The effect of endurance training on cardiac and muscle damage in male football players

This study aimed to investigate the effects of a six-week endurance training program on heart and muscle damage in football players. Twenty male football players from the same team voluntarily participated in the study. Participants were randomly divided into two groups: the experimental group (n = 10; mean age 22 ± 2.21 years) and the control group (n = 10; mean age 22.3 ± 1.76 years). On the first day of the study, 3 mL of venous blood samples were collected into ethylenediaminetetraacetic acid tubes by a specialist to measure N-Terminal Pro-B-Type Natriuretic Peptide for cardiac damage and Creatine Kinase (CK) for muscle damage. On the second day of the study, the Yo-Yo Intermittent Recovery Test Level-1 (YIRT1) was conducted to assess the players’ maximum oxygen consumption (VO2max) and maximum aerobic speed (MAS) values. After six weeks of endurance training, the procedures above were repeated. A statistically significant difference between the pre-test and post-test data of CK, NT-ProBNP and VO2max in the experimental group (p < 0.01) was observed. No statistically significant difference was observed between the pre and post-test data in the control group (p > 0.05). Additionally, based on the analysis of variance repeated measured analysis, a statistically significant difference was observed between the experimental and control groups regarding the time and time × group variables for NT-ProBNP and VO2max parameters (p < 0.01). However, no statistically significant difference was observed for CK levels (p > 0.05). A statistically significant difference was observed in CK levels in terms of the group variable (p < 0.01), while no statistically significant difference was observed in NT-ProBNP and VO2max levels (p > 0.05). Ultimately, our study revealed that endurance training positively affects heart and muscle damage.

Brain natriuretic peptide; Creatin kinase; Maximal aerobic speed

[1] Makaracı Y, Nas K, Aydemir M, Gündüz K, Gedik MC. Mediolateral postural sway velocity as a possible indicator of ground reaction force-derived 180° turn performance in male soccer players: a cross-sectional study. Pamukkale Journal of Sport Sciences. 2024; 15: 234–252.

[2] Falces-Prieto M, González-Fernández FT, García-Delgado G, Silva R, Nobari H, Clemente FM. Relationship between sprint, jump, dynamic balance with the change of direction on young soccer players’ performance. Scientific Reports. 2022; 12: 12272.

[3] Metaxas TI. Match running performance of elite soccer players: VO2max and players position influences. The Journal of Strength & Conditioning Research. 2021; 35: 162–168.

[4] Jung D, Hong J. Effects of short-rest interval time on resisted sprint performance and sprint mechanical variables in elite youth soccer players. Applied Sciences. 2024; 14: 5082.

[5] Fereday K, Hills SP, Russell M, Smith J, Cunningham DJ, Shearer D, et al. A comparison of rolling averages versus discrete time epochs for assessing the worst-case scenario locomotor demands of professional soccer match-play. Journal of Science and Medicine in Sport. 2020; 23: 764–769.

[6] McCormack S, Jones B, Elliott D, Rotheram D, Till K. Coaches’ assessment of players physical performance: subjective and objective measures are needed when profiling players. European Journal of Sport Science. 2022; 22: 1177–1187.

[7] Jordan AC, Perry CG, Cheng AJ. Promoting a pro-oxidant state in skeletal muscle: potential dietary, environmental, and exercise interventions for enhancing endurance-training adaptations. Free Radical Biology and Medicine. 2021; 176: 189–202.

[8] Markus I, Constantini K, Hoffman JR, Bartolomei S, Gepner Y. Exercise-induced muscle damage: Mechanism, assessment and nutritional factors to accelerate recovery. European Journal of Applied Physiology. 2021; 121: 969–992.

[9] Córdova-Martínez A, Caballero-García A, Bello HJ, Perez-Valdecantos D, Roche E. Effects of eccentric vs. concentric sports on blood muscular damage markers in male professional players. Biology. 2022; 11: 343.

[10] Felismino AS, Costa EC, Aoki MS, Ferraresi C, de Araújo Moura Lemos TM, de Brito Vieira WH. Effect of low-level laser therapy (808 nm) on markers of muscle damage: a randomized double-blind placebo-controlled trial. Lasers in Medical Science. 2014; 29: 933–938.

[11] Ventura-Clapier R, Kuznetsov A, Veksler V, Boehm E, Anflous K. Functional coupling of creatine kinases in muscles: species and tissue specificity. Molecular and Cellular Biochemistry. 1998; 184: 231–247.

[12] Hood DA, Irrcher I, Ljubicic V, Joseph AM. Coordination of metabolic plasticity in skeletal muscle. Journal of Experimental Biology. 2006; 209: 2265–2275.

[13] Buchheit M, Laursen PB. High-intensity interval training, solutions to the programming puzzle: Part I: cardiopulmonary emphasis. Sports Medicine. 2013; 43: 313–338.

[14] Rakobowchuk M, Stuckey MI, Millar PJ, Gurr L, MacDonald MJ. Effect of acute sprint interval exercise on central and peripheral artery distensibility in young healthy males. European Journal of Applied Physiology. 2009; 105: 787–795.

[15] Bravo DF, Impellizzeri FM, Rampinini E, Castagna C, Bishop D, Wisloff U. Sprint vs. interval training in football. International Journal of Sports Medicine. 2008; 29: 668–674.

[16] Cunningham TC, Maghrabi K, Sanatani S. Morbidities in the ultra-athlete and marathoner. Cardiology in the Young. 2017; 27: S94–S100.

[17] Franklin BA, Thompson PD, Al-Zaiti SS, Albert CM, Hivert MF, Levine BD, et al.; American heart association physical activity committee of the council on lifestyle and cardiometabolic health; council on cardiovascular and stroke nursing; council on clinical cardiology; and stroke council. Exercise-related acute cardiovascular events and potential deleterious adaptations following long-term exercise training: placing the risks into perspective-an update: a scientific statement from the American heart association. Circulation. 2020; 141: e705–e736.

[18] Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Jr DE, Colvin MM, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart failure society of America. Circulation. 2017; 136: e137–e161.

[19] Morimoto K, Mori T, Ishiguro S, Matsuda N, Hara Y, Kuroda H. Perioperative changes in plasma brain natriuretic peptide concentrations in patients undergoing cardiac surgery. Surgery Today. 1998; 28: 23–29.

[20] Elnoamany MF, Abdelhameed AK. Mitral annular motion as a surrogate for left ventricular function: correlation with brain natriuretic peptide levels. European Journal of Echocardiography. 2006; 7: 187–198.

[21] Sarzani R, Allevi M, Di Pentima C, Schiavi P, Spannella F, Giulietti F. Role of cardiac natriuretic peptides in heart structure and function. International Journal of Molecular Sciences. 2022; 23: 14415.

[22] Sapna FN, Raveena FN, Chandio M, Bai K, Sayyar M, Varrassi G, et al. Advancements in heart failure management: a comprehensive narrative review of emerging therapies. Cureus. 2023; 15: e46486.

[23] Dilek SÖ, Erdem S, Kurdak SS, Özbarlas N. Evaluation of cardiac biomarkers, electrocardiogram changes and echocardiography findings before and after exercise in paediatric athletes. Cukurova Medical Journal. 2023; 48; 929–938.

[24] Tiller NB, Wheatley-Guy CM, Fermoyle CC, Robach P, Ziegler B, Gavet A, et al. Sex-specific physiological responses to ultramarathon. Medicine & Science in Sports & Exercise. 2022; 54: 1647–1656.

[25] Foulkes SJ, Howden EJ, Haykowsky MJ, Antill Y, Salim A, Nightingale SS, et al. Exercise for the prevention of anthracycline-induced functional disability and cardiac dysfunction: the BREXIT study. Circulation. 2023; 14: 532–545.

[26] Davoodi M, Rezaei S, Negarandeh Z, Gholamalishahi S. The evalutation of the effect of 12 weeks of water aerobic exercise and Atrovastain drug on apolipoproteins A1 Changes, ANP, BNP and CRP in older men with cardiovascular disesaes. The Therapeutic Clinic. 2022; 173: 362–368.

[27] Baker D. Recent trends in high-intensity aerobic training for field sports. UK Strength and Conditioning Association. 2011; 3–8.

[28] Berthoin S, Gerbeaux M, Turpin E, Guerrin F, Lensel‐Corbeil G, Vandendorpe F. Comparison of two field tests to estimate maximum aerobic speed. Journal of Sports Sciences. 1994; 12: 355–362.

[29] Bangsbo J, Iaia FM, Krustrup P. The Yo-Yo intermittent recovery test: a useful tool for evaluation of physical performance in intermittent sports. Sports Medicine. 2008; 38: 37–51.

[30] Castagna C, Impellizzeri FM, Chamari K, Carlomagno D, Rampinini E. Aerobic fitness and yo-yo continuous and intermittent tests performances in soccer players: a correlation study. The Journal of Strength & Conditioning Research. 2006; 20: 320–325.

[31] Devrilmez M, Soslu R. The effect of repetitive running on middle distance athletes’ muscle damage [master’s thesis]. Karamanoğlu Mehmetbey Üniversitesi. 2022.

[32] Mendeş B. Comparing the capacity of total oxidant and total antioxidant which is induced by acute exercise among professional footballers and sedanteries [Doctoral thesis]. Institute of Health Sciences, Firat Üniversity. 2012.

[33] Mark DB, Felker GM. B-type natriuretic peptide—a biomarker for all seasons? New England Journal of Medicine. 2004; 350: 718–720.

[34] Nishikimi T, Nakagawa Y. Potential pitfalls when interpreting plasma BNP levels in heart failure practice. Journal of Cardiology. 2021; 78: 269–274.

[35] Djordjevic T, Arena R, Guazzi M, Popovic D. Prognostic value of NT-Pro brain natriuretic peptide during exercise recovery in ischemic heart failure of reduced, midrange, and preserved ejection fraction. Journal of Cardiopulmonary Rehabilitation and Prevention. 2021; 41: 282–287.

[36] Jörres M, Gunga HC, Steinach M. Physiological changes, activity, and stress during a 100-km–24-h walking-march. Frontiers in Physiology. 2021; 12: 640710.

[37] Egger F, Schilling T, Baumann S, Meyer T, Scharhag J. Cardiovascular risk of veterans’ football: an observational cohort study with follow-up. PLOS ONE. 2024; 19: e0297951.

[38] Zare Karizak S, Kashef M, Gaeini AA, Nejatian M. Impact of high intensity interval and moderate continuous training on plasma ratios of NT-ProBNP1-108/BNP1-32 and NT-NT-ProBNP1-76/BNP1-32 after coronary artery bypass grafting surgery. Frontiers in Physiology. 2023; 14: 1114813.

[39] McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology (ESC) with the special contribution of the heart failure association (HFA) of the ESC. European Journal of Heart Failure. 2021; 42: 3599–3726.

[40] Yao F, Zhang Y, Kuang X, Zhou Q, Huang L, Peng J, et al. Effects of cardiac rehabilitation training in patients with heart failure based on traditional Chinese exercise: a systematic review and meta‐analysis. Evidence‐Based Complementary and Alternative Medicine. 2021; 2021: 1068623.

[41] Pieske B, Wachter R, Shah SJ, Baldridge A, Szeczoedy P, Ibram G, et al. Effect of sacubitril/valsartan vs. standard medical therapies on plasma NT-NT-ProBNP concentration and submaximal exercise capacity in patients with heart failure and preserved ejection fraction: the parallax randomized clinical trial. JAMA. 2021; 326: 1919–1929.

[42] Ahmed Elshazly MD, Selım G, Abdelrahman M, Gamal M, Khorshıd M. Impact of exercise training on CRP & BNP in patients with heart failure with reduced EF (HFrEF). The Medical Journal of Cairo University. 2022; 90: 2457–2463.

[43] do Nascimento DM, Bock PM, Nemetz B, Goldraich LA, Schaan BD. Meta-analysis of physical training on natriuretic peptides and Inflammation in heart failure. The American Journal of Cardiology. 2022; 178: 60–71.

[44] Fu TC, Wang CH, Lin PS, Hsu CC, Cherng WJ, Huang SC, et al. Aerobic interval training improves oxygen uptake efficiency by enhancing cerebral and muscular hemodynamics in patients with heart failure. International Journal of Cardiology. 2013; 167: 41–50.

[45] Smart NA, Meyer T, Butterfield JA, Faddy SC, Passino C, Malfatto G, et al. Individual patient meta-analysis of exercise training effects on systemic brain natriuretic peptide expression in heart failure. European Journal of Preventive Cardiology. 2012; 19: 428–435.

[46] Passino C, Severino S, Poletti R, Piepoli MF, Mammini C, Clerico A, et al. Aerobic training decreases b-type natriuretic peptide expression and adrenergic activation in patients with heart failure. Journal of the American College of Cardiology. 2006; 47: 1835–1839.

[47] Kenney K, Landau ME, Gonzalez RS, Hundertmark J, O’Brien K, Campbell WW. Serum creatine kinase after exercise: drawing the line between physiological response and exertional rhabdomyolysis. Muscle & Nerve. 2012; 45: 356–362.

[48] Kobaner B. Evaluation of post-exercise creatine kinase levels in athletes [master’s thesis]. Hamidiye Institute of Sports Health and Sports Sciences, University of Health Sciences, 2023.