{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:06:17Z","timestamp":1793412377741,"version":"4.5.0"},"reference-count":12,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Finnish Foundation for Cardiovascular Research, Helsinki, Finland"},{"name":"Turku University Hospital, Turku, Finland"},{"name":"Finnish Society of Clinical Chemistry, Helsinki, Finland"},{"name":"Turku University Foundation, Turku, Finland"},{"DOI":"10.13039\/501100005609","name":"University of Turku","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005609","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Finnish Cultural Foundation, Turku, Finland"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2024,10,22]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"\n Objectives<\/jats:title>\n 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).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Total cTnT exceeded the upper reference limit (>14\u2009ng\/L) in 37 (82%) runners. Troponin ratio was lower in runners ((IQR) 0.17 (0.11\u20130.24) vs 0.62 (0.29\u20130.96), p<0.001). With increasing troponin release the troponin ratio decreased (r=\u22120.497, p<0.001) in marathon runners and the concentration of long cTnT remained in all runners below 8.4\u2009ng\/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\u2009ng\/L vs 835\u2009ng\/L and 4.1 vs 385\u2009ng\/L, p<0.001 for both).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT06000930<\/jats:ext-link>.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/openhrt-2024-002954","type":"journal-article","created":{"date-parts":[[2024,11,17]],"date-time":"2024-11-17T21:55:15Z","timestamp":1731880515000},"page":"e002954","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Composition of cardiac troponin release differs after marathon running and myocardial infarction"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct06000930","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06000930","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04465591","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct05858112","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0193-568X","authenticated-orcid":false,"given":"K E Juhani","family":"Airaksinen","sequence":"first","affiliation":[{"name":"University of Turku, Turku, Finland"},{"name":"Heart Centre, Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomas","family":"Paana","sequence":"additional","affiliation":[{"name":"Heart Centre, Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuija","family":"Vasankari","sequence":"additional","affiliation":[{"name":"University of Turku, Turku, Finland"},{"name":"Heart Centre, Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7941-5951","authenticated-orcid":false,"given":"Selma","family":"Salonen","sequence":"additional","affiliation":[{"name":"Biotechnology Unit, Department of Life technologies, University of Turku, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6239-4348","authenticated-orcid":false,"given":"Tuulia","family":"Tuominen","sequence":"additional","affiliation":[{"name":"Biotechnology Unit, Department of Life technologies, University of Turku, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Linko-Parvinen","sequence":"additional","affiliation":[{"name":"Clinical Chemistry, TYKS Turku University Hospital, Turku, Finland"},{"name":"Department of Clinical Chemistry, University of Turku, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna-Mari","family":"Pallari","sequence":"additional","affiliation":[{"name":"Clinical Chemistry, TYKS Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tapio","family":"Hellman","sequence":"additional","affiliation":[{"name":"University of Turku, Turku, Finland"},{"name":"Kidney Centre, Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konsta","family":"Teppo","sequence":"additional","affiliation":[{"name":"University of Turku, Turku, Finland"},{"name":"Heart Centre, Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli J","family":"Heinonen","sequence":"additional","affiliation":[{"name":"Paavo Nurmi Centre & Department of Physical Activity and Health, University of Turku, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5944-6814","authenticated-orcid":false,"given":"Samuli","family":"Jaakkola","sequence":"additional","affiliation":[{"name":"University of Turku, Turku, Finland"},{"name":"Heart Centre, Turku University Hospital, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7886-3477","authenticated-orcid":false,"given":"Saara","family":"Wittfooth","sequence":"additional","affiliation":[{"name":"Biotechnology Unit, Department of Life technologies, University of Turku, Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,11,17]]},"reference":[{"key":"2025081612280098000_11.2.e002954.1","doi-asserted-by":"crossref","unstructured":"Thygesen K , Alpert JS , Jaffe AS , et al . Fourth universal definition of myocardial infarction (2018). Eur Heart J 2018. doi:10.1093\/eurheartj\/ehy462","DOI":"10.1161\/CIR.0000000000000617"},{"key":"2025081612280098000_11.2.e002954.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2019.08.019"},{"key":"2025081612280098000_11.2.e002954.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.056208"},{"key":"2025081612280098000_11.2.e002954.4","doi-asserted-by":"publisher","DOI":"10.1373\/jalm.2018.027144"},{"key":"2025081612280098000_11.2.e002954.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.060845"},{"key":"2025081612280098000_11.2.e002954.6","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1093\/clinchem\/hvae075","article-title":"Highly Sensitive Immunoassay for Long Forms of Cardiac Troponin T Using Upconversion Luminescence","volume":"70","author":"Salonen","year":"2024","journal-title":"Clin Chem"},{"key":"2025081612280098000_11.2.e002954.7","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2016.261644"},{"key":"2025081612280098000_11.2.e002954.8","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.200543"},{"key":"2025081612280098000_11.2.e002954.9","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2018.301127"},{"key":"2025081612280098000_11.2.e002954.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2019.12.020"},{"key":"2025081612280098000_11.2.e002954.11","doi-asserted-by":"crossref","first-page":"2103","DOI":"10.1007\/s00421-023-05282-5","article-title":"Exercise-induced myocardial damage is associated with cardiac edema and dysfunction: adding another piece to the troponin puzzle","volume":"123","author":"Eijsvogels","year":"2023","journal-title":"Eur J Appl Physiol"},{"key":"2025081612280098000_11.2.e002954.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2013.04.022"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2024-002954","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T19:28:08Z","timestamp":1755372488000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2024-002954"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,11,17]]},"published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1136\/openhrt-2024-002954"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2024-002954","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11]]}}}