Transient cardiac dysfunction but elevated cardiac and kidney biomarkers 24 h following an ultra-distance running event in Mexican Tarahumara

Christensen, Dirk L.; Espino, Diana; Infante-Ramírez, Rocío; Cervantes-Borunda, Mónica S.; Hernández-Torres, Rosa P.; Rivera-Cisneros, Antonio E.; Castillo, Daniel; Westgate, Kate; Terzic, Dijana; Brage, Soren; Hassager, Christian; Goetze, Jens P.; Kjaergaard, Jesper

doi:10.1186/s13728-017-0057-5

Table 3 Alterations of echocardiographic measures, plasma markers, and electrocardiogram following 63 km of running at moderate-to-low altitude in male Tarahumara (n = 10) presented as mean (95% CI)

From: Transient cardiac dysfunction but elevated cardiac and kidney biomarkers 24 h following an ultra-distance running event in Mexican Tarahumara

Parameter	Pre-race	Post-race changes (mean values (95% CI) with statistical differences from pre-race value)
Parameter	Pre-race	< 5-min/30-min	p value	6-h	p value	24-h	p value
Echocardiography^a,b
TAPSE (cm)	2.6 (2.4; 2.9)	− 0.2 (− 0.5; 0.1)	0.257	− 0.1 (− 0.4; 0.2)	0.654	0.4 (0.1; 0.7)	0.007
RV S’ (cm s⁻¹)	15.5 (14.3; 16.7)	− 2.1 (− 3.6; − 0.5)	0.009	1.0 (− 0.6; 2.6)	0.233	0.8 (− 0.9; 2.5)	0.330
LV outflow VTI (cm)	22.1 (20.3; 23.8)	− 2.6 (− 4.6; − 0.7)	0.007	− 2.2 (− 4.3; − 0.1)	0.041	− 0.4 (− 2.5; 1.7)	0.699
LV SAX GCS (%)	17.8 (15.0; 20.6)	− 1.7 (− 5.1; 1.6)	0.303	2.5 (− 1.4; 6.3)	0.206	4.3 (0.7; 7.9)	0.019
Plasma biomarkers^a,c
LDH (U L⁻¹)	102.8 (19.3; 186.3)	259.9 (176.4; 343.4)	0.004	209.4 (116.6; 302.1)	0.065	270.3 (177.5; 363.0)	0.004
Creatine kinase (U L⁻¹)	140.0 (66.2; 213.8)	2737 (2683; 7267)	< 0.001	5535 (2298; 8772)	< 0.001	5380 (2234; 8527)	< 0.001
Creatine kinase-MB (µg L⁻¹)	3.1 (1.3; 4.8)	62.5 (26.5; 98.6)	< 0.001	70.6 (27.0; 114.3)	< 0.001	56.3 (21.5; 91.0)	< 0.001
Creatine kinase ratio	2.3 (1.3; 3.3)	0.4 (− 1.0; 1.8)	0.573	− 0.9 (− 2.3; 0.6)	0.258	− 1.0 (− 2.5; 0.5)	0.179
Creatinine (µmol L⁻¹)	64.9 (50.0; 79.8)	88.1 (73.2; 103.0)	0.002	88.6 (72.5; 104.7)	0.004	69.6 (53.5; 85.7)	0.565
hs-CRP (mg L⁻¹)	0.8 (0.1; 1.4)	1.2 (0.3; 2.1)	0.336	9.9 (1.7; 18.1)	< 0.001	15.8 (2.8; 28.8)	< 0.001
Iron (µmol L⁻¹)	15.1 (12.3; 17.9)	13.5 (11.7; 15.2)	0.226	7.0 (5.4; 8.6)	< 0.001	20.5 (17.4; 23.6)	0.004
Haptoglobin (g L⁻¹)	0.9 (0.7; 1.1)	0.3 (0.2; 0.5)	<0.001	0.4 (0.2; 0.6)	< 0.001	0.8 (0.6; 1.0)	0.165
Sodium (mmol L⁻¹)	138 (131; 146)	128 (121; 135)	0.020	141 (133; 149)	0.549	152 (144; 160)	0.005
Potassium (mmol L⁻¹)	4.3 (3.8; 4.7)	4.6 (4.1; 5.0)	0.354	4.3 (3.8; 4.8)	0.917	4.5 (4.0; 5.0)	0.572
Albumin (g L⁻¹)	46.8 (44.7; 48.8)	51.4 (49.3; 53.4)	< 0.001	47.0 (44.7; 49.2)	0.877	44.1 (41.8; ; 46.3)	0.045
Electrocardiogram^a,d
PQ interval (ms)	154 (147; 162)	− 4 (− 12; 3)	0.254			0.0 (− 8; 8)	0.975
QRS complex (ms)	86 (81; 91)	− 2 (− 6; 1)	0.230			− 2 (− 6; 1)	0.192
QTc (ms)	405 (390; 419)	19 (− 2; 40)	0.073			28 (6; 49)	0.011
Hemodynamics^a,d
Heart rate (bts min⁻¹)	56 (51; 61)	33 (26; 40)	< 0.001	11 (4; 18)	0.002	4 (− 3; 11)	0.302
Stroke volume (L min⁻¹)	7.1 (6.6; 7.7)	− 2.0 (− 2.6; − 1.3)	< 0.001	− 0.7 (− 1.3; 0.2)	0.057	1.7 (− 0.5,0.9)	0.612
SBP (mmHg)	105 (99; 111)	− 6 (− 13; 19	0.008	− 7 (− 15; 0.0)	0.043	− 8 (− 15; − 1)	0.030
DBP (mmHg)	64 (60; 67)	1 (− 3; 6)	0.613	− 6 (− 11; − 1)	0.018	− 9 (− 14; − 4)	< 0.001

TAPSE tricuspid annular plane systolic excursion; RV S’ right ventricular annular maximal longitudinal velocity; LV outflow VTI left ventricular velocity time integral; LV SAX GCS left ventricular parasternal short-axis global circumferential strain; LDH lactate dehydrogenase; creatine kinase-MB creatine kinase isoform myocardial band; hs-CRP high-sensitivity C-reactive protein; SBP systolic blood pressure; DBP diastolic blood pressure
^aAnalyses age-adjusted
^bFirst post-race echocardiographic measurement carried out 30 min post-race
^cFirst post-race blood samples collected < 5 min post-race
^dFirst post-race electrocardiogram measurement carried out < 40 min post-race

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