Composition of cardiac troponin release differs after marathon running and myocardial infarction

Objectives Elevations of cardiac troponin T (cTnT) levels are common after strenuous exercise. We assessed whether the composition of cTnT release after marathon race differs from that of acute myocardial infarction (MI).Methods Troponin composition was analysed in plasma samples taken from 45 runne...

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Main Authors: Olli J Heinonen, K E Juhani Airaksinen, Konsta Teppo, Tuomas Paana, Tuija Vasankari, Selma Salonen, Tuulia Tuominen, Anna Linko-Parvinen, Hanna-Mari Pallari, Tapio Hellman, Samuli Jaakkola, Saara Wittfooth
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/11/2/e002954.full
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author Olli J Heinonen
K E Juhani Airaksinen
Konsta Teppo
Tuomas Paana
Tuija Vasankari
Selma Salonen
Tuulia Tuominen
Anna Linko-Parvinen
Hanna-Mari Pallari
Tapio Hellman
Samuli Jaakkola
Saara Wittfooth
author_facet Olli J Heinonen
K E Juhani Airaksinen
Konsta Teppo
Tuomas Paana
Tuija Vasankari
Selma Salonen
Tuulia Tuominen
Anna Linko-Parvinen
Hanna-Mari Pallari
Tapio Hellman
Samuli Jaakkola
Saara Wittfooth
author_sort Olli J Heinonen
collection DOAJ
description Objectives Elevations of cardiac troponin T (cTnT) levels are common after strenuous exercise. We assessed whether the composition of cTnT release after marathon race differs from that of acute myocardial infarction (MI).Methods Troponin composition was analysed in plasma samples taken from 45 runners after marathon race and from 84 patients with type 1 MI. The concentration of long cTnT (intact and mildly fragmented cTnT) was measured with a novel upconversion luminescence immunoassay, total cTnT with a commercial high-sensitivity cTnT assay, and the ratio of long to total cTnT (troponin ratio) was determined as a measure of troponin fragmentation.Results Total cTnT exceeded the upper reference limit (>14 ng/L) in 37 (82%) runners. Troponin ratio was lower in runners ((IQR) 0.17 (0.11–0.24) vs 0.62 (0.29–0.96), p<0.001). With increasing troponin release the troponin ratio decreased (r=−0.497, p<0.001) in marathon runners and the concentration of long cTnT remained in all runners below 8.4 ng/L. In contrast to marathon runners, troponin ratio increased (r=0.565, p<0.001) with the increase of cTnT release in patients with MI. The median total and long cTnT concentrations were lower in marathon runners than in patients with MI (25 ng/L vs 835 ng/L and 4.1 vs 385 ng/L, p<0.001 for both).Conclusion In contrast to type 1 MI, only a small fraction of circulating cTnT exists as intact cTnT or long molecular forms after strenuous exercise and the difference in troponin composition is more pronounced in runners with higher troponin release.Trial registration number NCT06000930.
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publishDate 2024-11-01
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series Open Heart
spelling doaj-art-5a9c99f1066941b7a9120aea4f8a48e02024-11-20T21:30:08ZengBMJ Publishing GroupOpen Heart2053-36242024-11-0111210.1136/openhrt-2024-002954Composition of cardiac troponin release differs after marathon running and myocardial infarctionOlli J Heinonen0K E Juhani Airaksinen1Konsta Teppo2Tuomas Paana3Tuija Vasankari4Selma Salonen5Tuulia Tuominen6Anna Linko-Parvinen7Hanna-Mari Pallari8Tapio Hellman9Samuli Jaakkola10Saara Wittfooth11Paavo Nurmi Centre & Department of Physical Activity and Health, University of Turku, Turku, FinlandUniversity of Turku, Turku, FinlandUniversity of Turku, Turku, FinlandHeart Centre, Turku University Hospital, Turku, FinlandUniversity of Turku, Turku, FinlandBiotechnology Unit, Department of Life technologies, University of Turku, Turku, FinlandBiotechnology Unit, Department of Life technologies, University of Turku, Turku, FinlandClinical Chemistry, TYKS Turku University Hospital, Turku, FinlandClinical Chemistry, TYKS Turku University Hospital, Turku, FinlandUniversity of Turku, Turku, FinlandUniversity of Turku, Turku, FinlandBiotechnology Unit, Department of Life technologies, University of Turku, Turku, FinlandObjectives Elevations of cardiac troponin T (cTnT) levels are common after strenuous exercise. We assessed whether the composition of cTnT release after marathon race differs from that of acute myocardial infarction (MI).Methods Troponin composition was analysed in plasma samples taken from 45 runners after marathon race and from 84 patients with type 1 MI. The concentration of long cTnT (intact and mildly fragmented cTnT) was measured with a novel upconversion luminescence immunoassay, total cTnT with a commercial high-sensitivity cTnT assay, and the ratio of long to total cTnT (troponin ratio) was determined as a measure of troponin fragmentation.Results Total cTnT exceeded the upper reference limit (>14 ng/L) in 37 (82%) runners. Troponin ratio was lower in runners ((IQR) 0.17 (0.11–0.24) vs 0.62 (0.29–0.96), p<0.001). With increasing troponin release the troponin ratio decreased (r=−0.497, p<0.001) in marathon runners and the concentration of long cTnT remained in all runners below 8.4 ng/L. In contrast to marathon runners, troponin ratio increased (r=0.565, p<0.001) with the increase of cTnT release in patients with MI. The median total and long cTnT concentrations were lower in marathon runners than in patients with MI (25 ng/L vs 835 ng/L and 4.1 vs 385 ng/L, p<0.001 for both).Conclusion In contrast to type 1 MI, only a small fraction of circulating cTnT exists as intact cTnT or long molecular forms after strenuous exercise and the difference in troponin composition is more pronounced in runners with higher troponin release.Trial registration number NCT06000930.https://openheart.bmj.com/content/11/2/e002954.full
spellingShingle Olli J Heinonen
K E Juhani Airaksinen
Konsta Teppo
Tuomas Paana
Tuija Vasankari
Selma Salonen
Tuulia Tuominen
Anna Linko-Parvinen
Hanna-Mari Pallari
Tapio Hellman
Samuli Jaakkola
Saara Wittfooth
Composition of cardiac troponin release differs after marathon running and myocardial infarction
Open Heart
title Composition of cardiac troponin release differs after marathon running and myocardial infarction
title_full Composition of cardiac troponin release differs after marathon running and myocardial infarction
title_fullStr Composition of cardiac troponin release differs after marathon running and myocardial infarction
title_full_unstemmed Composition of cardiac troponin release differs after marathon running and myocardial infarction
title_short Composition of cardiac troponin release differs after marathon running and myocardial infarction
title_sort composition of cardiac troponin release differs after marathon running and myocardial infarction
url https://openheart.bmj.com/content/11/2/e002954.full
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