title: 72-h kinetics of high-sensitive troponin T and inflammatory markers after marathon.
abstract: BACKGROUND
  Strenuous exercise induces significant increases in cardiac biomarkers. However, it is still unclear whether this is caused by cardiomyocyte necrosis or secondary mechanisms such as ischemia, cardiac energy deficiency, increased inflammation, or renal dysfunction.
  
  
  METHODS
  Therefore, we investigated cardiac biomarkers (high-sensitive cardiac troponin T (hs-cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (h-FABP)), inflammation markers (high-sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10, tumor necrosis factor-α), and renal function (cystatin C) in 102 healthy men age 42 ± 9 yr before and 0, 24, and 72 h after a marathon.
  
  
  RESULTS
  Kinetics of hs-cTnT revealed a peak immediately after the race (V3) that decreased rapidly to pretest values within 72 h (V5) (median (interquartile range) = 31.07 (19.25-46.86) ng·L(-1) at V3 and 3.61 (3.20-6.70) ng·L(-1) at V5, P < 0.001). NT-proBNP and h-FABP kinetics showed a similar pattern (NT-proBNP = 92.6 (56.9-149.7) ng·L(-1) at V3 and 34.9 (21.7-54.5) ng·L(-1) at V5; h-FABP = 44.99 (32.19-64.42) μg·L(-1) at V3 and 7.66 (5.64-10.60) μg·L(-1) at V5; always P < 0.001). Proinflammatory markers, such as IL-6 and hs-CRP, and renal dysfunction were significantly augmented immediately after the race (before the race compared with maximum after the race: IL-6 = 15.5-fold, hs-CRP = 28-fold, cystatin C = 1.22-fold, all P < 0.001). These increases were not related to the increase of hs-cTnT. Similarly, training history, finishing time, and exercise intensity were not associated with changes of hs-cTnT.
  
  
  CONCLUSIONS
  Cardiac biomarkers were increased immediately after a marathon race. Interestingly, values returned to normal levels within 72 h. These kinetics with a sharp peak indicate that cardiac necrosis during marathon running seems very unlikely but may be explained by altered myocyte metabolism.
authors: Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany. scherr@sport.med.tum.de
authors: Johannes
authors: J
authors: Scherr
authors: Siegmund
authors: S
authors: Braun
authors: Tibor
authors: T
authors: Schuster
authors: Charlotte
authors: C
authors: Hartmann
authors: Stefan
authors: S
authors: Moehlenkamp
authors: Bernd
authors: B
authors: Wolfarth
authors: Axel
authors: A
authors: Pressler
authors: Martin
authors: M
authors: Halle
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D055316:Cystatin C / Q000097:blood; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000097:blood*; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010807:Physical Endurance; D012420:Running; D020107:Troponin T / Q000097:blood*; D055815:Young Adult
chemical_list: D055316:Cystatin C; C493408:FABP3 protein, human; D000074026:Fatty Acid Binding Protein 3; D050556:Fatty Acid-Binding Proteins; C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D020107:Troponin T; D020097:Natriuretic Peptide, Brain; D016753:Interleukin-10; D002097:C-Reactive Protein