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Cited by 80Cardiovascular Effects of ExerciseExercise and Physiological ResponsesCardiovascular and exercise physiology

Relationship between Inflammatory Cytokines and Indices of Cardiac Dysfunction following Intense Endurance Exercise

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La Gerche, Andre, Inder, Warrick J., Roberts, Timothy J., Brosnan, Maria J., Heidbuchel, Hein, Prior, David L.·2015·PLOS ONE
DOI 10.1371/journal.pone.0130031PMC PMC4466522
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Abstract

OBJECTIVES: Pro-inflammatory cytokines have been noted to increase following exercise but their relationship to exercise-induced cardiac dysfunction has not previously been investigated. We sought to evaluate whether exercise-induced cardiac dysfunction was associated with increases in cytokines, particularly the pro-inflammatory cytokines IL-1β, IL-12p70 and TNFα, which have been most implicated in cardiac pathology. METHODS: 40 well-trained endurance athletes underwent evaluation prior to and immediately following one of four endurance sporting events ranging from 3 to 11 hours duration. Cytokines (IL-1β, IL-6, IL-8, IL-10, IL-12p70 and TNFα) were analyzed by flow cytometry from serum samples collected within 50 minutes of race completion. Cardiac troponin (cTnI) and B-type natriuretic peptide were combined with an echocardiographic assessment of cardiac function, and a composite of cTnI > 0.04 μg/L, BNP increase > 10 ng/L and a decrease in right ventricular ejection (RVEF) > 10% were prospectively defined as evidence of myocardial dysfunction. RESULTS: Relative to baseline, IL-6 IL-8 and IL-10 increased 8.5-, 2.9-, and 7.1-fold, respectively, P<0.0001. Thirty-one (78%), 19 (48%) and 18 (45%) of the athletes met the pre-specified criteria for significant cTnI, BNP and RVEF changes, respectively. TNFα, IL-12p70 were univariate predictors of ΔRVEF and ΔBNP whilst none of the anti-inflammatory cytokines were significantly associated with these measures. Ten athletes (25%, all athletes competing in the endurance event of longest duration) met criteria for exercise-induced myocardial dysfunction. In these 10 athletes with myocardial dysfunction, as compared to those without, there was significantly greater post-race expression of the pro-inflammatory cytokines IL-12p70 (8.1±3.8 pg/ml vs. 2.5±2.6 pg/ml, P<0.0001) and TNFα (6.5±3.1 pg/ml vs. 2.0±2.5 pg/ml, P<0.0001). CONCLUSION: Cardiac dysfunction following intense endurance exercise was associated with increased expression of pro-inflammatory cytokines. This does not prove a causal relationship but provides rationale for further investigations into whether inflammation mediates exercise-induced myocardial dysfunction.

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Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Theories suggest that complex mechanisms may contribute to AF, including alterations in autonomic tone, systemic inflammation, electrical remodeling, and LA enlargement and fibrosis.

    “Theories suggest that complex mechanisms may contribute to AF, including alterations in autonomic tone, systemic inflammation, electrical remodeling, and LA enlargement and fibrosis [12,44,45,46,47,48,49,50].”

    From Atrial Fibrillation in Elite Athletes: A Comprehensive Review of the Literature (2024) · cites this paper as [46]

    The Discussion (page unavailable) suggests that inflammatory mediators may contribute to arrhythmias and cites an association between IL-6 and atrial fibrillation. The cited paper does not identify altered autonomic tone, electrical remodeling, or left atrial enlargement and fibrosis as AF mechanisms. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Intense exercise is known to acutely elevate inflammatory markers.

    “Second, intense exercise is known to acutely elevate inflammatory markers,31”

    From Wearable-Derived Training Load and Coronary Atherosclerosis in Middle-Aged and Older Athletes and Physically Active Controls: A New Perspective From the Master@Heart Study (2026) · cites this paper as [31]

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Authors
La Gerche, A., Inder, W. J., Roberts, T. J., Brosnan, M. J., Heidbuchel, H., & Prior, D. L.
Affiliations
  • The University of Queensland (AU)
  • The University of Melbourne (AU)
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2015-06-12
Volume
10
Issue
6
Pages
e0130031
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0130031
PMC
PMC4466522
OpenAlex
W640419040
Cited by
80
References
44
Citations by year
2026: 3 · 2025: 7 · 2024: 9 · 2023: 10 · 2022: 5 · 2021: 8 · 2020: 7 · 2019: 6 · 2018: 9 · 2017: 7 · 2016: 7 · 2015: 2
FWCI
6.07
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Document Server@UHasselt (UHasselt) (submittedVersion, cc-by)
Funders
  • Pfizer
  • Medical Research Council
  • National Health and Medical Research Council
  • National Medical Research Council
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Keywords
inflammatory cytokines, IL-12p70, TNF-α, interleukin-6, endurance athletes, cardiac troponin I, brain natriuretic peptide, right ventricular ejection fraction, exercise-induced cardiomyopathy, cytokine biomarkers, marathon running, echocardiography, serum cytokines, anti-inflammatory cytokines
MeSH terms
Adult, Blood Cell Count, Demography, Heart, Humans, Male, Myocardium, Physical Endurance, Stroke Volume, Biomarkers, Exercise, Cytokines, Inflammation Mediators, Athletes

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