Post-Race Kinetics of Cardiac Troponin T and I and N-Terminal Pro-Brain Natriuretic Peptide in Marathon Runners

Annually there are cases of sudden cardiac death during and after marathon races (1)(2)(3), which has caused athletes and physicians to frequently ask whether marathon running damages the heart. Modern laboratory analyses, such as tests for cardiac troponin T and I (cTnT and cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP), provide additional information about cardiac cell damage and wall stress with high sensitivity and specificity (4)(5)(6)(7). Previous studies have investigated cTnT and cTnI in runners, cyclists, and triathletes (8)(9)(10)(11)(12)(13)(14)(15)(16), but the results are controversial, mainly because the assays were first- (cTnI) or second-generation (cTnT) troponin assays and the cutoff points were inconsistent. In the present study we investigated cTnT and cTnI during a marathon race with third- (cTnT) and second-generation (cTnI) assays, as well as NT-proBNP. We hypothesized that marathon running may change cardiac troponin concentrations and that increased troponin concentrations are possibly associated with an increased mechanical load on the myocardium, exemplified by NT-proBNP.We investigated 46 randomly selected participants (40 males and 6 females) of the Mainz Marathon 2002 (Germany) with a mean (SD) age of 40 (7) years, a mean height of 178 (7) cm, a mean weight of 73 (9) kg, and a mean body mass index (BMI) of 23.1 (1.9). The mean running time was 239 (34) min. To allow coverage of the whole spectrum of participating runners, there were no particular exclusion criteria. All participants filled in a questionnaire to register health status, cardiovascular risk factors, and training volume. The analysis of these questionnaires revealed that runners had performed regular endurance training over the past 7 (6) years. Cardiovascular risk factors and diseases were distributed as follows: acute …