Exercise-Induced Cardiac Troponin I Elevations in Children

Abstract

Background: Cardiac troponin I (cTnI) levels have been shown to increase after exercise, but pediatric-specific data remain limited. Objectives: The aim of this study was to investigate the increase in cTnI levels following exercise in children and adolescents and to assess the relationship between this increase and factors such as age, gender, type of exercise, and duration of physical activity. Methods: This retrospective study included pediatric participants who visited the hospital due to chest pain after exercise and had elevated cTnI levels. The age and gender of the participants, as well as the type and duration of exercise before hospital admission, were recorded. Post-exercise cTnI levels, creatine kinase–myocardial band (CK-MB) levels, and biochemical blood parameters were obtained from patient files. Results: Over the course of one year, 25 pediatric participants presented to our pediatric emergency clinic with chest pain after exercise. The mean cTnI level obtained at the participants' first admission was 133.03 ± 129.46 ng/L, and the mean CK-MB level was 16.06 ± 12.11 ng/L. Echocardiography (ECHO) results were found to be normal in all participants. It was observed that the mean cTnI level decreased to 78.05 ± 97.16 ng/L in 12 hours, 16.01 ± 18.42 ng/L in 24 hours, and then 3.25 ± 2.48 ng/L in 48 hours.There was a negative correlation between cTnI levels and the longevity of the participants' exercise history (P = 0.024, r = -0.450, P = 0.023, r = -0.454, respectively). Additionally, a negative correlation was observed between age and cTnI levels (P = 0.001, r = -0.620; P = 0.000, r = -0.672; P = 0.041, r = -0.411; P = 0.002, r = -0.589, respectively). There was a significant correlation between post-exercise cTnI levels and the duration of exercise (P = 0.000, r = 0.924; P = 0.000, r = 0.902; P = 0.007, r = 0.523; P = 0.002, r = 0.582, respectively). Conclusions: As a result, it should be kept in mind that in cases with elevated troponin (Tp) values, elevations due to exercise, rather than underlying cardiac pathology, may be present.