Cardiac Troponin T and I Release After a 30-km Run

Lieke J. J. Klinkenberg, Peter Luyten, Noreen van der Linden, Kim Urgel, Danielle P. C. Snijders, Christian Knackstedt, Robert Dennert, Bastiaan L. J. H. Kietselaer, Alma Mingels, Eline P. M. Cardinaels, Frederique E. C. M. Peeters, Jeroen D. E. van Suijlen, Joop ten Kate, Elke Marsch, Thomas L. Theelen, Judith C. Sluimer, Kristiaan Wouters, Otto Bekers, Bas Bekkers, Lucas van LoonMarja Visser - van Dieijen, Steven J. R. Meex*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Prolonged endurance-type exercise is associated with elevated cardiac troponin (cTn) levels in asymptomatic recreational athletes. It is unclear whether exercise-induced cTn release mirrors a physiological or pathological underlying process. The aim of this study was to provide a direct comparison of the release kinetics of high-sensitivity cTnI (hs-cTnI) and T (hs-cTnT) after endurance-type exercise. In addition, the effect of remote ischemic preconditioning (RIPC), a cardioprotective strategy that limits ischemia-reperfusion injury, was investigated in a randomized controlled crossover manner. Twenty-five healthy volunteers completed an outdoor 30-km running trial preceded by RIPC (4 x 5 min 220 mm Hg unilateral occlusion) or control intervention. hs-cTnT, hs-cTnI, and sensitive cTnI (s-cTnI) concentrations were examined before, immediately after, 2 and 5 hours after the trial. The completion of a 30-km run resulted in a significant increase in circulating cTn (tiine: all p <0.001), with maximum hs-cTnT, hs-cTnI, and s-cTnI levels of 47 +/- 27, 69 +/- 62, and 82 +/- 64 ng/L (mean +/- SD), respectively. Maximum hs-cTnT concentrations were measured in 60% of the participants at 2 hours after exercise, compared with maximum hs-cTnI and s-cTnI concentrations at 5 hours in 84% and 80% of the participants. Application of an RIPC stimulus did not reduce exercise-induced cTn release (time x trial: all p >0.5). In conclusion, in contrast to acute myocardial infarction, maximum hs-cTnT levels after exercise precede maximum hs-cTnI levels. Distinct release kinetics of hs-cTnT and hs-cTnI and the absence of an effect of RIPC favors the concept that exercise induced cTn release may be mechanistically distinct from cTn release in acute myocardial infarction.
Original languageEnglish
Pages (from-to)281-287
JournalAmerican Journal of Cardiology
Issue number2
Publication statusPublished - 15 Jul 2016


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