High-Sensitivity Cardiac Troponin T Release After the 20-m Shuttle Run Test in 733 Healthy Children and Adolescents

Abstract

This study aimed to assess the effect of exercise on high-sensitivity cardiac troponin T (hs-cTnT) concentrations in children and adolescents and to examine whether sex, maturational status, anthropometric characteristics, cardiorespiratory fitness, and physical activity influence the hs-cTnT response. In this trial 733 participants completed the 20-m shuttle run test. Venous blood samples were collected at rest and 3 h postexercise to determine hs-cTnT concentrations. We included 296 girls and 437 boys (12.2 ± 1.7 years; 40% girls). At baseline, 61% of participants had hs-cTnT values below the limit of detection (LoD), and 2.5% exceeded the upper reference limit (URL). Postexercise, 36% remained below LoD, while 7.5% exceeded the URL. Overall, hs-cTnT increased from baseline to 3 h postexercise in 56.2% of participants. Linear mixed-effects models showed a significant main effect of time (β = −0.42, 95% CI 0.35–0.49; p < 0.01) and no main effect of sex (p = 0.85), although a small but significant time × sex interaction was observed (β = −0.11, 95% CI −0.20 to −0.02; p = 0.021), indicating a slightly greater exercise-induced increase in girls. Additional significant time × covariate interactions were identified for maturational, anthropometric, and fitness-related variables. However, these factors together explained only a small proportion of the overall variability in hs-cTnT response. Consequently, the 20-m shuttle run test induces a significant increase in hs-cTnT concentrations in children and adolescents. Exercise-induced hs-cTnT release is common but highly heterogeneous, and is only partly explained by sex, maturational, anthropometric, and fitness-related factors, suggesting an important contribution of individual-specific determinants not captured by conventional variables.

This research was funded by the State Program for Research, Development, and Innovation Oriented to the Challenges of Society, within the framework of the State Plan for R+D+I 2020–2024. The project title is: “Evaluación de diversos parámetros de salud y niveles de actividad física en la escuela primaria y secundaria” (grant number PID2020-117932RB-I00). Additionally, the research was supported by the consolidated research group “Human Movement” of the Generalitat de Catalunya (021 SGR 01619). S.A.-R. was supported by the predoctoral grants program FI SDUR from the Department of Research and Universities of the Generalitat de Catalunya, co-funded by the European Social Fund Plus (2024 FISDU 00122).