The relationship between exercise‐induced troponin elevation and non‐obstructive coronary artery disease (CAD) is unclear. This observational study assessed non‐obstructive CAD's impact on exercise‐induced cardiac Troponin I (cTnI) elevation in middle‐aged recreational athletes. cTnI levels of 40 well‐trained recreational athletes (73% males, 50 ± 9 years old) were assessed by a high‐sensitive cTnI assay 24 h before, and at 3 and 24 h following two high‐intensity exercises of different durations; a cardiopulmonary exercise test (CPET), and a 91‐km mountain bike race. Workload was measured with power meters. Coronary computed tomography angiography was used to determine the presence or absence of non‐obstructive (<50% obstruction) CAD. A total of 15 individuals had non‐obstructive CAD (Atherosclerotic group), whereas 25 had no atherosclerosis (normal). There were higher post‐exercise cTnI levels following the race compared with CPET, both at 3 h (77.0 (35.3–112.4) ng/L vs. 11.6 (6.4–22.5) ng/L, p < 0.001) and at 24 h (14.7 (6.7–16.3) vs. 5.0 (2.6–8.9) ng/L, p < 0.001). Absolute cTnI values did not differ among groups. Still, the association of cTnI response to power output was significantly stronger in the CAD versus Normal group both at 3 h post‐exercise (Rho = 0.80, p < 0.001 vs. Rho = −0.20, p = 0.33) and 24‐h post‐exercise (Rho = 0.87, p < 0.001 vs. Rho = −0.13, p = 0.55). Exercise‐induced cTnI elevation was strongly correlated with exercise workload in middle‐aged athletes with non‐obstructive CAD but not in individuals without CAD. This finding suggests that CAD influences the relationship between exercise workload and the cTnI response even without coronary artery obstruction.

中文翻译：

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工作负荷与运动引起的心肌肌钙蛋白升高之间的关系受非阻塞性冠状动脉粥样硬化的影响


运动引起的肌钙蛋白升高与非阻塞性冠状动脉疾病（CAD）之间的关系尚不清楚。这项观察性研究评估了非阻塞性 CAD 对中年休闲运动员运动引起的心肌肌钙蛋白 I (cTnI) 升高的影响。 40 名训练有素的休闲运动员（73% 男性，50 ± 9 岁）在两次不同持续时间的高强度运动前 24 小时以及运动后 3 小时和 24 小时通过高灵敏度 cTnI 测定法评估了 cTnI 水平；心肺运动测试 (CPET) 和 91 公里山地自行车比赛。工作负载是用功率计测量的。冠状动脉计算机断层扫描血管造影用于确定是否存在非阻塞性（<50% 阻塞）CAD。共有 15 人患有非阻塞性 CAD（动脉粥样硬化组），而 25 人没有动脉粥样硬化（正常组）。与 CPET 相比，赛后运动后 cTnI 水平较高（3 小时（77.0 (35.3–112.4) ng/L vs. 11.6 (6.4–22.5) ng/L，p < 0.001）和 24 小时） （14.7 (6.7–16.3) 与 5.0 (2.6–8.9) ng/L，p < 0.001）。绝对 cTnI 值在各组之间没有差异。尽管如此，在运动后 3 小时（Rho = 0.80，p < 0.001 vs. Rho = -0.20，p = 0.33）和 24 小时，CAD 组的 cTnI 反应与功率输出的相关性明显强于正常组。运动后（Rho = 0.87，p < 0.001 vs. Rho = -0.13，p = 0.55）。在患有非阻塞性 CAD 的中年运动员中，运动引起的 cTnI 升高与运动量密切相关，但在没有 CAD 的个体中则不然。这一发现表明，即使没有冠状动脉阻塞，CAD 也会影响运动量和 cTnI 反应之间的关系。