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See detailMeasurement of circulating 25-hydroxyvitamin D: A historical review
Delvin, Edgar; LE GOFF, Caroline ULg; CAVALIER, Etienne ULg et al

in Practical Laboratory Medicine (in press)

The constantly increasing requests for the measurement of serum 25-hydroxyvitamin D over the last years has led reagent manufacturers to market different automated and semi-automated methods, that being ... [more ▼]

The constantly increasing requests for the measurement of serum 25-hydroxyvitamin D over the last years has led reagent manufacturers to market different automated and semi-automated methods, that being unfortunately not fully harmonized, yield different results. Liquid chromatography coupled to tandem mass spectrometry (LC/MS2) has more recently been introduced. This approach allows the distinction between the two forms of 25-hydroxyvitamin D and to measure other metabolites. This approach also requires harmonization to curtail the differences between the different analytical methods. To meet this requirement, the American National Institutes of Health (NIH), the CDC (Centre for Disease Control and Prevention) in Atlanta, the NIST (National Institute of Standards and Technology) and the vitamin D Reference laboratory of Ghent University have pooled their expertise to develop a standardization program. This article reviews the main elements and the difficulties of the automated and semi-automated methods for 25-hydroxyvitamin D, from sample preparation to the analytical phase, as well as those related to mass spectrometry. It also addresses the issues related to the clinical decision thresholds and the possibility of measurements in different biological liquids. [less ▲]

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See detailThe cardiovascular impact of intense eccentric isokinetic exercise versus aerobic treadmill running
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; LAURENT, Terry ULg et al

in Isokinetics & Exercise Science (2016), 24(3), 201-208

BACKGROUND: Regular physical activity is an important health factor, but intense physical stress can increase the risk of heart disease. OBJECTIVE: Our aim was to determine the potential cardiac ... [more ▼]

BACKGROUND: Regular physical activity is an important health factor, but intense physical stress can increase the risk of heart disease. OBJECTIVE: Our aim was to determine the potential cardiac repercussions of, and the oxidative stress resulting from a maximal eccentric isokinetic exercise and a 1-hour treadmill run at 75% ˙V O2 max (maximal exercise done 6 weeks before). METHODS: Twelve young sedentary healthy subjects randomly performed two tests separated by 6 weeks: 1) 3 sets of 30 maximal eccentric isokinetic contractions of the quadriceps; 2) a 1-hour running on treadmill at 75% ˙V O2 max. We drew blood samples just before each exercise (T1), and just after (T2), 3 hours after (T3), and 24 hours after (T4) the end of each exercise to measure cardiac and oxidative stress biomarkers. RESULTS: In the running group, we observed significant differences for myoglobin (T3: 145 ± 80 μg/L), creatinine kinase (T4: 593 ± 350 mg/L), oxidized glutathione (T2: 22 ± 15.6 μmol/L), and highly sensitive cardiac troponin T, (T3: 0.051 ± 0.038 ng/mL). In the isokinetic group, we observed significant differences for myoglobin (T3:1419 ± 2533 mg/L), creatine kinase (3303 ± 7159 mg/L), and oxidized glutathione (T4:24 ± 14 μmol/L). Between isokinetic exercise and running, we observed significant differences for uric acid (p < 0.05, running > eccentric), myoglobin (p < 0.05, ditto), NT-proBNP (p < 0.05, ditto), hsTnT (p < 0.01, ditto), and oxidized glutathione (p < 0.05). CONCLUSIONS: As cardiac biomarkers appear practically unmodified after the isokinetic exercise, despite the considerable oxidative stress, we suggest that the application of intense maximal eccentric isokinetic exercise, when indicated, should be safe for most patients including those whose cardiac status is unknown. On the other hand, the increase in cardiac biomarkers observed after running, could reflect leakage of these biomarkers from the cytosolic pool of cardiac cells, linked to membrane damage, rather than the result of a major injury and hence running is supposed to be a safe practice. However, since sudden death during running has been previously described, assesment of the cardiac biomarkers and a follow-up by a sport doctor is important especially if there is a cardiac family history. [less ▲]

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See detailImpact of a mountain ultra-marathon on cardiac biomarkers
Le Goff, Caroline ULg; Gergelé, Laurent; Kaux, Jean-François ULg et al

in Crossing borders through sport science (2016, July)

Objectives. While moderate exercise has beneficial effects on the cardiovascular system, consequences of a supra-physiological effort are not clear yet. In particular, the physiological consequences of ... [more ▼]

Objectives. While moderate exercise has beneficial effects on the cardiovascular system, consequences of a supra-physiological effort are not clear yet. In particular, the physiological consequences of ultramarathons need to be further documented. The aim of the study was to assess the changes of various cardiac biomarkers after a mountain ultra-marathon. Material and methods. Blood and urine samples were collected on 28 runners (17 men) participating to the Ultra-Trail du Mont Blanc (105km, total positive elevation: 5600 m) at 3 different times: before the race (Pre), within 1 h after the finish (Post) and 7 days after the finish (D+7). Several biomarkers involved in heart disease (coronary syndrome, heart failure and fibrosis) and in inflammation were assayed on different analyzers such a COBAS® (for CKMB,TnThs, NT-proBNP, H-FABP and CRPs) and KRYPTOR® (for Copeptin). ST2 was measured manually with the Presage kit from CRITICAL DIAGNOSTIC®. Results. Plasma levels of cardiac markers (CKMB, TnThs, NT-proBNP, copeptin, H FABP, ST2) and inflammation (CRPs) increased significantly at Post. Means values increased from Pre to Post as follows: 2.3 to 91.9 UI/L for CKMB (p<0.0001); 7.6 to 31.7 ng/L for TnThs (p<0.0001); 41.7 to 1190.5 ng/L for NT-proBNP, 4.2 to 22.9 pmol/L for copeptin (p=0.001); 3.6 to 107.8 ng/mL for H-FABP (p<0.0001), 29.7 to 126.2 ng/mL for ST2 (p<0.0001); 0.5 to 29.1 mg/L for CRPs (p<0.0001). With the exception of a few (H-FABP, ST2, CRPs) biomarkers in some subjects, all values were back to Pre values at D+7. Discussion-conclusion. Prolonged strenuous running exercise caused an elevation in cardiac biomarkers. Elevation in CK-MB levels lacks specificity for cardiac damage as runners have increased CKMB from skeletal muscles as well. Previous studies suggested that exercise induced TnThs elevation is a benign reversible physiologic phenomenon but this parameter, as well as H-FABP, could be a sign of ischemia. Different phenomena occurred such as stretch of myocytes causing an increase in pressure or volume and neurohormonal activation which can explain the Copeptine and NT-proBNP increase, while ST2 is a biomarker of cardiac remodeling and fibrosis. CRP is an acute phase compound that tends to increase following a strenuous and prolonged bout of exercise and/or muscular injury. As the values tended to return within the normal reference range values within 7 days after the race, our study suggests that there is no permanent structural damage at the myocardium level. [less ▲]

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See detailExploring the effect of a second closely-timed infiltration of platelet-rich plasma to treat proximal patellar tendinopathies
Kaux, Jean-François ULg; CROISIER, Jean-Louis ULg; FORTHOMME, Bénédicte ULg et al

in European Journal of Physical and Rehabilitation Medicine (2016, April), 54(Suppl. 1 No. 2), 199

Intorduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of jumper’s knee. Although it is possible that a single infiltrative administration may prove to ... [more ▼]

Intorduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of jumper’s knee. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of 2 or 3 successive infiltrations. Purpose: The aim of this study was to evaluate whether 2 infiltrations of PRP proves more effective than a single treatment. Methods: Twenty patients suffering from chronic jumper’s knee were enrolled into the study and split into two randomized groups (1 or 2 infiltrations of PRP, respectively). The 3-month follow-up evaluation consisted of VAS, IKDC and VISA-P scores, along with algometer, isokinetic and ultrasounds evaluations. After 1 year, subjects were contacted to define their functional evolution. Results: The concentration of the PRP used for each infiltration was similar in both groups, and contained no red or white cells. Results revealed no difference in treatment efficacy between the groups. Discussion and Conclusion: The comparison between 1 or 2 infiltrations of PRP did not reveal any difference between the 2 groups at short to mid term. A second closely-timed infiltration of PRP to treat jumper’s knees is not necessary to improve the efficacy of this treatment in the short term. A second infiltration should perhaps be envisaged later, but this remains to be demonstrated. [less ▲]

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See detailIs isokinetic exercise dangerous for the heart?
Le Goff, Caroline ULg; Kaux, Jean-François ULg; Cavalier, Etienne ULg et al

in European Journal of Physical and Rehabilitation Medicine (2016, April), 52(suppl. 1 No. 2), 457

INTRODUCTION: Very strenuous exercises can be performed on an isokinetic dynamometer in order to evaluate the resistance to fatigue of different muscular groups. Good cardiac function is necessary in ... [more ▼]

INTRODUCTION: Very strenuous exercises can be performed on an isokinetic dynamometer in order to evaluate the resistance to fatigue of different muscular groups. Good cardiac function is necessary in order to perform these very intensive exercises; otherwise an acute myocardial dysfunction could theoretically appear in predisposed patients. PURPOSE: Our study aimed to observe the cardiovascular impact (by biological point of view) of maximal intense isokinetic eccentric and concentric protocols performed by a population of sedentary young men. METHOD: Resting (T0) and post-exercise (just after (T1), 3 hours (T2) and 24 hours after the exercise (T3)) blood samples were taken in 2 populations of young sedentary men: 12 subjects (22.5±1.15 yo) for the eccentric protocol and 18 subjects (22.4±2.6 yo) for the concentric protocol. These subjects performed an intense maximal isokinetic exercise of the quadriceps muscles involving 30 knee flexions–extensions for each leg. We evaluated markers of cardiovascular risk (highly sensitive troponin T (hs-TnT), N-Terminal Brain natriuretic peptide (NT-proBNP), myoglobin (MYO)), of inflammation (highly sensitive C-reactive protein (hsCRP)), muscle damage (creatine kinase (CK)) and of oxidative stress (myeloperoxidase (MPO), lipidic peroxides (POXL), reduced (GSH) and oxidised glutathione (GSSG)). Haemodynamic parameters were measured continuously using a Portapres, and respiratory parameters were measured using a Sensormedics Vmax 29C. RESULTS: All the physiological parameters measured presented statistically significant changes. For the eccentric exercise, no significant modification in cardiac (NT-proBNP, hs-TNT) and inflammation (hsCRP) biomarkers was observed. However, a significant increase for CK (T3), MYO (T2), MPO (T1), POXL (T1), GSSG (T3) and ratio GSH/GSSG (T2-T3) was shown. For the concentric exercise, the results showed significant increases for the CK (T1-T2-T3), MYO (T1-T2), GSH/GSSG (T1). Evolutionary trends were also observed for the following biomarkers: NT-proBNP (T1-T2-T3), MPO (T2), and GSSG (T4). DISCUSSION and CONCLUSIONS: No modification in cardiac biomarkers was observed after the maximal eccentric isokinetic exercise but some variations can be observed for these biomarkers after the concentric exercise. However, these changes do not exceed the reference values in healthy subjects. We were thus able to prove that the exercise could be performed without any risk to cardiac function in young sedentary subjects. Nevertheless, a significant level of oxidative stress was induced by both exercises. [less ▲]

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See detailComparaison de l’impact du « VeinoPlus Sport » et du « TENS » sur la récupération de jeunes footballeurs amateurs
God, Maxime; LE GOFF, Caroline ULg; Evrard, Frédéric et al

in Journal de Traumatologie du Sport (2016), 33(1), 14-19

Aims The aim of this study was to evaluate the impact of “VeinoPlus Sport” on amateur soccer players’ recovery after an intense physical activity (2 drills). Method We proceeded to a comparative study ... [more ▼]

Aims The aim of this study was to evaluate the impact of “VeinoPlus Sport” on amateur soccer players’ recovery after an intense physical activity (2 drills). Method We proceeded to a comparative study between two devices: “VeinoPlus Sport” and “TENS” (used as a control system) on a population of 20 players (average age 17,1±0,8). Under identical conditions each player used the two devices during two separate sessions (called group “VeinoPlus Sport” and group “TENS”). The players performed an intense effort following the YoYo test concept. Four blood samples were taken from each participant and a Myotest evaluation was performed: one before the test, one just after the first intense effort, another after a short recovery time following the first effort, and the last one right after the second intense effort. For statistical analysis, we used the Anova algorithm of the “StatPlus” system and a Scheffé test. Results With both devices, we observed a significant elevation of lactate, HCO3− ions, and myoglobin as time progressed. The analysis of other blood parameters did not show any significant evolution in the course of the testing. The “VeinoPlus Sport” group, after the session, expressed feeling lighter and more fit than usual following an intense physical activity. They did not suffer any pain, tiredness, nor diminishment of strength. The same observation was made with the “TENS” group with the exception that some players felt a bit of soreness in their thigh and calf areas. In general, all participants admitted preferring the use of recovery machines instead of natural recovery. At the same time, none expressed any preferences between either of the devices. Conclusion The main asset of this study resided in the highlighting of minor differences as no way significant between the two machines tested on the chosen population. The “TENS” shows similar results as the “VeinoPlus Sport” even if a slight preference for the latter was expressed. Both devices permitted an equal or even better performance in the second drill in comparison to the first drill. [less ▲]

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See detailUsing platelet-rich plasma to treat jumper’s knees: Exploring the effect of a second closely-timed infiltration
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Forthomme, Bénédicte ULg et al

in Journal of Science and Medicine in Sport (2016), 19(3), 200-204

Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative administration may prove ... [more ▼]

Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of two or three successive infiltrations. The aim of this study was to evaluate whether two infiltrations of PRP proves more effective than a single treatment. DESIGN: Prospective, randomized and comparative study of level 2. METHODS: Twenty patients suffering from chronic proximal patellar tendinopathy were enrolled into the study and split into two randomized groups (one or two infiltrations of PRP, respectively). The 3-month follow-up evaluation consisted of VAS, IKDC and VISA-P scores, along with algometer, isokinetic and ultrasounds evaluations. After 1 year, subjects were contacted to define their functional evolution. RESULTS: The concentration of the PRP used for each infiltration was similar in both groups, and contained no red or white cells. Results revealed no difference in treatment efficacy between the groups. CONCLUSIONS: The comparison between one or two infiltrations of PRP did not reveal any difference between the two groups at short to mid term. A second closely-timed infiltration of PRP to treat proximal patellar tendinopathies is not necessary to improve the efficacy of this treatment in the short term. [less ▲]

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See detailConcordance between Iothalamate and Iohexol Plasma Clearance
DELANAYE, Pierre ULg; LE GOFF, Caroline ULg; JOURET, François ULg et al

in American Journal of Kidney Diseases (2016), 68(2), 329-330

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See detailConcordance between iohexol and iothalamate plasma clearance
DELANAYE, Pierre ULg; JOURET, François ULg; LE GOFF, Caroline ULg et al

in American Journal of Kidney Diseases (2016)

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See detailExploring the effect of a second closely-timed infiltration of PRP to treat proximal patellar tendinopathy
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; Forthomme, Bénédicte ULg et al

in European Journal of Sports Medicine (2015, September), 3(Suppl 1), 54

Introduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative ... [more ▼]

Introduction: Some clinical series have evaluated the effect of platelet-rich plasma (PRP) in the treatment of proximal patellar tendinopathy. Although it is possible that a single infiltrative administration may prove to be an effective treatment for this indication, most of the existing studies evaluated the effects of 2 or 3 successive infiltrations. The aim of this study was to evaluate whether 2 infiltrations of PRP proves more effective than a single treatment. Material and methods: Twenty patients suffering from chronic proximal patellar tendinopathy were enrolled into the study and split into two randomized groups (1 or 2 infiltrations of PRP, respectively). The 3-month follow-up evaluation consisted of VAS, IKDC and VISA-P scores, along with algometer, isokinetic and ultrasounds evaluations. After 1 year, subjects were contacted to define their functional evolution. Results: The concentration of the PRP used for each infiltration was similar in both groups, and contained no red or white cells. Results revealed no difference in treatment efficacy between the groups. Discussion and conclusion: The comparison between 1 or 2 infiltrations of PRP did not reveal any difference between the 2 groups at short to mid term. A second closely-timed infiltration of PRP to treat chronic proximal patellar tendinopathy is not necessary to improve the efficacy of this treatment in the short term. [less ▲]

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See detailOne-year follow-up of platelet-rich plasma infiltration to treat chronic proximal patellar tendinopathies
Kaux, Jean-François ULg; Bruyère, Olivier ULg; Croisier, Jean-Louis ULg et al

in European Journal of Sports Medicine (2015, September), 3(Suppl 1), 113

Introduction: Infiltration of Platelet-Rich Plasma (PRP) may be considered as a recent therapeutic option for chronic tendinopathies. The aim of this study is to evaluate the clinical status and the ... [more ▼]

Introduction: Infiltration of Platelet-Rich Plasma (PRP) may be considered as a recent therapeutic option for chronic tendinopathies. The aim of this study is to evaluate the clinical status and the return to sports activities in patients with chronic upper patellar tendinopathies. Material and methods : Twenty subjects with chronic upper patellar tendinopathy benefited from 1 infiltration of PRP. The follow-up (up to 1 year) was assessed by means of a Visual Anologue Scale (VAS), the International Knee Documentation Committee (IKDC) form and the Victorian Institute of Sport Assessment (VISA-P) score. Moreover, subjects had to answer an information questionnaire concerning their life and sports activities. Results : Seventy percents of the patients reported a favourable evolution with decrease of pain, and returned to sports activities. With time, VAS dropped significantly and both IKDC and VISA-P scores improved also significantly. Conclusion : This study confirms that a local injection of PRP coupled with a program of eccentric rehabilitation for treating a chronic jumper's knee, improves pain symptoms and the functionalities of the subjects’ knee up to 1 year after injection. [less ▲]

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See detailImpact of an ultra-trail of 330 km on plasma levels of cardiac biomarkers
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Gergelé, Laurent et al

in European Journal of Sports Medicine (2015, September), 3(Suppl 1), 77

Introduction/Aim: While a moderate exercise produces beneficial effects on the cardiovascular system, consequences of a supraphysiological effort are not yet clear. The aim of our study was to evaluate ... [more ▼]

Introduction/Aim: While a moderate exercise produces beneficial effects on the cardiovascular system, consequences of a supraphysiological effort are not yet clear. The aim of our study was to evaluate the consequences of such an effort on cardiac markers, markers of inflammation but also markers of renal function. This project also studied the evolution of new biomarkers of cardiac fibrosis such as the ST2 and galectin-3. Material and Methods: 51 people attending the Tor des Géants (330 km, with an altitude range of 24,000 meters) have been followed. The study is conducted on 33 participants having reached at least half of the race (148.7 km). Blood and urine samples were collected at four different times: before the race, halfway, at the finish and three days after arrival. Several biomarkers were assayed on different analyzers such COBAS®, KRYPTOR®, VIDAS® and ETIMAX®. Meanwhile, the ST2 was measured manually. Results: During this ultra-endurance effort, the plasma levels of cardiac markers (hsTnT, NT-proBNP, copeptin, H-FABP, ST2, Gal-3), muscle (CK, myoglobin) and inflammation (CRP DFO, GB) have increased significantly to halfway (148.7 km). Meanwhile, the markers of renal function (urinary NGAL and plasma and urinary creatinine) have only slightly varied, excepting plasma creatinine. Conclusions: The study suggests that there is no permanent structural damage at the myocardium level. However, the low pace adopted by the runners, due to fatigue, caused an inflammatory response as well as muscle damage less important than a shorter race. Nevertheless, an endurance race as the Tor des Géants means an intense physical and psychological effort. [less ▲]

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See detailComparison between VeinoPlus Sport and TENS on the recovery on young soccer players
God, Maxime; LE GOFF, Caroline ULg; Evrard, Frédéric et al

in European Journal of Sports Medicine (2015, September), 3(Suppl 1), 106

Introduction Every physical activity is tiresome for the body; muscles produce metabolites and lactic acid which limit its working ability. It is then necessary to efficiently and quickly recover after ... [more ▼]

Introduction Every physical activity is tiresome for the body; muscles produce metabolites and lactic acid which limit its working ability. It is then necessary to efficiently and quickly recover after the effort. In fact, a bad recovery could bring prejudice to the following performance and the athlete's physical state. Active recovery and balneotherapy together with new techniques such as cryotherapy and electro stimulation are upcoming tools to recover better. The goal of this study was to compare the impact of 2 types of electro stimulator : « VeinoPlus Sport » (VPS) and « TENS » on amateur soccer players after Yo-Yo-type effort. Material and methods In an identical context, each athlete (20 soccer players; average age 17,1 ± 0,79) benefited from VPS and TENS during 2 different treatment sessions after 2 Yo-Yo-type efforts. Four blood samples were taken (lactate, blood gases, ions, cardiac markers,...) and an explosiveness Myotest evaluation was conducted respectively before effort, just after effort, after recovery, and after the second effort. A questionnaire on the fatigue state was filled out by each athlete. For the statistical analysis, we used the Anova algorithm of the StatPlus system and a Scheffé test. Results All athletes have ran a greater distance in their second effort especially in the VPS group but differences were insignificant. The test lead to a significant variation of lactate, HCO3- ions and myoglobin. The study of other blood parameters and of the explosiveness parameters didn't show any significant variations. Nevertheless according to the subjective athlete's opinion the VPS group has noted less legs pain, less overall fatigue, less diminishment of strength and fitter than the TENS group between 12 and 24 hours after effort. Finally all athletes have said to like the use of a electro-stimulation recovery device better than their normal daily recovery techniques without expressing any preferences between VPS and TENS. Discussion - Conclusion This comparative study only shows minor differences, non significant, between the two devices. The two groups have ran the greatest distance during the second effort which suggests that the test wasn't tiresome despite biological signs of "fatigue". However on subjective criteria of recovery and well-being a slight preference was shown for the VPS device. The results should be taken into consideration in a other comparative study of the recovery devices with more tiresome effort. [less ▲]

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See detailIdentification of cardiac repercussions after intense and prolonged concentric isokinetic exercise in young sedentary people
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Couffignal, Vincent et al

in Clinical physiology and functional imaging (2015), 35(5), 368-375

INTRODUCTION: Cardiopathies are the world's leading cause of mortality and morbidity. Although rare, cardiovascular accidents can occur during intense and infrequent sporting activity, particularly among ... [more ▼]

INTRODUCTION: Cardiopathies are the world's leading cause of mortality and morbidity. Although rare, cardiovascular accidents can occur during intense and infrequent sporting activity, particularly among those who are unaware of their heart condition. The development of cardiospecific biochemical markers has led to a reconsideration of the role of biology in the diagnosis of cardiovascular illnesses. The aim of this study therefore was, through the use of cardiac biomarker assays, to highlight the impact of sustained physical effort in the form of intense and prolonged concentric isokinetic exercise and to research potential cardiovascular risks. MATERIALS AND METHODS: Eighteen subjects participated in a maximal concentric isokinetic exercise involving 30 knee flexion-extensions for each leg. Five blood tests were taken to study the kinetics of the cardiac biomarkers. Haemodynamic parameters were measured continuously using a Portapres, and respiratory parameters were measured using a Sensormedics Vmax 29C. RESULTS: The results showed significant increases in the creatine kinase, myoglobin, homocysteine and haemoglobin cardiac markers. Evolutionary trends were also observed for the following biomarkers: NT-proBNP, myeloperoxydase and C-reactive protein. All the physiological parameters measured presented statistically significant changes. CONCLUSION: Isokinetic effort leads to the release of cardiac markers in the blood, but these do not exceed the reference values in healthy subjects. Maximal concentric isokinetic exercise does not, therefore, lead to an increased risk of cardiovascular pathologies. [less ▲]

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