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

in Pediatric Exercise Science
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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.

Cirer-Sastre and Corbi are with the National Institute of Physical Education of Catalonia (INEFC), Lleida, Spain. Cirer-Sastre, Corbi, and Reverter-Masià are with Research Group Human Movement (RGHM), Universitat de Lleida (UdL), Lleida, Spain. Legaz-Arrese is with the Section of Physical Education and Sports, University of Zaragoza, Zaragoza, Spain. George is with the Centre of Sports and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom. Nie is with the School of Physical Education and Sports, Macao Polytechnic Institute, Macao, China. Carranza-García is with the Facultad de Organización Deportiva, Universidad Autónoma de Nuevo León, México. Reverter-Masià is also with the Department of Special Didactics, Universitat de Lleida (UdL), Lleida, Spain.

Cirer-Sastre (rcirer@inefc.es) is corresponding author.
Pediatric Exercise Science
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