Exercise-induced alterations of the cardiac markers troponin, ischemia-modified albumin and B-type natriuretic peptide;Belastungsinduzierte veränderungen der kardialen marker troponin, ischämie-modifiziertes albumin und B-typ natriuretisches peptid

Deutsche Zeitschrift fur Sportmedizin

Volumn 58, Issue 10, 2007, Pages 357-363

  Scharhag, Jürgen ^a   Urhausen, A ^b   Kindermann, W ^a  

^a SAARLAND UNIVERSITY   (Germany)

^b Clinique d'Eich   (Luxembourg)

Author keywords

Athlete's heart; Endurance exercise; Marathon; Myocardial infarction; Myocardjum

Indexed keywords

EID: 36148972096     PISSN: 03445925     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (99)

1. Almeida S, Azevedo A, Castro A, Frioes F, Freitas J, Ferreira A, Bettencourt P: B-type natriuretic peptide is related to left ventricular mass in hypertensive patients but not in athletes. Cardiology 98 (2002)113-115.
2. Alpert JS, Thygesen K, Antman E, Bassand JP: Myocardial infarction redefined - a consensus document of The Joint European Society of Cardiology/ American College of Cardiology Committee for the redefinition of myocardial infarction. J Am Coll Cardiol 36 (2000) 959-969.
3. Apple F, Quist H, Doyle P, Otto A, Murakami M: Plasma 99th percentile reference limits for cardiac troponin and creatine kinase MB mass for use with European Society of Cardiology/American College of Cardiology consensus recommendations. Clin Chem 49 (2003) 1331-1336.
4. Apple F, Wu A, Jaffe A: European Society of Cardiology and American College of Cardiology guidelines for redefinition of myocardial infarction: how to use existing assays clinically and for clinical trials. Am Heart J 144 (2002) 981-986.
5. Apple FS, Quist HE, Otto AP, Mathews WE, Murakami MM: Release characteristics of cardiac biomarkers and ischemia-modified albumin as measured by the albumin cobalt-binding test after a marathon race. Clin Chem 48 (2002) 1097-1100.
6. Baxter G: Natriuretic peptides and myocardial ischemia. Basic Res Cardiol 99 (2004) 30-33.
7. Bolli R und Marban E: Molecular and cellular mechanisms of myocardial stunning. Physiol Rev 79 (1999) 609-634.
8. Brunner-La Rocca H, Kaye D, Woods R, Hastings J, Esler M: Effects of intravenous brain natriuretic peptide on regional sympathetic activity in patients with chronic heart failure as compared with healthy control subjects. J Am Coll Cardiol 37 (2001)1221-1227.
9. Burnett JJ: Vasopeptidase inhibition: a new concept in blood pressure management. J Hypertens 17 (Suppl) (1999) 37-43.
10. Conraads VM, Beckers P, Vaes J, Martin M, Van Hoof V, De Maeyer C, Possemiers N, Wuyts FL, Vrints CJ: Combined endurance/resistance training reduces NT-proBNP levels in patients with chronic heart failure. Eur Heart J 25 (2004)1797-1805.
11. Convertino VA, Brock PJ, Keil LC, Bernauer EM, Greenleaf JE: Exercise training-induced hypervolemia: role of plasma albumin, renin, and vasopressin. J Appl Physiol 48 (1980) 665-669.
12. D'Souza S und Baxter G: B Type natriuretic peptide: a good omen in myocardial ischaemia? Heart 89 (2003) 707-709.
13. D'Souza S, Yellon D, Martin C, Schulz R, Heusch G, Onody A, Ferdinandy P, Baxter G: B-type natriuretic peptide limits infarct size in rat isolated hearts via KATP channel opening. Am J Physiol Heart Circ Physiol 284 (2003)1592-1600.
14. Douglas PS, O'Toole ML, Katz SE: Prolonged exercise alters cardiac chronotropic responsiveness in endurance athletes. J Sports Med Phys Fitness 38 (1998)158-163.
15. Eysmann SB, Gervino E, Vatner DE, Katz SE, Decker L, Douglas PS: Prolonged exercise alters beta-adrenergic responsiveness in healthy sedentary humans. J Appl Physiol 80 (1996) 616-622.
16. Filippatos G, Gangopadhyay N, Lalude O, Parameswaran N, Said S, Spielman W, Uhal B: Regulation of apoptosis by vasoactive peptides. Am J Physiol Lung Cell Mol Physiol 281 (2001) 749-761.
17. Foote R, Pearlman J, Siegel A, Yeo K: Detection of exercise-induced ischemia by changes in B-type natriuretic peptides. J Am Coll Cardiol 16 (2004)1980-1987.
18. Gardner RS, Ozalp F, Murday AJ, Robb SD, McDonagh TA: N-terminal pro-brain natriuretic peptide. A new gold standard in predicting mortality in patients with advanced heart failure. Eur Heart J 24 (2003)1735-1743.
19. George K, Whyte G, Stephenson C, Shave R, Dawson E, Edwards B, Gaze D, Collinson P: Postexercise left ventricular function and cTnT in recreational marathon runners. Med Sci Sports Exerc 36 (2004) 1709-1715.
20. 2+ influx and skeletal muscle cell damage. Acta Physiol Scand 171 (2001) 327-334.
21. Hall C: Essential biochemistry and physiology of (NT-pro)BNP. Eur J Heart Fail 6 (2004)257-260.
22. Hamm C: Leitlinien: Akutes Koronarsyndrom (ACS). Teil 1: ACS ohne persitierende ST-Hebung. Z Kardiol 93 (2004) 72-90.
23. Hart E, Dawson E, Rasmussen P, George K, Secher NH, Whyte G, Shave R: Beta-adrenergic receptor desensitization in man: insight into post-exercise attenuation of cardiac function. J Physiol 577 (2006) 717-725.
24. Herrmann M, Scharhag J, Miclea M, Urhausen A, Herrmann W, Kindermann W: Post-race kinetics of cardiac troponin T and I and N-terminal pro-brain natriuretic peptide in marathon runners. Clin Chem 49 (2003)831-834.
25. Hess G, Runkel S, Zdunek D, Hitzler WE: Reference interval determination for N-terminal-B-type natriuretic peptide (NT-proBNP): A study in blood donors. Clin Chim Acta 360 (2005)187-193.
26. Houben AJ, van der Zander K, de Leeuw PW: Vascular and renal actions of brain natriuretic peptide in man: physiology and pharmacology. Fundam Clin Pharmacol 19 (2005) 411-419.
27. Huber KR, Mostafaie N, Bauer K, Worofka B, Kittl E, Hofmann J, Hejtman M, Redei K, Jungwirth S, Fischer P, Tragl KH: Concentrations of N-terminal pro-brain natriuretic peptide and troponin T in plasma of 75-year-old apparently healthy persons. Clin Chem Lab Med 42 (2004)1430-1433.
28. Jernberg T, James S, Lindahl B, Stridsberg M, Venge P, Wallentin L: NT-ProBNP in non-ST-elevation acute coronary syndrome. J Card Fail 11 (2005) 54-58.
29. Jernberg T, James S, Lindahl B, Stridsberg M, Venge P, Wallentin L: NT-proBNP in unstable coronary artery disease - experiences from the FAST, GUSTO IV and FRISC II trials. Eur J Heart Fail 6 (2004) 319-325.
30. Jernberg T, Stridsberg M, Venge P, Lindahl B: N-terminal pro brain natriuretic peptide on admission for early risk stratification of patients with chest pain and no ST-segment elevation. J Am Coll Cardiol 40 (2002):437-445.
31. Jonsdottir S, Andersen KK, Sigurosson AF, Sigurosson SB: The effect of physical training in chronic heart failure. Eur J Heart Fail 8 (2006):97-101.
32. Kindermann W und Scharhag J: Ist Ausdauersport ungesund? Dtsch Z Sportmed 58 (2007) 121.
33. Koller A: Exercise-induced increases in cardiac troponins and prothrombotic markers. Med Sci Sports Exerc 35 (2003) 444-448.
34. Konig D, Schumacher Y, Heinrich L, Schmid A, Berg A, Dickhuth H: Myocardial stress after competitive exercise in professional road cyclists. Med Sci Sports Exerc 35 (2003)1679-1683.
35. Korff S, Katus HA, Giannitsis E: Differential diagnosis of elevated troponins. Heart 92 (2006) 987-993.
36. Krüger S, Graf J, Kunz D, Stickel T, Hanrath P, Janssens U: Brain natriuretic peptide levels predict functional capacity in patients with chronic heart failure. J Am Coll Cardiol 40 (2002) 718-722.
37. Kuhn M, Holtwick R, Baba H, Perriard J, Schmitz W, Ehler E: Progressive cardiac hypertrophy and dysfunction in atrial natriuretic peptide receptor (GC-A) deficient mice. Heart 87 (2002) 368-374.
38. Löffel M, Selzer N, Busch R, Edte S, Breidenbach T, von Hodenberg E: BNP als Marker der Trainingssteuerung chronisch herzinsuffizienter Patienten. Dtsch Z Sportmed 56 (2005) 208, PO Nr. 189.
39. Lubien E, DeMaria A, Krishnaswamy P, Clopton P, Koon J, Kazanegra R, Gardetto N, Wanner E, Maisel A: Utility of B-natriuretic peptide in detecting diastolic dysfunction. Circulation 105 (2002) 595-601.
40. Luchner A, Burnett JC, Jr., Jougasaki M, Hense HW, Heid IM, Muders F, Riegger GA, Schunkert H: Evaluation of brain natriuretic peptide as marker of left ventricular dysfunction and hypertrophy in the population. J Hypertens 18 (2000) 1121-1128.
41. Luchner A, Holmer S, Schunkert H, Riegger G: Bedeutung der Herzinsuffizienzmarker BNP und NT-proBNP für die Klinik. Dtsch Ärzteblatt 100 (2003):A3314-3321.
42. Maisel A: B-type natriuretic peptide levels: a potential novel "white count" for congestive heart failure. J Card Fail 7 (2001) 183-193.
43. Maisel A, Krishnaswamy P, Nowak R, McCord J, Hollander J, Duc P, Omland T, Storrow A, Abraham W, Wu A, Clopton P, Steg P, Westheim A, Knudsen C, Perez A, Kazanegra R, Herrmann H, McCullough P: Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure (Breathing Not Properly Multinational Study Investigators. N Engl J Med 347 (2002)161-167.
44. Maron BJ, Tholakanahalli VN, Zenovich AG, Casey SA, Duprez D, Aeppli DM, Cohn JN: Usefulness of B-type natriuretic peptide assay in the assessment of symptomatic state in hypertrophic cardiomyopathy. Circulation 109 (2004) 984-989.
45. McCullough P, Nowak R, McCord J, Hollander J, Herrmann H, Steg P, Duc P, Westheim A, Omland T, Knudsen C, Storrow A, Abraham W, Lamba S, Wu A, Perez A, Clopton P, Krishnaswamy P, Kazanegra R, Maisel A: B-type natriuretic peptide and clinical judgment in emergency diagnosis of heart failure: analysis from Breathing Not Properly (BNP) Multinational Study. Circulation 106 (2002) 416-422.
46. McNeil P und Terasaki M: Coping with the inevitable: how cells repair a torn surface membrane. Nat Cell Biol 3 (2001) 124-129.
47. Meyer T, Gabriel H, Auracher M, Scharhag J, Kindermann W: Metabolic profile of 4 h cycling in the field with varying amounts of carbohydrate supply. Eur J Appl Physiol 88 (2003) 431-437.
48. Meyer T, Schwaab B, Gorge G, Scharhag J, Herrmann M, Kindermann W: Can serum NT-proBNP detect changes of functional capacity in patients with chronic heart failure? Z Kardiol 93 (2004) 540-545.
49. Middleton N, Shave R, George K, Hart E, Gaze D, Whyte G, Atkinson G: Post-Exercise Cardiac TVoponin T: A Meta-Analysis. Med Sci Sports Exerc 39 (2007) 286,1745.
50. Middleton N, Shave R, George K, Whyte G, Forster J, Oxborough D, Gaze D, Collinson P: Novel application of flow propagation velocity and ischaemia-modified albumin in analysis of postexercise cardiac function in man. Exp Physiol 91 (2006) 511-519.
51. Mizuno Y, Yoshimura M, Harada E, Nakayama M, Sakamoto T, Shimasaki Y, Ogawa H, Kugiyama K, Saito Y, Nakao K, Yasue H: Plasma levels of Aand B-type natriuretic peptides in patients with hypertrophic cardiomyopathy or idiopathic dilated cardiomyopathy. Am J Cardiol 86 (2000)1036-1040, A11.
52. Möllmann H, Nef H, Weber M, Hamm C, Elsässer A, Holubarsch C: Ischämie ist ein unabhängiger Trigger für die BNP-Expression. Clin Res Cardiol 95 (Suppl.7) (2006) 132.
53. Montgomery H, Clarkson P, Dollery C, Prasad K, Losi M, Hemingway H, Statters D, Jubb M, Girvain M, Varnava A, World M, Deanfield J, Talmund P, McEwan J, McKenna W, Humphries S: Association of angiotensin-converting enzyme gene I/D polymorphism with change in left ventricular mass in response to physical training. Circulation 96 (1997) 741-747.
54. Mottram PM, Haluska BA, Marwick TH: Response of B-type natriuretic peptide to exercise in hypertensive patients with suspected diastolic heart failure: correlation with cardiac function, hemodynamics, and workload. Am Heart J 148 (2004) 365-370.
55. Mueller C, Laule-Kilian K, Christ A, Staub D: The use of B-type natriuretic peptide in the diagnosis of acute dyspnoea. Clin Lab 51 (2005) 5-9.
56. Nakamura T, Sakamoto K, Yamano T, Kikkawa M, Zen K, Hikosaka T, Kubota T, Azuma A, Nishimura T: Increased plasma brain natriuretic peptide level as a guide for silent myocardial ischemia in patients with non-obstructive hypertrophic cardiomyopathy. J Am Coll Cardiol 40 (2002) 1657-1563.
57. Neilan TG, Januzzi JL, Lee-Lewandrowski E, Ton-Nu TT, Yoerger DM, Jassal DS, Lewandrowski KB, Siegel AJ, Marshall JE, Douglas PS, Lawlor D, Picard MH, Wood MJ: Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon. Circulation 114 (2006) 2325-2333.
58. Neumayr G, Gaenzer H, Pfister R, Sturm W, Schwarzacher S, Eibl G, Mitterbauer G, Hoertnagl H: Plasma levels of cardiac troponin I after prolonged strenuous endurance exercise. Am J Cardiol 87 (2001) 369-371.
59. Neumayr G, Pfister R, Mitterbauer G, Eibl G, Hoertnagl H: Effect of competitive marathon cycling on plasma N-terminal pro-brain natriuretic peptide and cardiac troponin T in healthy recreational cyclists. Am J Cardiol 96 (2005) 732-735.
60. Ohba H, Takada H, Musha H, Nagashima J, Mori N, Awaya T, Omiya K, Murayama M: Effects of prolonged strenuous exercise on plasma levels of atrial natriuretic peptide and brain natriuretic peptide in healthy men. Am Heart J 141 (2001) 751-758.
61. Passino C, Severino S, Poletti R, Piepoli MF, Mammini C, Clerico A, Gabutti A, Nassi G, Emdin M: Aerobic training decreases B-type natriuretic peptide expression and adrenergic activation in patients with heart failure. J Am Coll Cardiol 47 (2006) 1835-1839.
62. Pfister R, Erdmann E, Schneider CA: Natriuretic peptides BNP and NT-pro-BNP - The "new troponins" for estimation of heart failure? Dtsch Med Wochenschr 128 (2003) 1007-1012.
63. Prusczyk P: N-terminal pro-brain natriuretic peptide as an indicator of right ventricular dysfunction. J Card Fail 11(5 Suppl) (2005) 65-69.
64. Raymond I, Groenning B, Hildebrandt P, Nilsson J, Baumann M, Trawinski J, Pedersen F: The influence of age, sex and other variables on the plasma level of N-terminal pro brain natriuretic peptide in a large sample of the general population. Heart 89 (2003) 745-751.
65. Redfield M, Rodeheffer R, Jacobsen S, Mahoney D, Bailey K, Burnett JJ: Plasma brain natriuretic peptide concentration: impact of age and gender. J Am Coll Cardiol 40 (2002) 976-982.
66. Rifai N, Douglas P, O'Toole M, Rimm E, Ginsburg G: Cardiac troponin T and I, echocardiographic [correction of electrocardiographic] wall motion analyses, and ejection fractions in athletes participating in the Hawaii Ironman Triathlon. Am J Cardiol 83 (1999)1085-1089.
67. Roth HJ, Leithauser RM, Doppelmayr H, Doppelmayr M, Finkernagel H, von Duvillard SP, Korff S, Katus HA, Giannitsis E, Beneke R: Cardiospecificity of the 3(rd) generation cardiac troponin T assay during and after a 216 km ultra-endurance marathon run in Death Valley. Clin Res Cardiol 96 (2007) 359-364.
68. Scharhag J, Herrmann M, Urhausen A, Haschke M, Herrmann W, Kindermann W: Independent elevations of N-terminal pro-brain natriuretic peptide and cardiac troponins in endurance athletes after prolonged strenuous exercise. Am Heart J 150 (2005) 1128-1134.
69. Scharhag J, Herrmann M, Weissinger M, Herrmann W, Kindermann W: N-terminal B-type natriuretic peptide concentrations are similarly increased by 30 minutes of moderate and brisk walking in patients with coronary artery disease. Clin Res Cardiol 96 (2007) 218-226.
70. Scharhag J und Kindermann W: Verhalten der kardialen Marker BNP und Troponin nach standardisierten Belastungen bei Leistungssportlern mit und ohne Sportherz. Bundesinstitut für Sportwissenschaft-Jahrbuch 2007:im Druck.
71. Scharhag J, Urhausen A, Herrmann M, Kindermann W: Glück gehabt! Kasuistik eines 55-jährigen Marathonläufers mit koronarer Hauptstammund RIVA-Stenose. Dtsch Z Sportmed 4 (2003) 118-121.
72. Scharhag J, Urhausen A, Herrmann W, Schneider G, Kramann B, Herrmann W, Kindermann W: No difference in N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations between endurance athletes with athlete's heart and healthy untrained controls. Heart 90 (2004) 1055-1056.
73. Scharhag J, Urhausen A, Schneider G, Herrmann M, Schumacher K, Haschke M, Krieg A, Meyer T, Herrmann W, Kindermann W: Reproducibility and clinical significance of exercise-induced increases in cardiac troponins and N-terminal pro brain natriuretic peptide (NT-proBNP) in endurance athletes. Eur J Cardiovasc Prev Rehabil 13 (2006) 388-397.
74. Scharhag J und Kindermann W: Brain natriuretic peptide (BNP) and exercise-induced immune reactions: Reply to the letter-to-the-editor of McLachlan and Mossop. Am Heart J 152 (2006) 3.
75. Shave R, Dawson E, Whyte G, George K, Ball D, Gaze D, Collinson P: Evidence of exercise-induced cardiac dysfunction and elevated cTnT in separate cohorts competing in an ultra-endurance mountain marathon race. Int J Sports Med 23 (2002) 489-494.
76. Shave R, Dawson E, Whyte G, George K, Gaze D, Collinson P: Altered cardiac function and minimal cardiac damage during prolonged exercise. Med Sci Sports Exerc 36 (2004) 1098-1103.
77. Shave R, Whyte GP, George K, Gaze DC, Collinson PO: Prolonged exercise should be considered alongside typical symptoms of acute myocardial infarction when evaluating increases in cardiac troponin T. Heart 91 (2005) 1219-1220.
78. Siegel AJ, Lewandrowski EL, Chun KY, Sholar MB, Fischman AJ, Lewandrowski KB: Changes in cardiac markers including B-natriuretic peptide in runners after the Boston marathon. Am J Cardiol 88 (2001) 920-923.
79. Sinha MK, Gaze DC, Tippins JR, Collinson PO, Kaski JC: Ischemia modified albumin is a sensitive marker of myocardial ischemia after percutaneous coronary intervention. Circulation 107 (2003) 2403-2405.
80. Sinha MK, Roy D, Gaze DC, Collinson PO, Kaski JC: Role of "Ischemia modified albumin", a new biochemical marker of myocardial ischaemia, in the early diagnosis of acute coronary syndromes. Emerg Med J 21 (2004) 29-34.
81. Staub D, Jonas N, Zellweger MJ, Nusbaumer C, Wild D, Pfisterer ME, Mueller-Brand J, Perruchoud AP, Mueller C: Use of N-terminal pro-B-type natriuretic peptide to detect myocardial ischemia. Am J Med 118 (2005)1287.
82. Tamura N, Ogawa Y, Chusho H, Nakamura K, Nakao K, Suda M, Kasahara M, Hashimoto R, Katsuura G, Mukoyama M, Itoh H, Saito Y, Tanaka I, Otani H, Katsuki M: Cardiac fibrosis in mice lacking brain natriuretic peptide. Proc Natl Acad Sci U S A 97 (2000) 4239-4244.
83. Tateishi J, Masutani M, Ohyanagi M, Iwasaki T: Transient increase in plasma brain (B-type) natriuretic peptide after percutaneous transluminal coronary angioplasty. Clin Cardiol 23 (2000) 776-780.
84. Thompson PD, Apple FS, Wu A: Marathoner's heart? Circulation 114 (2006) 2306-2308.
85. Toda G, Shibata S, Nakamizo R, Seto S, Yano K: Effect of physical exercise training on health-related quality of life and exercise tolerance in patients with left ventricular dysfunction. J Cardiol 44 (2004)179-187.
86. Tulevski I, Groenink M, van Der Wall E, van Veldhuisen D, Boomsma F, Stoker J, Hirsch A, Lemkes J, Mulder B: Increased brain and atrial natriuretic peptides in patients with chronic right ventricular pressure overload: correlation between plasma neurohormones and right ventricular dysfunction. Heart 86 (2001) 27-30.
87. Tulloh L, Robinson D, Patel A, Ware A, Prendergast C, Sullivan D, Pressley L: Raised troponin T and echocardiographic abnormalities after prolonged strenuous exercise-the Australian Ironman Triathlon. Br J Sports Med 40 (2006) 605-609.
88. Urhausen A, Albers T, Kindermann W: Are the cardiac effects of anabolic steroid abuse in strength athletes reversible? Heart 90 (2004):496-501.
89. Urhausen A, Scharhag J, Herrmann M, Kindermann W: Clinical significance of increased cardiac troponin T and I in participants of ultra-endurance events. Am J Cardiol 94 (2004) 696-698.
90. Venditti P und Di Meo S: Antioxidants, tissue damage, and endurance in trained and untrained young male rats. Arch Biochem Biophys 331 (1996) 63-68.
91. Vidotto C, Tschan H, Atamaniuk J, Pokan R, Bachl N, Muller MM: Responses of N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) to competitive endurance exercise in recreational athletes. Int J Sports Med 26 (2005) 645-650.
92. Weber M, Dill T, Arnold R, Rau M, Ekinci O, Muller KD, Berkovitsch A, Mitrovic V, Hamm C: N-terminal B-type natriuretic peptide predicts extent of coronary artery disease and ischemia in patients with stable angina pectoris. Am Heart J 148 (2004) 612-620.
93. Welsh RC, Warburton DE, Humen DP, Taylor DA, McGavock J, Haykowsky MJ: Prolonged strenuous exercise alters the cardiovascular response to dobutamine stimulation in male athletes. J Physiol 569 (2005) 325-330.
94. Whyte G, George K, Shave R, Dawson E, Stephenson C, Edwards B, Gaze D, Oxborough D, Forster J, Simspon R: Impact of marathon running on cardiac structure and function in recreational runners. Clin Sci (Lond) 108 (2005) 73-80.
95. Wiese S, Breyer T, Dragu A, Wakili R, Burkard T, Schmidt-Schweda S, Fuchtbauer E, Dohrmann U, Beyersdorf F, Radicke D, Holubarsch C: Gene expression of brain natriuretic peptide in isolated atrial and ventricular human myocardium: influence of angiotensin II and diastolic fiber length. Circulation 102 (2000) 3074-3079.
96. Win HK, Chang SM, Raizner M, Shah G, Al Basky F, Desai U, Plana JC, Mahmarian JJ, Quinones MA, Zoghbi WA: Percent change in B-type natriuretic peptide levels during treadmill exercise as a screening test for exercise-induced myocardial ischemia. Am Heart J 150 (2005) 695-700.
97. Wu A und Feng Y: Biochemical differences between cTnT and cTnI and their significance for diagnosis of acute coronary syndromes. Eur Heart J 19 Suppl N (1998) 25-29.
98. Yeo K, Lee H, Wong K, Foote R: Can exercise-induced changes in B-type natriuretic peptides be used to detect cardiac ischemia? J Card Fail 11(5 Suppl) (2005) 59-64.
99. Zapico-Muniz E, Santalo-Bel M, Merce-Muntanola J, Montiel JA, Martinez-Rubio A, Ordonez-Llanos J: Ischemia-modified albumin during skeletal muscle ischemia. Clin Chem 50 (2004)1063-1065.