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.