Korean J Sports Med.  2018 Sep;36(3):135-142. 10.5763/kjsm.2018.36.3.135.

Effects of Super-Ultramarathon Races (622 km) on Cardiac Bio-Markers and Markers of Muscle Damage

  • 1Department of Clinical Laboratory Science, Shinsung University, Dangjin, Korea.
  • 2Department of Rehabilitation Medicine, Sanggye-Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 3Department of Exercise Rehabilitation Welfare, Soojung Campus, Sungshin University, Seoul, Korea. kyj87@sungshin.ac.kr


Changes in serum biomarkers of cardiac and muscle damage have been studied in ultra-marathon runners for distances up to 308 km. We investigated these biomarker changes following a 622-km super-ultramarathon race.
A group of men with a mean age of 52.7±4.8 years participated. Blood samples were obtained pre-race, during the race, and post-race, to analyze the aforementioned biomarkers.
Creatine kinase and creatine kinase-MB (CK-MB) levels increased during the race, and both steadily declined post-race with CK-MB declining at a slower rate. Lactic acid dehydrogenase levels overall were increased over pre-race levels. White blood cell counts increased during the race. Red blood cell decreased from pre-race to 300 km and 622 km. Platelet increased only in the recovery period. High-sensitivity C-reactive protein levels were increased throughout the race and at day 3 compared to pre-race levels. Cardiac troponin I (cTnI) levels increased during the race. N-terminal pro b-type natriuretic peptide (NT-proBNP) levels increased during the race.
The rise in cTnI was not clinically significant, and highly elevated NT-proBNP levels during the race indicates that myocardial burden rose linearly as running distance increased. However, no clinical risk was found as most of the markers returned to normal range during the recovery.


Creatine kinase; Creatine Kinase-MB; N-terminal pro-BNP; Rhabdomyolysis
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