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Immediate and 24-h post-marathon cardiac troponin T is associated with relative exercise intensity



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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Fig. 1

Data availability

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


Heart rate


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


Electrochemiluminescence technology


Limit of the blank


Standard deviation


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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.

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Authors and Affiliations



Conceived and designed the experiments: IMN JSG DS EC BH NP CH. Performed the experiments: IMN JSG DS EC BH NP CH. Analyzed the data: IMN JSG DS CH. Wrote the manuscript: IMN. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors.

Corresponding author

Correspondence to Ignacio Martínez-Navarro.

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Northing to declare.

Ethical standards

Research Ethics Committee of the Jaume I University of Castellon (Expedient number: DOGV 7993, 6/03/2017).

Informed consent

All individuals included in the current study were fully informed and gave their written consent to participate and for the data to be published.

Additional information

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).

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