Overview
The goal of this observational study is to learn about cardiac biomarker release following exercise in amateur athletes.
The main questions it aims to answer are:
Question 1: What are the reference values for exercise-induced cardiac troponin elevations following walking, cycling and running exercise? Hypothesis 1: We hypothesize that the exercise-induced cTn release is different following walking, cycling and running exercise. Therefore, we will establish reference values for post-exercise cTn concentrations across each of these sport types.
Question 2: Is the prevalence of (subclinical) coronary artery disease higher in individuals with high post-exercise cardiac troponin concentrations in comparison to individuals with low post-exercise cardiac troponin concentrations? Hypothesis 2: We hypothesize that athletes with the highest post-exercise cTn concentrations have a higher prevalence of coronary atherosclerosis compared to athletes matched for sex and age with the lowest post-exercise cTn concentrations.
Question 3: What is the association between post-exercise cardiac troponin concentrations and major adverse cardiovascular events (MACE) and mortality during long-term follow-up? Hypothesis 3: We hypothesize that post-exercise cTn concentrations beyond the 99th percentile are associated with an increased risk for MACE and mortality during follow-up.
This study consists of three phases:
Phase 1: two or three visits to the study location for (amongst other measurements) blood draws to assess cardiac troponin concentrations
Phase 2: CT scan of the heart in 10% of participants to assess the prevalence of (subclinicial) coronary artery disease.
Phase 3: longitudinal follow-up to assess the incidence of major adverse cardiovascular events and mortality during 20-year follow-up.
Participants will visit our study centre two, three or four times:
Visit 1: baseline measurements including height, weight, body composition and blood pressure will be obtained and a blood sample will be drawn.
Visit 2: a blood sample will be drawn and activity data will be obtained from participants' own sports watch or bike computer.
Optional visit 3: a blood sample will be drawn. Visit 4: 10% of participants will undergo a cardiac CT scan to assess the prevalence of (subclinical) coronary artery disease.
Description
For a detailed description, please see the attached study protocol under 'Documents'.
Eligibility
Inclusion criteria:
In order to be eligible to participate in this study, a subject must meet all of the following criteria: - Participant of an affiliated mass-participation exercise event with a: - Walking distance ≥20 km - Cycling distance ≥100 km - Running distance ≥15 km - Age: ≥ 40 and <70 years old - Able to understand and perform study related procedures For Phase 2 of the study (i.e. assessment of (sub)clinical coronary artery disease), the following additional criteria are present: • Free from (known) cardiovascular diseases Exclusion Criteria: A potential subject who meets any of the following criteria will be excluded from participation in Phase 2 of the study: - Renal transplantation in the past - Contrast nephropathy in the past - estimated glomerular filtration rate (eGFR) < 30 ml/min - Atrial fibrillation (heart rhythm disorder) - Previous allergic reaction to iodine contrast - Participation in other studies involving radiation - Not willing to be informed about potential incidental findings from the CT-scan