Cardiac Biomarker Release After Exercise in Healthy Children and Adolescents: A Systematic Review and Meta-Analysis

Pediatr Exerc Sci. 2019 Feb 1;31(1):28-36. doi: 10.1123/pes.2018-0058. Epub 2018 Sep 30.

Abstract

Purpose: The authors evaluated the impact of acute exercise and 24-hour recovery on serum concentration of cardiac troponins T and I (cTnT and cTnI) and N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP) in healthy children and adolescents. The authors also determined the proportion of participants exceeding the upper reference limits and acute myocardial infarction cutoff for each assay.

Method: Web of Science, SPORTDiscus, MEDLINE, ScienceDirect, and Scopus databases were systematically searched up to November 2017. Studies were screened and quality-assessed; the data was systematically extracted and analyzed.

Results: From 751 studies initially identified, 14 met the inclusion criteria for data extraction. All 3 biomarkers were increased significantly after exercise. A decrease from postexercise to 24 hours was noted in cTnT and cTnI, although this decrease was only statistically significant for cTnT. The upper reference limit was exceeded by 76% of participants for cTnT, a 51% for cTnI, and a 13% for NT-proBNP. Furthermore, the cutoff value for acute myocardial infarction was exceeded by 39% for cTnT and a 11% for cTnI. Postexercise peak values of cTnT were associated with duration and intensity (Q(3) = 28.3, P < .001) while NT-proBNP peak values were associated with duration (Q(2) = 11.9, P = .003).

Conclusion: Exercise results in the appearance of elevated levels of cTnT, cTnI, and NT-proBNP in children and adolescents. Postexercise elevations of cTnT and NT-proBNP are associated with exercise duration and intensity.

Keywords: NT-proBNP; cTnI; cTnT; sport medicine.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Biomarkers / blood*
  • Child
  • Exercise / physiology*
  • Female
  • Heart / physiology
  • Humans
  • Male
  • Myocardial Infarction / blood
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Troponin I / blood*
  • Troponin T / blood*

Substances

  • Biomarkers
  • Peptide Fragments
  • Troponin I
  • Troponin T
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain