بررسی تاثیر فعالیت بدنی بر تروپونین‌های قلبی: یک مرور سیستماتیک

نوع مقاله : مقاله مروری Released under CC BY 4.0 license I Open Access I

نویسندگان

1 استادیار، گروه فیزیولوژی ورزشی، واحد کرمانشاه، دانشگاه آزاد اسلامی، کرمانشاه، ایران.

2 دانشجوی دکتری فیزیولوژی ورزشی، واحد کرمانشاه، دانشگاه آزاد اسلامی، کرمانشاه، ایران.

3 متخصص قلب و عروق، فلوشیپ اینترونشنال کاردیولوژی، استادیار و عضو هیئت علمی دانشگاه علوم پزشکی کرمانشاه، مرکز تحقیقات قلب و عروق،

10.22049/jahssp.2021.27158.1346

چکیده

هدف: انفارکتوس حاد میوکارد از شایع­ترین بیماری­های قلبی است، تروپونین I و تروپونین T نشانگرهای زیستی برای تشخیص نکروز سلول­های قلبی در بیماران مبتلا به سندرم کرونری حاد هستند. علاوه بر سکته قلبی، ورزش و فعالیت بدنی شدید می­تواند باعث افزایش حاد تروپونین I و تروپونین T شود. هدف از پژوهش حاضر، مروری سیستماتیک بر روی مطالعات انجام شده جهت بررسی اثر فعالیت­های بدنی و ورزش بر تروپونین­های قلبی می­باشد. روش شناسی: مطالعات مربوط به پاسخ تروپونین I و تروپونین T به ورزش و فعالیت­های بدنی در مقالات منتشر شده را در Springer, Hindawi,PubMed,Google Scholar, Scopus,  ,SID وISC  با استفاده از کلید واژه­های Exercise induced troponin, Exercise-induced cardiac injury, Troponin release, Exercise and troponin و Myocardial infarction and troponin جستجو کردیم. یافته­ها: در مطالعات مربوط به مسابقات ماراتن، 11 مطالعه بررسی شد، تعداد آزمودنی­ها 881 نفر بودند، در 67 درصد افراد ، افزایش تروپونین مشاهده شده است، در مسابقات دو استقامتی 4 مقاله بررسی شد، تعداد ورزشکاران 118 نفر بودند، که در 65 درصد افراد افزایش تروپونین دیده شده است. در 5 مطالعه در ارتباط با تاثیر پیاده روی بر تروپونین، 194 ورزشکار تحت مطالعه قرار گرفته­اند که در 8 درصد موارد افزایش تروپونین مشاهده شده است. در بررسی 3 مطالعه در ورزش سه گانه مردان هم، 58 نفر تحت مطالعه قرار گرفتند که در 69 درصد موارد افزایش تروپونین رخ داده است. همچنین در 5 مطالعه­ی تاثیر ورزش دوچرخه سواری بر تروپونین، 94 نفر تحت مطالعه قرار گرفتند که در 27 درصد از ورزشکاران افزایش تروپونین دیده شده است. نتیجه گیری: تروپونین I و تروپونین T در ورزش طولانی مدت یا شدید بایستی به دقت بررسی شود، هر چه شدت و زمان ورزش بیشتر باشد، افزایش تروپونین نیز بیشتر است. در چنین مواقعی احتمال خطر سکته قلبی وجود دارد. آگاهی از تفاوت زمان تقریبی افزایش و کاهش تروپونین بعد از سکته قلبی و ورزش می­تواند در تشخیص پاتولوژیک یا فیزیولوژیک بودن افزایش تروپونین کمک کننده باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Investigation Effect of Exercise and Physical Activity on Cardiac Troponins: A Systematic Review

نویسندگان [English]

  • Mehran Ghahramani 1
  • Peyman Kaikhosro Doulatyari 2
  • Mohammad Rouzbahani 3
1 Assistant Professor , Department of Exercise Physiology,Kermanshah Branch, Islamic Azad University, Kermanshah, Iran
2 Ph.D Student Department of Exercise Physiology, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran.
3 Interventional cardiologist, assistant professor of Cardiology Kermanshah University of Medical Sciences, Cardiovascular Reserch Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
چکیده [English]

Aim:  Acute myocardial infarction is one of the most common heart diseases. Troponin I and troponin T are biomarkers for the diagnosis of cardiac cell necrosis in patients with acute coronary syndrome.In addition to myocardial infarction, exercise and strenuous physical activity can cause acute increases in troponin I and troponin T. The purpose of this study was to provide a systematic review of studies on the effects of physical activity and exercise on cardiac troponins. Methods: Search for studies on troponin I and troponin T in exercise and physical activity in the reputable databases Springer, Hindawi, PubMed, Google Scholar, Scopus, SID and ISC using the keyword Exercise induced troponin, Exercise-induced cardiac injury, Troponin release, Exercise and troponin, and Myocardial infarction and troponin were performed. Results: In a review of marathon studies showing 11 studies were reviewed, the number of athletes was 881, in 593 (67%), increase in troponin was observed, In the endurance Running competitions with the mentioned conditions, 4 articles were reviewed, The number of athletes was 118, with a 65% increase in troponin. In 5 studies related to the effect of walking on troponin, 194 athletes were studied, which in 8% of cases showed increase in troponin. In a review of three studies in the Ironman Triathlon, 58 athletes were studied, with a 69% increase in troponin. Also, in 5 studies on the effect of cycling exercise on troponin, 94 athletes were studied, As a result, increase in troponin was seen in 27% of athletes. Conclusion: Troponin I and troponin T in prolonged or strenuous exercise should be monitored carefully. The more intense and time the exercise, The increase in troponin is also greater. In such cases, there is a risk of Myocardial infarction. Knowing the difference between the approximate time of increase and decrease of troponin after myocardial infarction and exercise can be helpful in diagnosing whether the increase in troponin is pathological or physiological.

کلیدواژه‌ها [English]

  • Myocardial infarction
  • Physical Activity
  • troponin I
  • Troponin T
  1. rgarfard M, Basati F, Sadeghi M, Rouzbehani R, Golabchi A. Effects of a Cardiac Rehabilitation Program on Diastolic Filling Properties and Functional Capacity in Patients with Myocardial Infarction. Journal of Isfahan Medical School.2011;29(131).
  2.  Amirian Z, Jalali R, Rigi F, Nadery A, Amirian M, Salehi S. Comparison of the quality of life in patients after coronary artery bypass graft surgery (CABG) in the rural and urban communities. Journal of Kermanshah University of Medical Sciences.2014;18(4).
  3. Fortier A, Gullapalli V, Mirshams RA. Review of biomechanical studies of arteries and their effect on stent performance. IJC Heart & Vessels.2014;4:8-12.
  4. Salari N, Doulatyari PK, Daneshkhah A, Vaisi-Raygani A, Jalali R, kord Jamshidi P, et al. The prevalence of metabolic syndrome in cardiovascular patients in Iran: a systematic review and meta-analysis. Diabetology & Metabolic Syndrome.2020;12(1):1-10.
  5.  Razaghi A, Sadeghi H. Effect of Exercise-based Cardiac Rehabilitation on Coronary Artery Biomechanical Variables in Atherosclerotic Patients: A Systematic Review Study.2020.
  6. Guidelines ESCCfP, Jeroen JB, Helmut B, Claudio C, Veronica D, Christi D, et al. Third universal definition of myocardial infarction. Journal of the American College of Cardiology. 2012;60(16):1581-98.
  7. Mohayyer GA, Nakhostin RB, Bolboli L. The effect of two different intensities of aerobic exercise on myocardial injury Biomarkers in non-athletes middle-aged males2019.
  8. Aakre KM, Omland T. Physical activity, exercise and cardiac troponins: clinical implications. Progress in cardiovascular diseases.2019;62(2):108-115.
  9.  Thygesen K, Alpert JS, White HD, Task Force Members: Chairpersons: Kristian Thygesen JSAHDW, Biomarker Group: Allan S. Jaffe CFSAMGHAKLKNJR, Ecg Group: Bernard Chaitman C-oPMCMDHHPP, et al. Universal definition of myocardial infarction. circulation. 2007;116(22):2634-53.
  10. Lippi G, Impellizzeri F, Salvagno GL, Mion M, Zaninotto M, Cervellin G, et al. Kinetics of highly sensitive troponin I and T after eccentric exercise. Clinical Chemistry and Laboratory Medicine (CCLM).2010;48(11)1677-9.
  11.  Lippi G, Banfi G. Exercise-related increase of cardiac troponin release in sports: An apparent paradox finally elucidated? Clinica chimica acta; international journal of clinical chemistry. 2010;4111(7-8):610-1.
  12. Dixon JB. The effect of obesity on health outcomes. Molecular and cellular endocrinology.2010;316(2);104-8.
  13.  Gresslien T, Agewall S. Troponin and exercise. International journal of cardiology. 2016;221:609-21.
  14. Sabatine MS, Morrow DA, de Lemos JA, Jarolim P, Braunwald E. Detection of acute changes in circulating troponin in the setting of transient stress test-induced myocardial ischaemia using an ultrasensitive assay: results from TIMI 35. European heart journal.2009;(2)162-9.
  15. Røsjø H, Kravdal G, Høiseth AD, Jørgensen M, Badr P, Røysland R, et al. Troponin I measured by a high-sensitivity assay in patients with suspected reversible myocardial ischemia: data from the Akershus Cardiac Examination (ACE) 1 study. Clinical chemistry.2012;58(11)1565-73.
  16. Lear SA, Brozic A, Myers JN, Ignaszewski A. Exercise Stress Testing. An Overview of Current Guidelines. Sports medicine (Auckland, NZ). 1999;27(5);285-312.
  17. O'Hanlon R, Wilson M, Wage R, Smith G, Alpendurada FD, Wong J, et al. Troponin release following endurance exercise: is inflammation the cause? a cardiovascular magnetic resonance study. Journal of Cardiovascular Magnetic Resonance.2010;12(1):1-7.
  18. Wilson M, O'Hanlon R, Prasad S, Oxborough D, Godfrey R, Alpendurada F, et al. Biological markers of cardiac damage are not related to measures of cardiac systolic and diastolic function using cardiovascular magnetic resonance and echocardiography after an acute bout of prolonged endurance exercise. British journal of sports medicine.2011;45(10)780-4.
  19. Shave R, Dawson E, Whyte G, George K, Ball D, Collinson P, et al. The cardiospecificity of the third-generation cTnT assay after exercise-induced muscle damage. Medicine and science in sports and exercise.2002;34(4):651-4.
  20. Mazzeschi C, Piana N, Capezzali D, Mommi A, Aiello C, Gatti M, et al. The impact of strenuous group physical activity on mood states, personal views, body composition, and markers of myocardial damage in overweight/obese adults: The “Step-by-step Italy’s coast to coast” trek. BioMed research international. 2014;
  21. Planer D, Leibowitz D, Hadid A, Erlich T, Sharon N, Paltiel O, et al. The effect of prolonged physical activity performed during extreme caloric deprivation on cardiac function. PLoS One. 2012;7(2):e31266.
  22. Boos CJ, Mellor A, Begley J, Stacey M, Smith C, Hawkins A, et al. The effects of exercise at high altitude on high-sensitivity cardiac troponin release and associated biventricular cardiac function. Clinical Research in Cardiology.2014;103(4):291-9.
  23.  Eijsvogels T, George K, Shave R, Gaze D, Levine BD, Hopman MTE, et al. Effect of prolonged walking on cardiac troponin levels. The American journal of cardiology.2010;105(2)267-72.
  24. Tulloh L, Robinson D, Patel A, Ware A, Prendergast C, Sullivan D, et al. Raised troponin T and echocardiographic abnormalities after prolonged strenuous exercise-the Australian ironman triathlon. British Journal of Sports Medicine. 2006;40(7)605-9.
  25. Rifai N, Douglas PS, O’Toole M, Rimm E, Ginsburg GS. Cardiac troponin T and I, electrocardiographic wall motion analyses, and ejection fractions in athletes participating in the Hawaii Ironman Triathlon. The American journal of cardiology. 1999;83(7)1085-9.
  26. Shave R, Dawson E, Whyte G, George K, Nimmo M, Layden J, et al. The impact of prolonged exercise in a cold environment upon cardiac function. Medicine and science in sports and exercise. 2004;36(9);1522-7.
  27. Bonetti A, Tirelli F, Albertini R, Monica C, Monica M, Tredici G. Serum cardiac troponin T after repeated endurance exercise events. International Journal of Sports Medicine.1996;17(4);259-62.
  28.  Shave R, George KP, Atkinson G, Hart E, Middleton N, Whyte G, et al. Exercise-induced cardiac troponin T release: a meta-analysis. Medicine and science in sports and exercise. 2007;39(12)2099-106.
  29. Sedaghat-Hamedani F, Kayvanpour E, Frankenstein L, Mereles D, Amr A, Buss S, et al. Biomarker changes after strenuous exercise can mimic pulmonary embolism and cardiac injury—a metaanalysis of 45 studies. Clinical chemistry. 2015; 61(10)1246-55.
  30. Regwan S, Hulten EA, Martinho S, Slim J, Villines TC, Mitchell J, et al. Marathon running as a cause of troponin elevation: a systematic review and meta‐analysis. Journal of interventional cardiology. 2010;23(5);443-50.
  31. Vilela EM, Bastos JC, Rodrigues RP, Nunes JP. High-sensitivity troponin after running--a systematic review. Neth J Med. 2014;72(1):5-9.
  32. Serrano‐Ostáriz E, Terreros‐Blanco JL, Legaz‐Arrese A, George K, Shave R, Bocos‐Terraz P, et al. The impact of exercise duration and intensity on the release of cardiac biomarkers. Scandinavian journal of medicine & science in sports.2011;21(2):244-9.
  33.  Eijsvogels TMH, Fernandez AB, Thompson PD. Are there deleterious cardiac effects of acute and chronic endurance exercise? Physiological reviews.2016;96(1):99-125.
دوره 8، شماره 1
فروردین 1400
صفحه 12-20
  • تاریخ دریافت: 08 اسفند 1399
  • تاریخ بازنگری: 28 فروردین 1400
  • تاریخ پذیرش: 14 اردیبهشت 1400
  • تاریخ اولین انتشار: 14 اردیبهشت 1400