Tomas K. Tong

Resting and post-exercise serum biomarkers of cardiac and skeletal muscle damage in adolescent runners

This study examined the response of serum biomarkers of cardiac and skeletal muscle damage at rest and after a routine workout of 21 km run in 12 male adolescent (16.2±0.6 years) long‐distance runners. Biomarkers of cardiac [troponins (cTnT, cTnI), creatine kinase MB mass (CK‐Mbmass)] and skeletal muscle [creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and hydroxybutyrate dehydrogenase (HBD)] damage were assayed at rest, 2, 4 and 24 h post‐exercise. At rest, cTnT and cTnI were not detectable; however, CK, CK‐MBmass, AST, ALT and HBD were above corresponding clinical cut‐off values. Post‐exercise significant elevations above rest were observed for all biomarkers, except ALT, 2 and 4 h following the run, and remained elevated in cTnI, CK, CK‐MBmass, LDH and AST 24 h post‐workout. A significant increase in data points above clinical cut‐off values from rest to post‐exercise was reported for cTnT, cTnI and CK at 2 and 4 h, and in cTnI and CK 24 h post‐exercise. In conclusion, a 21 km run in adolescent runners increased post‐exercise biomarkers of cardiac and skeletal muscle damage.

Serum Cardiac Troponin T in Adolescent Runners: Effects of Exercise Intensity and Duration

The purpose of this study was to evaluate the interactive effects of exercise duration and intensity on the elevation of serum cardiac troponin T (cTnT) in trained adolescent athletes following prolonged exercise in a laboratory-based setting. Thirteen male adolescent runners (mean age 14.8+/-1.6 year) performed two 45-min and two 90-min constant-load treadmill runs with intensities set at the running speeds that corresponded to either 80% or 100% ventilatory threshold (Th(vent)): 80%Th(vent)45 min, 80%Th(vent)90 min, 100%Th(vent)45 min and 100%Th(vent)90 min. Serum cTnT was assessed pre and post exercise. In the 100%Th(vent)45 min trial, the post-exercise serum cTnT level [(Median) 0.015 ng x ml(-1); (Range)<0.01-0.375 ng x ml(-1)] was greater than that of the 80%Th(vent)45 min (undetectable cTnT) and 80%Th(vent)90 min (detectable cTnT in two subjects, 0.021 and 0.133 ng x ml(-1)) trials (P<0.01). The serum cTnT level was further increased in the 100%Th(vent)90 min trial [(Median) 0.063 ng x ml(-1); (Range)<0.01-0.417 ng x ml(-1)] when the treadmill run was sustained for an additional 45 min (P<0.05). Similar changes were observed in the cTnT positive rate in subjects. These findings suggest that exercise duration and intensity are essential factors in eliciting cTnT release interactively following an endurance exercise. Nevertheless, exercise intensity compared to duration appears to cause a more pronounced increase in cTnT levels.

The Influence of a Half-Marathon Race Upon Cardiac Troponin T Release in Adolescent Runners

OBJECTIVES Post-exercise cardiac troponin T (cTnT) release has been widely reported in adult athletes but limited data is available for adolescents. The aim of this study was to determine the incidence and magnitude of cTnT appearance in a large group of adolescent runners, and to determine any association between cTnT release and personal characteristics of adolescents. METHODS We recruited 63 adolescent runners (mean±SD: age 16.4±1.5 years; 10 females) who all completed a simulated half-marathon race (an all-out 21-km run) during routine training. Personal data collected included age, training history, 21-km run performance as well as pre-post exercise serum cTnT levels. Serum cTnT was assayed using a 3rd generation assay. RESULTS At pre-exercise, cTnT concentrations were below the 0.01 µg/L cTnT detection limit of assay in 58/63 runners. The post-exercise cTnT level (range: <0.01-1.36 µg/L) was significantly (p<0.001) greater than that of the pre-exercise (range: <0.01-0.02 µg/L). After the exercise, 57 (90%) and 44 (70%) subjects had cTnT concentrations above the detection: 0.01, and clinical thresholds: 0.05 µg/L, respectively. Post-exercise cTnT was inversely correlated with training years (r=-0.25, p<0.05) and age (r=-0.31, p<0.05). Compared with runners who had trained for ≥ 3 years, runners with less training experience demonstrated increased post-race cTnT levels (p<0.01). CONCLUSION cTnT increases are virtually universal among adolescent runners following a 21-km run during routine training and can reach levels typically diagnostic for acute myocardial infarction potentially initiating diagnostic dilemmas. Adolescents with less training experience had higher post-exercise cTnT.

Inspiratory muscle warm-up attenuates muscle deoxygenation during cycling exercise in women athletes

This study examines the effects of inspiratory muscle warm-up (IMW) on performance and muscle oxygenation during cycling exercise. In a randomized crossover study of 10 female soccer players, the IMW, placebo (IMWP) and control (CON) trials were conducted before two 6-min submaximal cycling exercises (100 and 150W) followed by intermittent high-intensity sprint (IHIS, 6×10s with 60s recovery). The reduction in tissue saturation index (TSI) in legs in the IMW were significantly less than those in IMWP and CON (P<0.01) during submaximal cycling exercises. The average reduction in TSI during the IHIS test with IMW was significantly less than those in the IMWP and CON (P=0.023). Nevertheless, the IHIS performance with IMW did not differ from that in other trials. In conclusion, the leg TSI during continuous submaximal cycling exercise followed by intermittent sprinting was likely improved by specific IMW (40% maximal inspiratory mouth pressure), which did not enhance IHIS performance.

Functional Inspiratory and Core Muscle Training Enhances Running Performance and Economy.

Abstract Tong, TK, McConnell, AK, Lin, H, Nie, J, Zhang, H, and Wang, J. “Functional” inspiratory and core muscle training enhances running performance and economy. J Strength Cond Res 30(10): 2942–2951, 2016—We compared the effects of two 6-week high-intensity interval training interventions. Under the control condition (CON), only interval training was undertaken, whereas under the intervention condition (ICT), interval training sessions were followed immediately by core training, which was combined with simultaneous inspiratory muscle training (IMT)—“functional” IMT. Sixteen recreational runners were allocated to either ICT or CON groups. Before the intervention phase, both groups undertook a 4-week program of “foundation” IMT to control for the known ergogenic effect of IMT (30 inspiratory efforts at 50% maximal static inspiratory pressure [P0] per set, 2 sets per day, 6 days per week). The subsequent 6-week interval running training phase consisted of 3–4 sessions per week. In addition, the ICT group undertook 4 inspiratory-loaded core exercises (10 repetitions per set, 2 sets per day, inspiratory load set at 50% post-IMT P0) immediately after each interval training session. The CON group received neither core training nor functional IMT. After the intervention phase, global inspiratory and core muscle functions increased in both groups (p ⩽ 0.05), as evidenced by P0 and a sport-specific endurance plank test (SEPT) performance, respectively. Compared with CON, the ICT group showed larger improvements in SEPT, running economy at the speed of the onset of blood lactate accumulation, and 1-hour running performance (3.04% vs. 1.57%, p ⩽ 0.05). The changes in these variables were interindividually correlated (r ≥ 0.57, n = 16, p ⩽ 0.05). Such findings suggest that the addition of inspiratory-loaded core conditioning into a high-intensity interval training program augments the influence of the interval program on endurance running performance and that this may be underpinned by an improvement in running economy.

Sex differences in release of cardiac troponin T after endurance exercise

Abstract Context: Post-exercise cardiac troponin release has been extensively described in athletic groups but little attention has been given to any role of sex in mediating this phenomenon. Objective: We compared the release of cardiac troponin T (cTnT) after endurance running in training-experience, biological-age and maturity-matched young male and female runners. Materials and methods: Nineteen male (training history: 2.3 ± 1.0 years; mean age: 16.1 ± 1.2 years; Tanner stage: 3.7 ± 0.6) and 19 female (training history: 2.2 ± 1.0 years; mean age: 15.9 ± 1.4 years; Tanner stage: 4.0 ± 0.4) runners performed a 21 km run with “all-out” effort. Serum cTnT levels were assessed at pre-exercise (Pre-ex) and at 4 h post-exercise (Post-ex). Results: At Pre-ex, cTnT concentrations were below the 99th percentile value (10 ng.l−1) in 32/38 runners. Post-ex cTnT increased in all subjects but the response was substantially higher (p < 0.05) in males [median (range): 210 (20–1360) ng.l−1] than females [median (range): 80 (10–550) ng.l−1]. At Post-ex, 95% (95% confidence interval: 75–99%) of males and 63% (95% confidence interval: 41–81%) of females (p < 0.05) had cTnT concentrations above the cut-off for acute myocardial infarction. Conclusions: The present data suggest that post-exercise cTnT elevation occurs in all runners but is augmented in young male compared to female athletes.

Histological evidence for reversible cardiomyocyte changes and serum cardiac troponin T elevation after exercise in rats.

This study characterized cardiac troponin T (cTnT) appearance and associated histological evidence of reversible or irreversible changes in myocardial ultrastructure, determined via electron microscopy, in rats undertaking isoproterenol (ISO) infusion or an endurance exercise challenge. Male rats were randomized into ISO and exercise groups. In ISO trials rats were killed 5 h (ISO‐5H) and 24 h (ISO‐REC19H) after a single ISO or saline injection (SAL‐5H; SAL‐REC19H). In the exercise trials rats were killed before, as a control (EXE‐CON), immediately after (EXE‐END5H) and 19 h after (EXE‐REC19H) a 5‐h bout of swimming with 5% body weight attached to their tail. Serum cTnT was quantified by electrochemiluminescence, and myocardial samples in ISO‐REC19H, EXE‐REC19H and SAL‐REC19H were harvested for assessment of specific mitochondrial injury scores using electron‐microscopy. cTnT was undetectable in all control animals (SAL‐5H/SAL‐REC19H and EXE‐CON). cTnT increased in all animals after ISO and exercise but the response was significantly higher (P < 0.05) at ISO‐5H (median [range]: 2.60 [1.76–6.18] μg · L−1) than at EXE‐END5H (median [range]: 0.05 [0.02–0.14] μg · L−1). cTnT returned to baseline at EXE‐REC19H, but had not completely recovered at ISO‐REC19H (median [range]: 0.17 [0.09–1.22] μg · L−1). Mitochondrial “injury scores” were significantly higher (P < 0.05) in ISO‐REC19H compared to EXE‐REC19H and SAL‐REC19H, with no difference between EXE‐REC19H and SAL‐REC19H. Mitochondria from EXE‐REC19H appeared aggregated in nonlinear clusters in a small number of scans. These findings suggest that acute exercise‐induced appearance of cTnT in this animal model is only associated with reversible changes in cardiomyocyte structure.

High-Intensity Interval Training in Normobaric Hypoxia Improves Cardiorespiratory Fitness in Overweight Chinese Young Women

Previous studies have investigated the effects of high-intensity interval training (HIIT) on cardiorespiratory fitness and body composition in overweight populations. However, the additive effect of HIIT and hypoxia on health parameters is not clear. This study compared the effects of HIIT under hypoxic conditions on cardiometabolic function with that under normoxia in overweight Chinese young women. Methods: A double-blind randomized controlled experimental design was applied. Twenty-four sedentary overweight Chinese young women (weight: 68.8 ± 7.0 kg, BMI: 25.8 ± 2.3 kg·m−2) participated in the HIIT under either normoxia (NORM, n = 13, PIO2: 150 mmHg, FIO2: 0.21) or normobaric hypoxia (HYP, n = 11, PIO2: 117 mmHg, FIO2: 0.15) for 5 weeks. HIIT was composed of 60 repetitions of 8 s maximal cycling effort interspersed with 12-s recovery per day, for 4 days per week. Cardiorespiratory fitness [peak oxygen uptake (V·O2peak), and peak oxygen pulse (peak O2 pulse)], serum lipid profile [triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C)], and body composition (regional and whole-body), were assessed at pre- and post-intervention during the days beyond the self-reported menstrual phase of the participants. Habitual physical activity and diary behavior were maintained during the intervention period. Results: With similar daily energy intake and physical activity, the increases in V·O2peak [NORM: 0.26 ± 0.37 L·min−1 (+11.8%) vs. HYP: 0.54 ± 0.34 L·min−1 (+26.1%)] and peak O2 pulse (NORM: +13.4% vs. HYP: +25.9%) for HYP were twice-larger than for NORM (p < 0.05). Although the 5-wk HIIT led to significant improvements in the ratios of TC/HDL-C (p = 0.035) and TG/HDL-C (p = 0.027), no significant group effects were found on the serum variables. Further, no significant changes in body composition or serum fasting leptin were observed in either group. Conclusion: 5-wk of HIIT improved cardiorespiratory fitness and blood lipids in overweight Chinese young females, while the additive effect of the HIIT under normobaric hypoxia solely enhanced cardiorespiratory fitness, but not body composition or serum lipid profile.

Effects of 12-Week Endurance Training at Natural Low Altitude on the Blood Redox Homeostasis of Professional Adolescent Athletes: A Quasi-Experimental Field Trial

This field study investigated the influences of exposure to natural low altitude on endurance training-induced alterations of redox homeostasis in professional adolescent runners undergoing 12-week off-season conditioning program at an altitude of 1700 m (Alt), by comparison with that of their counterparts completing the program at sea-level (SL). For age-, gender-, and Tanner-stage-matched comparison, 26 runners (n = 13 in each group) were selected and studied. Following the conditioning program, unaltered serum levels of thiobarbituric acid reactive substances (TBARS), total antioxidant capacity (T-AOC), and superoxide dismutase accompanied with an increase in oxidized glutathione (GSSG) and decreases of xanthine oxidase, reduced glutathione (GSH), and GSH/GSSG ratio were observed in both Alt and SL groups. Serum glutathione peroxidase and catalase did not change in SL, whereas these enzymes, respectively, decreased and increased in Alt. Uric acid (UA) decreased in SL and increased in Alt. Moreover, the decreases in GSH and GSH/GSSG ratio in Alt were relatively lower compared to those in SL. Further, significant interindividual correlations were found between changes in catalase and TBARS, as well as between UA and T-AOC. These findings suggest that long-term training at natural low altitude is unlikely to cause retained oxidative stress in professional adolescent runners.

Influence of recovery duration during 6-s sprint interval exercise on time spent at high rates of oxygen uptake

Background/Objective This study examined whether time spent at high rates of oxygen consumption (VO2) during 6-s sprint interval exercises (SIE) is a function of recovery interval duration. Methods In a randomised crossover study, thirteen male endurance runners performed 40 × 6-s all-out sprints interspersed with 15-s, 30-s and 60-s passive recovery intervals (SIE15, SIE30, and SIE60 trials respectively), and a work duration-matched Wingate-SIE (8 × 30-s all-out sprints with 4-min passive recovery, SIEWin trial). The accumulated exercise time at ≥ 80%, 85%, 90%, 95% and 100% of VO2max, and maximum heart rate (HRmax) in the four trials were compared. Results During the 6-s SIEs, accumulated time spent at all selected high rates of VO2max increased as recovery time decreased, whilst the SIE work rate decreased (p < .05). In SIEWin, although the exercise lasted longer, the time spent at ≥90% VO2max (74 ± 16 s) was significant less than that in SIE15 (368 ± 63 s, p < .05), yet comparable to that in SIE30 (118 ± 30 s, p > .05), and longer than that in SIE60 (20 ± 14 s, p < .05). The differences between the four trials in accumulated time at high percentages of HRmax were similar to those for VO2, although the temporal characteristics of the increases in HR and VO2 during the SIEs were different. Conclusion In conclusion, the duration of the recovery interval in 6-s SIE protocols appears to be a crucial parameter when sprint interval training is prescribed to enhance aerobic capacity. Further, the SIE15 protocol may represent a potential alternative to 30-s SIEWin in the development of time-efficient aerobic training intervention.