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Effect of treadmill exercise stress testing on troponin levels in children and adolescents

Published online by Cambridge University Press:  18 March 2022

Anthony G. Pompa Open the ORCID record for Anthony G. Pompa [Opens in a new window] ,
Gaurav Arora Open the ORCID record for Gaurav Arora [Opens in a new window]  and
Tyler H. Harris
Anthony G. Pompa*
Affiliation:
Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Gaurav Arora
Affiliation:
Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Tyler H. Harris
Affiliation:
Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
*
Author for correspondence: A. G. Pompa, MD, Heart Institute, UPMC Children’s Hospital of Pittsburgh, Fifth Floor Faculty Pavilion, 4401 Penn Ave., Pittsburgh, PA 15224, USA. Tel: 412-692-5540; Fax: 412-692-5138. E-mail: anthony.pompa@chp.edu
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Abstract

Background:

Chest pain is a common complaint among paediatric patients and cardiac troponin (cTn) level is often part of the initial emergency department evaluation. It is well known that after intense endurance exercise cTn levels can be elevated in patients with otherwise healthy hearts, however the effect shorter duration exercise has on cTn levels in this population is not known.

Objective:

Determine the behaviour of cTn levels in healthy children and adolescent patients after short burst, high-intensity aerobic exercise.

Methods:

Patients without haemodynamically significant heart disease referred for a treadmill exercise stress test (EST) were recruited over a 6-month period. cTn levels were measured prior to exercise and 4 hours after exercise.

Results:

Thirteen patients enrolled. Indications for EST were exertional syncope (six), chest pain (four), and long QT syndrome (three). The median exercise time was 12.9 (9.9–13.7) minutes with an average endurance at the fiftieth percentile for age and maximum heart rate rose to an average of 92 (74–98)% of the predicted peak for age. cTn levels prior to exercise were undetectable in all patients. There was no cTn rise in any patient after exercise. There were no ischaemic changes or arrhythmias on exercise electrocardiograms.

Conclusion:

Serum cTn levels do not rise significantly in healthy children after short duration, high-intensity aerobic exercise. Physicians evaluating paediatric patients with an elevated cTn level after less than prolonged strenuous activity likely cannot attribute this lab value solely to exercise and may need to undertake further cardiac investigation.

Keywords

Troponinexercise stress testcardiac biomarkers
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 3 , March 2023 , pp. 380 - 382
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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