Strenuous and prolonged exercise like marathon, ultra running and triathlon can lead to changes in biomarkers of cardiac, muscle and kidney functional damage.

We present the data of 29 (15 male, 14 female) non-elite participants of the Kalmar Ironman 2015 3.8 km swimming, 180 km cycling, 42 km running). Pre-race electrocardiograms and echocardiograms showed a high frequency of abnormalities. Post race elevations of troponin T, creatine kinase, myoglobin, N-terminal pro b-type natriuretic peptide, aspartataminotransferas, creatinine and leucocytes returned to normal in almost all cases within 5-8 days. In 100% of male and 93% of female participants’ troponin T increase was compatible with the diagnosis of minor myocardial infarction. Some results are shown in the table (* denotes level of significance between male and female results).

                                           Before race         Directly after race        5-8 days after race

CK [µkat/L]                                      

male                                                 3.7 ± 2.1**       48,1 ± 44.1                4.5 ± 4.0

female                                   1.5 ± 0.7          30.5 ± 41.5                3.1 ± 3.6

Myoglobin [µg/L] 

male                                      58.3 ± 35.9        2449 ± 1923             51.3 ± 38.5

female                                    30.6 ± 11.0         1134 ± 756*             50.4 ± 67.7

Creatinine [µmol/L]

male                                       87.4 ± 11.4         119.9 ± 23.4           85.1 ± 12.1

female                                     73.0 ± 13.4         84.1 ± 14.1***        69.6 ± 6.3

p-NT-proBNP [ng/L]

male                                        60.1 ± 25.2          658.7 ± 354.9        61.9 ± 22.7

female                                      95.5 ± 69.5          907.9 ± 433.1        76.9 ± 26.9

Troponin T [ng/L]

male                                         8.5 ± 4.3             68.1 ± 41.1           7.4 ± 4.4

female                                       7.1 ± 4.9             54.3 ± 49.5           5.8 ± 1.7

The results will be discussed in the light of the current literature and the so far unanswered question about the long-term significance of repetitive organ damage due to strenuous exercise. Long-term follow-up of these athletes is needed.