We aimed at exploring whether cardiopulmonary fitness, echocardiographic measures and relative exercise intensity were associated with high-sensitivity cardiac troponin T (hs-TNT) rise and normalization following a marathon.
Nighty-eight participants (83 men, 15 women; 38.72 ± 3.63 years) were subjected to echocardiographic assessment and a cardiopulmonary exercise test (CPET) before the race. hs-TNT was measured before, immediately after and at 24, 48, 96, 144 and 192 h post-race. Speed and mean heart rate (HR) during the race were relativized to CPET values: peak speed (%VVMAX), peak HR (HR%MAX), speed and HR at the second ventilatory threshold (HR%VT2 and %VVT2).
Hs-TNT increased from pre- to post-race (5.74 ± 5.29 vs. 50.4 ± 57.04 ng/L; p < 0.001), seeing values above the Upper Reference Limit (URL) in 95% of the participants. At 24 h post-race, 39% of the runners still exceeded the URL (High hs-TNT group). hs-TNT rise was correlated with marathon speed %VVT2 (r = 0.22; p = 0.042), mean HR%VT2 (r = 0.30; p = 0.007), and mean HR%MAX (r = 0.32; p = 0.004). Moreover, the High hs-TNT group performed the marathon at a higher Speed %VVT2 (88.21 ± 6.53 vs. 83.49 ± 6.54%; p = 0.002) and Speed %VVMAX (72 ± 4.25 vs. 69.40 ± 5.53%; p = 0.009). hs-TNT showed no significant associations with cardiopulmonary fitness and echocardiographic measures, except for a slight correlation with left ventricular end systolic diameter (r = 0.26; p = 0.018).
Post-race hs-TNT was above the URL in barely all runners. Magnitude of hs-TNT rise was correlated with exercise mean HR; whereas, its normalization kept relationship with marathon relative speed.
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Data from the Run, Recovery, Repeat, Always Healthy Project, to whom it belong results here presented, are stored at the Sports Service of the Jaume I University of Castellon. Applications for data sharing can be made.
High-sensitive cardiac troponin T
Cardiopulmonary exercise test
Upper reference limit
Body mass index
Maximum oxygen uptake
Respiratory exchange ratio
- VT2 :
Second ventilatory threshold
Right ventricular end diastolic diameter
Left ventricular end diastolic diameter
Left ventricular end systolic diameter
Interventricular septum at the end of diastole
Posterior wall at the end of diastole
Left ventricular ejection fraction
Limit of the blank
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Current research could be carried out, thanks to the collaboration of Fundacion Trinidad Alfonso, Vithas-Nisa Hospitals group and Sociedad Deportiva Correcaminos. Authors are also grateful to all the staff involved in the organization of the Valencia Fundacion Trinidad Alfonso EDP 2016 Marathon and all marathoners and volunteers participating in this study.
Fundacion Trinidad Alfonso and Vithas-Nisa Hospitals group.
Conflict of interest
Northing to declare.
Research Ethics Committee of the Jaume I University of Castellon (Expedient number: DOGV 7993, 6/03/2017).
All individuals included in the current study were fully informed and gave their written consent to participate and for the data to be published.
Communicated by Massimo Pagani.
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Martínez-Navarro, I., Sánchez-Gómez, J., Sanmiguel, D. et al. Immediate and 24-h post-marathon cardiac troponin T is associated with relative exercise intensity. Eur J Appl Physiol 120, 1723–1731 (2020). https://doi.org/10.1007/s00421-020-04403-8