059678.Search in Google Scholar
145. World Health Organization. WHO guidelines on physical activity and sedentary behaviour: at a glance; 2020. Available from: https://www.who.int/publications/i/item/9789240014886.Search in Google Scholar
146. Gao, W, Sanna, M, Chen, YH, Tsai, MK, Wen, CP. Occupational sitting time, leisure physical activity, and all-cause and cardiovascular disease mortality. JAMA Netw Open 2024;7:e2350680. https://doi.org/10.1001/jamanetworkopen.2023.50680.Search in Google Scholar PubMed PubMed Central
147. Piercy, KL, Troiano, RP, Ballard, RM, Carlson, SA, Fulton, JE, Galuska, DA, et al.. The physical activity guidelines for Americans. JAMA 2018;320:2020–8. https://doi.org/10.1001/jama.2018.14854.Search in Google Scholar PubMed PubMed Central
148. Gibson-Moore, H. UK Chief Medical Officers’ physical activity guidelines 2019: what’s new and how can we get people more active? Nutr Bull 2019;44:320–8. https://doi.org/10.1111/nbu.12409.Search in Google Scholar
149. Drezner, JA, O’Connor, FG, Harmon, KG, Fields, KB, Asplund, CA, Asif, IM, et al.. AMSSM position statement on cardiovascular preparticipation screening in athletes: current evidence, knowledge gaps, recommendations and future directions. Br J Sports Med 2017;51:153–67. https://doi.org/10.1136/bjsports-2016-096781.Search in Google Scholar PubMed
150. Corrado, D, Basso, C, Pavei, A, Michieli, P, Schiavon, M, Thiene, G. Trends in sudden cardiovascular death in young competitive athletes after implementation of a preparticipation screening program. JAMA 2006;296:1593–601. https://doi.org/10.1001/jama.296.13.1593.Search in Google Scholar PubMed
151. Malhotra, A, Dhutia, H, Finocchiaro, G, Gati, S, Beasley, I, Clift, P, et al.. Outcomes of cardiac screening in adolescent soccer players. N Engl J Med 2018;379:524–34. https://doi.org/10.1056/nejmoa1714719.Search in Google Scholar
152. Maron, BJ, Zipes, DP, Kovacs, RJ. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: preamble, principles, and general considerations: a scientific statement from the American Heart Association and American College of Cardiology. J Am Coll Cardiol 2015;66:2343–9. https://doi.org/10.1161/cir.0000000000000236.Search in Google Scholar
153. Harmon, KG, Asif, IM, Maleszewski, JJ, Owens, DS, Prutkin, JM, Salerno, JC, et al.. Incidence, cause, and comparative frequency of sudden cardiac death in national collegiate athletic association athletes: a decade in review. Circulation 2015;132:10–9. https://doi.org/10.1161/circulationaha.115.015431.Search in Google Scholar PubMed PubMed Central
154. Drezner, JA, Harmon, KG, Marek, JC. Incidence of sudden cardiac arrest in Minnesota high school student athletes: the limitations of catastrophic insurance claims. J Am Coll Cardiol 2014;63:1455–6. https://doi.org/10.1016/j.jacc.2013.11.012.Search in Google Scholar PubMed
155. Maron, BJ, Gohman, TE, Aeppli, D. Prevalence of sudden cardiac death during competitive sports activities in Minnesota high school athletes. J Am Coll Cardiol 1998;32:1881–4. https://doi.org/10.1016/s0735-1097(98)00491-4.Search in Google Scholar PubMed
156. Van Camp, SP, Bloor, CM, Mueller, FO, Cantu, RC, Olson, HG. Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc 1995;27:641–7. https://doi.org/10.1249/00005768-199505000-00005.Search in Google Scholar
157. Toresdahl, BG, Rao, AL, Harmon, KG, Drezner, JA. Incidence of sudden cardiac arrest in high school student athletes on school campus. Heart Rhythm 2014;11:1190–4. https://doi.org/10.1016/j.hrthm.2014.04.017.Search in Google Scholar PubMed
158. Maron, BJ. Sudden death in young athletes. N Engl J Med 2003;349:1064–75. https://doi.org/10.1056/nejmra022783.Search in Google Scholar
159. Maron, BJ, Haas, TS, Ahluwalia, A, Rutten-Ramos, SC. Incidence of cardiovascular sudden deaths in Minnesota high school athletes. Heart Rhythm 2013;10:374–7. https://doi.org/10.1016/j.hrthm.2012.11.024.Search in Google Scholar PubMed
160. Fuller, CM, McNulty, CM, Spring, DA, Arger, KM, Bruce, SS, Chryssos, BE, et al.. Prospective screening of 5,615 high school athletes for risk of sudden cardiac death. Med Sci Sports Exerc 1997;29:1131–8. https://doi.org/10.1097/00005768-199709000-00003.Search in Google Scholar PubMed
161. Hevia, AC, Fernandez, MM, Palacio, JMA, Martin, EH, Castro, MG, Reguero, JJR. ECG as a part of the preparticipation screening programme: an old and still present international dilemma. Br J Sports Med 2011;45:776–9. https://doi.org/10.1136/bjsm.2009.063958.Search in Google Scholar PubMed
162. Fudge, J, Harmon, KG, Owens, DS, Prutkin, JM, Salerno, JC, Asif, IM, et al.. Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-participation Physical Evaluation Monograph 4th Edition and ECG. Br J Sports Med 2014;48:1172–8. https://doi.org/10.1136/bjsports-2014-093840.Search in Google Scholar PubMed PubMed Central
163. Drezner, JA, Owens, DS, Prutkin, JM, Salerno, JC, Harmon, KG, Prosise, S, et al.. Electrocardiographic screening in national collegiate athletic association athletes. Am J Cardiol 2016;118:754–9. https://doi.org/10.1016/j.amjcard.2016.06.004.Search in Google Scholar PubMed
164. Zeltser, I, Cannon, B, Silvana, L, George, J, Schleifer, J, Garcia, M, et al.. Lessons learned from preparticipation cardiovascular screening in a state funded program. Am J Cardiol 2012;110:902–8. https://doi.org/10.1016/j.amjcard.2012.05.018.Search in Google Scholar PubMed
165. Dunn, TP, Pickham, D, Aggarwal, S, Saini, D, Kumar, N, Wheeler, MT, et al.. Limitations of current AHA guidelines and proposal of new guidelines for the preparticipation examination of athletes. Clin J Sport Med 2015;25:472–7. https://doi.org/10.1097/jsm.0000000000000203.Search in Google Scholar
166. Williams, EA, Pelto, HF, Toresdahl, BG, Prutkin, JM, Owen, DS, Salerno, JC, et al.. Performance of the American Heart Association (AHA) 14-point evaluation vs. electrocardiography for the cardiovascular screening of high school athletes: a prospective study. J Am Heart Assoc 2019;8:e012235. https://doi.org/10.1161/jaha.119.012235.Search in Google Scholar PubMed PubMed Central
167. Price, DE, McWilliams, A, Asif, IM, Martin, A, Elliott, SD, Dulin, M, et al.. Electrocardiography-inclusive screening strategies for detection of cardiovascular abnormalities in high school athletes. Heart Rhythm 2014;11:442–9. https://doi.org/10.1016/j.hrthm.2013.12.002.Search in Google Scholar PubMed
168. Fletcher, GF, Ades, PA, Kligfield, P, Fletcher, GF, Ades, PA, Kligfield, P, et al.. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation 2013;128:873–934. https://doi.org/10.1161/cir.0b013e31829b5b44.Search in Google Scholar PubMed
169. Gianrossi, R, Detrano, R, Mulvihill, D, Lehmann, K, Dubach, P, Colombo, A, et al.. Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis. Circulation 1989;80:87–98. https://doi.org/10.1161/01.cir.80.1.87.Search in Google Scholar PubMed
170. Corrado, D, Schmied, C, Basso, C, Borjesson, M, Schiavon, M, Pelliccia, A, et al.. Risk of sports: do we need a pre-participation screening for competitive and leisure athletes? Eur Heart J 2011;32:934–44. https://doi.org/10.1093/eurheartj/ehq482.Search in Google Scholar PubMed
171. Mont, L, Pelliccia, A, Sharma, S, Biffi, A, Borjesson, M, Brugada Terradellas, J, et al.. Pre-participation cardiovascular evaluation for athletic participants to prevent sudden death: position paper from the EHRA and the EACPR, branches of the ESC. Eur J Prev Cardiol 2017;24:41–69. https://doi.org/10.1177/2047487316676042.Search in Google Scholar PubMed
172. Guazzi, M, Adams, V, Conraads, V, Halle, M, Mezzani, A, Vanhees, L, et al.. EACPR/AHA scientific statement. Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Circulation 2012;126:2261–74. https://doi.org/10.1161/cir.0b013e31826fb946.Search in Google Scholar
173. Rizzo, M, Spataro, A, Cecchetelli, C, Quaranta, F, Livrieri, S, Sperandii, F, et al.. Structural cardiac disease diagnosed by echocardiography in asymptomatic young male soccer players: implications for pre-participation screening. Br J Sports Med 2012;46:371–3. https://doi.org/10.1136/bjsm.2011.085696.Search in Google Scholar PubMed
174. Pelliccia, A, Solberg, EE, Papadakis, M, Adami, PE, Biffi, A, Caselli, S, et al.. Recommendations for participation in competitive and leisure time sport in athletes with cardiomyopathies, myocarditis, and pericarditis: position statement of the Sport Cardiology Section of the European Association of Preventive Cardiology (EAPC). Eur Heart J 2019;40:19–33. https://doi.org/10.1093/eurheartj/ehy730.Search in Google Scholar PubMed
175. Tucker, WJ, Fegers-Wustrow, I, Halle, M, Haykowsky, MJ, Chung, EH, Kovacic, JC. Exercise for primary and secondary prevention of cardiovascular disease: JACC Focus Seminar 1/4. J Am Coll Cardiol 2022;80:1091–106. https://doi.org/10.1016/j.jacc.2022.07.004.Search in Google Scholar PubMed
176. Giri, S, Thompson, PD, Kiernan, FJ, Clive, J, Fram, DB, Mitchel, JF, et al.. Clinical and angiographic characteristics of exertion-related acute myocardial infarction. JAMA 1999;282:1731–6. https://doi.org/10.1001/jama.282.18.1731.Search in Google Scholar PubMed
177. Mittleman, MA, Maclure, M, Tofler, GH, Sherwood, JB, Goldberg, RJ, Muller, JE. Triggering of acute myocardial infarction by heavy physical exertion. Protection against triggering by regular exertion. Determinants of Myocardial Infarction Onset Study Investigators. N Engl J Med 1993;329:1677–83. https://doi.org/10.1056/nejm199312023292301.Search in Google Scholar PubMed
178. Siscovick, DS, Weiss, NS, Fletcher, RH, Lasky, T. The incidence of primary cardiac arrest during vigorous exercise. N Engl J Med 1984;311:874–7. https://doi.org/10.1056/nejm198410043111402.Search in Google Scholar PubMed
179. Waller, BF, Roberts, WC. Sudden death while running in conditioned runners aged 40 years or over. Am J Cardiol 1980;45:1292–300. https://doi.org/10.1016/0002-9149(80)90491-9.Search in Google Scholar PubMed
180. Noakes, TD, Opie, LH, Rose, AG, Kleynhans, PH, Schepers, NJ, Dowdeswell, R. Autopsy-proved coronary atherosclerosis in marathon runners. N Engl J Med 1979;301:86. https://doi.org/10.1056/nejm197907123010205.Search in Google Scholar
181. Marijon, E, Tafflet, M, Celermajer, DS, Dumas, F, Perier, MC, Mustafic, H, et al.. Sports-related sudden death in the general population. Circulation 2011;124:672–81. https://doi.org/10.1161/circulationaha.110.008979.Search in Google Scholar PubMed
182. Lavie, CJ, O’Keefe, JH, Sallis, RE. Exercise and the heart--the harm of too little and too much. Curr Sports Med Rep 2015;14:104–9. https://doi.org/10.1249/jsr.0000000000000134.Search in Google Scholar PubMed
183. Aengevaeren, VL, Hopman, MTE, Thompson, PD, Bakker, EA, George, KP, Thijssen, DHJ, et al.. Exercise-induced cardiac troponin I increase and incident mortality and cardiovascular events. Circulation 2019;140:804–14. https://doi.org/10.1161/circulationaha.119.041627.Search in Google Scholar
184. Parry-Williams, G, Sharma, S. The effects of endurance exercise on the heart: panacea or poison? Nat Rev Cardiol 2020;17:402–12. https://doi.org/10.1038/s41569-020-0354-3.Search in Google Scholar PubMed
185. Costache, AD, Leon-Constantin, MM, Roca, M, Maștaleru, A, Anghel, RC, Zota, IM, et al.. Cardiac biomarkers in sports cardiology. J Cardiovasc Dev Dis 2022;9:453. https://doi.org/10.3390/jcdd9120453.Search in Google Scholar PubMed PubMed Central
186. Janssen, SLJE, de Vries, F, Mingels, AMA, Kleinnibbelink, G, Hopman, MTE, Mosterd, A, et al.. Exercise-induced cardiac troponin release in athletes with vs. without coronary atherosclerosis. Am J Physiol Heart Circ Physiol 2024;326:H1045–52. https://doi.org/10.1152/ajpheart.00021.2024.Search in Google Scholar PubMed PubMed Central
187. Kleiven, O, Omland, T, Skadberg, O, Melberg, TH, Bjorkavoll-Bergseth, MF, Auestad, B, et al.. Occult obstructive coronary artery disease is associated with prolonged cardiac troponin elevation following strenuous exercise. Eur J Prev Cardiol 2019:1212–21. https://doi.org/10.1177/2047487319852808.Search in Google Scholar PubMed
188. Möhlenkamp, S, Leineweber, K, Lehmann, N, Braun, S, Roggenbuck, U, Perrey, M, et al.. Coronary atherosclerosis burden, but not transient troponin elevation, predicts long-term outcome in recreational marathon runners. Basic Res Cardiol 2014;109:391. https://doi.org/10.1007/s00395-013-0391-8.Search in Google Scholar PubMed
189. Paana, T, Jaakkola, S, Bamberg, K, Saraste, A, Tuunainen, E, Wittfooth, S, et al.. Cardiac troponin elevations in marathon runners. Role of coronary atherosclerosis and skeletal muscle injury. The MaraCat Study. Int J Cardiol 2019;295:25–8. https://doi.org/10.1016/j.ijcard.2019.08.019.Search in Google Scholar PubMed
190. Sorensen, NA, Guo, L, Haller, PM, Dehkordi, F, Lehmacher, J, Schock, A, et al.. Cardiac troponin assays to distinguish between acute and chronic myocardial injury. J Am Coll Cardiol 2023;82:1885–7. https://doi.org/10.1016/j.jacc.2023.08.048.Search in Google Scholar PubMed
© 2024 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Editorial
- Blood self-sampling: friend or foe?
- Reviews
- Blood self-sampling devices: innovation, interpretation and implementation in total lab automation
- Salivary fatty acids in humans: a comprehensive literature review
- Opinion Papers
- EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories
- Point-of-care testing: state-of-the art and perspectives
- A standard to report biological variation data studies – based on an expert opinion
- Ethical Checklists for Clinical Research Projects and Laboratory Medicine: two tools to evaluate compliance with bioethical principles in different settings
- Guidelines and Recommendations
- Assessment of cardiovascular risk and physical activity: the role of cardiac-specific biomarkers in the general population and athletes
- Genetics and Molecular Diagnostics
- Clinical utility of regions of homozygosity (ROH) identified in exome sequencing: when to pursue confirmatory uniparental disomy testing for imprinting disorders?
- An ultrasensitive DNA-enhanced amplification method for detecting cfDNA drug-resistant mutations in non-small cell lung cancer with selective FEN-assisted degradation of dominant somatic fragments
- General Clinical Chemistry and Laboratory Medicine
- The biological variation of insulin resistance markers: data from the European Biological Variation Study (EuBIVAS)
- The surveys on quality indicators for the total testing process in clinical laboratories of Fujian Province in China from 2018 to 2023
- Preservation of urine specimens for metabolic evaluation of recurrent urinary stone formers
- Performance evaluation of a smartphone-based home test for fecal calprotection
- Implications of monoclonal gammopathy and isoelectric focusing pattern 5 on the free light chain kappa diagnostics in cerebrospinal fluid
- Development and validation of a novel 7α-hydroxy-4-cholesten-3-one (C4) liquid chromatography tandem mass spectrometry method and its utility to assess pre-analytical stability
- Establishment of ELISA-comparable moderate and high thresholds for anticardiolipin and anti-β2 glycoprotein I chemiluminescent immunoassays according to the 2023 ACR/EULAR APS classification criteria and evaluation of their diagnostic performance
- Reference Values and Biological Variations
- Capillary blood parameters are gestational age, birthweight, delivery mode and gender dependent in healthy preterm and term infants
- Reference intervals and percentiles for soluble transferrin receptor and sTfR/log ferritin index in healthy children and adolescents
- Cancer Diagnostics
- Detection of serum CC16 by a rapid and ultrasensitive magnetic chemiluminescence immunoassay for lung disease diagnosis
- Cardiovascular Diseases
- The role of functional vitamin D deficiency and low vitamin D reservoirs in relation to cardiovascular health and mortality
- Annual Reviewer Acknowledgment
- Reviewer Acknowledgment
- Letters to the Editor
- EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) survey on cybersecurity
- Comment on Lippi et al.: EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories
- Six Sigma in laboratory medicine: the unfinished symphony
- Navigating complexities in vitamin D and cardiovascular health: a call for comprehensive analysis
- Simplified preanalytical laboratory procedures for therapeutic drug monitoring (TDM) in patients treated with high-dose methotrexate (HD-MTX) and glucarpidase
- New generation of Abbott enzyme assays: imprecision, methods comparison, and impact on patients’ results
- Correction of negative-interference from calcium dobesilate in the Roche sarcosine oxidase creatinine assay using CuO
- Two cases of MTHFR C677T polymorphism typing failure by Taqman system due to MTHFR 679 GA heterozygous mutation
- A falsely elevated blood alcohol concentration (BAC) related to an intravenous administration of phenytoin sodium
Articles in the same Issue
- Frontmatter
- Editorial
- Blood self-sampling: friend or foe?
- Reviews
- Blood self-sampling devices: innovation, interpretation and implementation in total lab automation
- Salivary fatty acids in humans: a comprehensive literature review
- Opinion Papers
- EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories
- Point-of-care testing: state-of-the art and perspectives
- A standard to report biological variation data studies – based on an expert opinion
- Ethical Checklists for Clinical Research Projects and Laboratory Medicine: two tools to evaluate compliance with bioethical principles in different settings
- Guidelines and Recommendations
- Assessment of cardiovascular risk and physical activity: the role of cardiac-specific biomarkers in the general population and athletes
- Genetics and Molecular Diagnostics
- Clinical utility of regions of homozygosity (ROH) identified in exome sequencing: when to pursue confirmatory uniparental disomy testing for imprinting disorders?
- An ultrasensitive DNA-enhanced amplification method for detecting cfDNA drug-resistant mutations in non-small cell lung cancer with selective FEN-assisted degradation of dominant somatic fragments
- General Clinical Chemistry and Laboratory Medicine
- The biological variation of insulin resistance markers: data from the European Biological Variation Study (EuBIVAS)
- The surveys on quality indicators for the total testing process in clinical laboratories of Fujian Province in China from 2018 to 2023
- Preservation of urine specimens for metabolic evaluation of recurrent urinary stone formers
- Performance evaluation of a smartphone-based home test for fecal calprotection
- Implications of monoclonal gammopathy and isoelectric focusing pattern 5 on the free light chain kappa diagnostics in cerebrospinal fluid
- Development and validation of a novel 7α-hydroxy-4-cholesten-3-one (C4) liquid chromatography tandem mass spectrometry method and its utility to assess pre-analytical stability
- Establishment of ELISA-comparable moderate and high thresholds for anticardiolipin and anti-β2 glycoprotein I chemiluminescent immunoassays according to the 2023 ACR/EULAR APS classification criteria and evaluation of their diagnostic performance
- Reference Values and Biological Variations
- Capillary blood parameters are gestational age, birthweight, delivery mode and gender dependent in healthy preterm and term infants
- Reference intervals and percentiles for soluble transferrin receptor and sTfR/log ferritin index in healthy children and adolescents
- Cancer Diagnostics
- Detection of serum CC16 by a rapid and ultrasensitive magnetic chemiluminescence immunoassay for lung disease diagnosis
- Cardiovascular Diseases
- The role of functional vitamin D deficiency and low vitamin D reservoirs in relation to cardiovascular health and mortality
- Annual Reviewer Acknowledgment
- Reviewer Acknowledgment
- Letters to the Editor
- EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) survey on cybersecurity
- Comment on Lippi et al.: EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories
- Six Sigma in laboratory medicine: the unfinished symphony
- Navigating complexities in vitamin D and cardiovascular health: a call for comprehensive analysis
- Simplified preanalytical laboratory procedures for therapeutic drug monitoring (TDM) in patients treated with high-dose methotrexate (HD-MTX) and glucarpidase
- New generation of Abbott enzyme assays: imprecision, methods comparison, and impact on patients’ results
- Correction of negative-interference from calcium dobesilate in the Roche sarcosine oxidase creatinine assay using CuO
- Two cases of MTHFR C677T polymorphism typing failure by Taqman system due to MTHFR 679 GA heterozygous mutation
- A falsely elevated blood alcohol concentration (BAC) related to an intravenous administration of phenytoin sodium