Document Type : Original Article
Authors
1 MSc of Exercise Physiology, Payame Noor University, Tehran, Iran.
2 Assistant Professor of Exercise Physiology, Payame Noor University, Tehran, Iran.
Abstract
Background and Aim: The high concentration of myocardial damage markers against the relatively low concentration in non-cardiac tissue preserves the characteristics of the heart. The aim of this study was to investigate the effect of eight- week of exercise training in hypoxia with blood flow restriction on myocardial damage markers in active men. Materials and Methods: thirty active men from Ardabil city (mean age 38.56 ± 3.46 years and body mass index 24.45 ± 1.77 kg/m2) were randomly selected for a study. They were divided into three groups: a hypoxia aerobic training group (A-Hypo), a resistance training with blood flow restriction group (R-BFR), and a control group (Con) with 10 participants for all groups. Two exercise groups performed selected sport exercises under special conditions for eight weeks, three times a week. One group did hypoxic training (from 25 to 40 minutes) and the other group did exercise with blood flow restriction (from 50% to 85% of maximum repetitions). Plasma cardiac intracellular troponin T (cTnT), cardiac troponin I (cTnI), homocysteine (HCY) and LDL/HDL ratio were measured using standardized methods. Analysis of covariance, Benferroni, and paired t- tests were used to analyze the results at the level of p<0.05. Results: Exercise training in the hypoxia and blood flow restriction had a significant increase in cTnI, cTnT, HCY and LDL/HDL ratio in active men (p=0.001). Conclusion: Both interventions have been shown to improve the levels of myocardial damage factors such as cTnI, cTnT and HCY, which is associated with the prevalence of myocardial damage. As a result, these interventions may have adaptive effects on the myocardium of the heart.
Keywords
Afzalpour, M.E. (2007). Effects of two types of aerobic exercises on low density lipoprotein (LDL) oxidation and cardiovascular risk factors in non-active men. Journal of Birjand University of Medical Sciences, 14(3), 27-37. [In Persian]. http://journal.bums.ac.ir/article-1-150-en.html
Belmin, J. (2000). Prevention of cardiovascular disease in the elderly. Presse Medicale (Paris, France: 1983), 29(22),1234-9. https://doi.org/10.2165/00002512-200522100-00005
Blake, G., & Ridker, P. (2002). Inflammatory bio‐markers and cardiovascular risk prediction. Journal of Internal Medicine, 252(4), 283-94. https://doi.org/10.1046/j.1365-2796.2002.01019.x
Boos, C.J., Mellor, A., Begley, J., Stacey, M., Smith, C., Hawkins, A., … & Woods, D.R. (2014). The effects of exercise at high altitude on high-sensitivity cardiac troponin release and associated biventricular cardiac function. Clinical Research in Cardiology, 103(4), 291-9. https://doi.org/10.1007/s00392-013-0654-2
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R.L., Torre, L.A., …& Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal For Clinicians, 68(6), 394-424. https://doi.org/10.3322/caac.21492
Chambers, J.C., McGregor, A., Jean-Marie, J., Obeid, O.A., Kooner, J.S. (1999). Demonstration of rapid onset vascular endothelial dysfunction after hyperhomocysteinemia: an effect reversible with vitamin C therapy. Circulation, 99(9), 1156-60. https://doi.org/10.1161/01.cir.99.9.1156
Chen, C. (2021). Effects of exercise on myocardial damage and heart failure due to hypoxia induced by obstructive sleep apnea. International Journal of Gerontology. 15(1), 2-6. https://doi.org/10.6890/IJGE.202101_15(1).0001
Chen, Y., Serfass, R.C., Mackey-Bojack, S.M., Kelly, K.L., Titus, J.L., Apple, F.S. (2000). Cardiac troponin T alterations in myocardium and serum of rats after stressful, prolonged intense exercise. Journal of Applied Physiology, 88(5), 1749-55. https://doi.org/10.1152/jappl.2000.88.5.1749
Cleave, P., Boswell, T.D., Speedy, D.B., & Boswell, D.R. (2001). Plasma cardiac troponin concentrations after extreme exercise. Clinical Chemistry, 47(3), 608-10. https://doi.org/10.1093/clinchem/47.3.608
Cook, S.B., Clark, B.C., & Ploutz-Snyder, L.L. (2007). Effects of exercise load and blood-flow restriction on skeletal muscle function. Medicine and Science in Sports and Exercise, 39(10), 1708-13. https://doi.org/10.1249/mss.0b013e31812383d6
Daste Barhagh, H., Hovanloo, F., Ghorbani, O., & Bazgir, B. (2015). Effect of a period high intensity interval training in two condition hypoxia and normoxia on leukocyte and CBC in response incremental exercise. Sport Physiology, 7(25), 47-56. [In Persian]. https://doi.org/20.1001.1.2322164.1394.7.25.3.3
Deminice, R., Ribeiro, D.F., & Frajacomo, F.T.T. (2016). The effects of acute exercise and exercise training on plasma homocysteine: a meta-analysis. PloS One, 11(3) e0151653. https://doi.org/10.1371/journal.pone.0151653
Deminice, R., Vannucchi, H., Simões-Ambrosio, L.M., & Jordao, A.A. (2011). Creatine supplementation reduces increased homocysteine concentration induced by acute exercise in rats. European Journal of Applied Physiology, 111(11), 2663-70. https://doi.org/10.1007/s00421-011-1891-6
Dezhan, M., Azarbayjani, M.A., & Peeri, M. (2020). Effect of aerobic and octopamine supplementation on the expression of ACC and ACYL genes and HDL / LDL ratio in visceral visceral adipose tissue of DFO recipient. RJMS, 27(7), 109-119. [In Persian]. https://doi.org/10.22038/mjms.2021.19342
El-Magd, M.A., Abdo, W.S., El-Maddaway, M., Nasr, N.M., Gaber, R.A., El-Shetry, E.S., … & Abdelhady, D.H. (2017). High doses of S-methylcysteine cause hypoxia-induced cardiomyocyte apoptosis accompanied by engulfment of mitochondaria by nucleus. Biomedicine & Pharmacotherapy, 94, 589-97. https://doi.org/10.1016/j.biopha.2017.07.100
Fathi, M., & Pouryamehr, E. (2018). The effect of aerobic exercise on homocysteine, C-reactive protein and lipid profile in active and inactive men. Report of Health Care, 4(4), 38-46. [In Persian]. https://journals.marvdasht.iau.ir/article_3027.html
Ganguly, P., Alam, SF. (2015). Role of homocysteine in the development of cardiovascular disease. Nutrition Journal, 14(1), 1-10. https://doi.org/10.1186/1475-2891-14-6
Guo, Y. P., & Pan, S. S. (2022). Exercise preconditioning improves electrocardiographic signs of myocardial ischemic/hypoxic injury and malignant arrhythmias occurring after exhaustive exercise in rats. Scientific Reports, 12(1), 18772. https://doi.org/10.1038/s41598-022-23466-5
Hamedchaman, N.H., & Riahy, S. (2019). The effect of 8 weeks of combined, interval aerobic and continuous aerobic training on lipid profile, function and some cardiovascular inflammatory markers in 30-45-year-olds militaries in cold and mountainous climates. Journal of Military Medicine, 21(6), 606-17. [In Persian]. https://www.academia.edu/114748667/
Hao, Z., Pan, S. S., Shen, Y. J., & Ge, J. (2014). Exercise preconditioning-induced early and late phase of cardioprotection is associated with protein kinase C epsilon translocation. Circulation Journal, 78(7), 1636-1645. https://doi.org/10.1253/circj.cj-13-1525
Hosseini Kakhk, S.A.R., Zamand, P., Haghighi, A.H., & Khademosharie, M. (2015). Comparison of hormonal responses to strength training with and without blood flow restriction. Journal of Sport Biosciences, 7(3), 391-405. https://doi.org/10.22059/jsb.2015.56254
Huang, Y., Liu, H.T., Yuan, Y., Guo, Y-P., Wan, D-F., & Pan, S-S. (2021). Exercise preconditioning increases Beclin1 and induces autophagy to promote early myocardial protection via intermittent myocardial ischemia-hypoxia. International Heart Journal, 62(2), 407-15. https://doi.org/10.1536/ihj.20-597
Huang, Y., Pan, S.S., Guo, Y.P., Wang, J.Y., Wan, D.F., Chen, T.R., & Yuan, J.Q. (2021). Comparison of myocardial ischemic/hypoxic staining techniques for evaluating the alleviation of exhaustive exercise-induced myocardial injury by exercise preconditioning. Journal of Molecular Histology, 52, 373-383. https://doi.org/10.1007/s10735-021-09958-0
Humphrey, L.L., Fu, R., Rogers, K., Freeman, M., & Helfand, M. (2008). Homocysteine level and coronary heart disease incidence: a systematic review and meta-analysis. Mayo Clinic Proceedings Elsevier. https://doi.org/10.4065/83.11.1203
Jiang, H., Zhu, J., Liu, W., & Cao, F. (2017). High-sensitivity cardiac troponins I sandwich assay by immunomagnetic microparticle and quantum dots. Frontiers in Laboratory Medicine. 1(3):107-13. https://doi.org/10.1016/j.flm.2017.09.001
Joubert, L.M., & Manore, M.M. (2006). Exercise, nutrition, and homocysteine. International Journal of Sport Nutrition and Exercise Metabolism,16(4), 341-61. https://doi.org/10.1123/ijsnem.16.4.341
Kambič, T., Novaković, M., Tomažin, K., Strojnik, V., & Jug, B. (2019). Blood flow restriction resistance exercise improves muscle strength and hemodynamics, but not vascular function in coronary artery disease patients: a pilot randomized controlled trial. Frontiers in physiology, 10, 656. https://doi.org/10.3389/fphys.2019.00656
Karimi Ahmadabadi, Z., Nemati, J., Mousavinia, S.H … & Rezaei, R. (2022). Acute effect of single bout aerobic exercise with and without blood flow restriction on hemodynamic and coagulation indicators in hypertension disease. Journal of Sport and Exercise Physiology, 15(2), 52-63. https://doi.org/10.52547/joeppa.15.2.52
Kemp, M., Donovan, J., Higham, H., & Hooper, J. (2004). Biochemical markers of myocardial injury. British Journal of Anaesthesia, 93(1), 63-73. https://doi.org/10.1007/BF02912874
Korff, S., Katus, H. A., & Giannitsis, E. (2006). Differential diagnosis of elevated troponins. Heart, 92(7), 987-93. https://doi.org/10.1136/hrt.2005.071282
La Gerche, A., Boyle, A., Wilson, A., & Prior, D. (2004). No evidence of sustained myocardial injury following an Ironman distance triathlon. International Journal of Sports Medicine, 25(01), 45-9. https://doi.org/10.1055/s-2003-45236
Lammers, M.D., Anéli, N.M., de Oliveira, GG., de Oliveira, Maciel, SF., Zanini, D., … & Mânica, A (2020). The anti-inflammatory effect of resistance training in hypertensive women: the role of purinergic signaling. Journal of Hypertension, 38(12), 2490-500. https://doi.org/10.1097/HJH.0000000000002578 .
Li, J.Y., Pan, S.S., Wang, J.Y., & Lu, J. (2019). Changes in autophagy levels in rat myocardium during exercise preconditioning-initiated cardioprotective effects. International Heart Journal, 60(2), 419-428. https://doi.org/10.1536/ihj.18-310
Maroto-Sánchez, B., Lopez-Torres, O., Palacios, G., & González-Gross, M. (2016). What do we know about homocysteine and exercise? A review from the literature. Clinical Chemistry and Laboratory Medicine (CCLM), 54(10), 1561-1577. https://doi.org/10.1515/cclm-2015-1040
Morita, H., Kurihara, H., Yoshida, S., Saito, Y., Shindo, T., Oh-hashi, Y., … & Nagai, R. (2001). Diet-induced hyperhomocysteinemia exacerbates neointima formation in rat carotid arteries after balloon injury. Circulation, 103(1), 133-9. https://doi.org/10.1161/01.cir.103.1.133
Niazi, S., Mirdar, S., Bazar, R., Hamidian, G., & Talebi, V. (2021) Evaluation of hif-1α response and the rate of bronchial and bronchiole apoptosis in lung tissue of male wistar rats in case of decreased exercise load and hypobaric hypoxia conditions belonging to high-intensity interval training. Studies in Medical Sciences, 32(6), 437-47. [In Persian]. https://doi.org/10.52547/umj.32.6.437
Negaresh, R., Ranjbar, R., Gharibvand, MMm., Habibi, A., & Moktarzade, M. (2017). Effect of 8-week resistance training on hypertrophy, strength, and myostatin concentration in old and young men. Iranian Journal of Ageing, 12(1), 56-67. [In Persian]. https://doi.org/10.21859/sija-120154
Nemati, M., Tahmasebi, W., & Azizi, M. (2020). Influences of normobaric hypoxia training on Apelin serum levels and insulin resistance in healthy overweight men. Sport Physiology, 11(44), 73-88. [In Persian]. https://doi.org/10.22089/spj.2020.6936.1953
Neuman, J.C., Albright, K.A., Schalinske, K.L. (2013). Exercise prevents hyperhomocysteinemia in a dietary folate-restricted mouse model. Nutrition Research. 33(6), 487-93. https://doi.org/10.1016/j.nutres.2013.04.008
Olkowicz, M., Tomczyk, M., Debski, J., Tyrankiewicz, U., Przyborowski, K., Borkowski, T., ... & Smolenski, R. T. (2021). Enhanced cardiac hypoxic injury in atherogenic dyslipidaemia results from alterations in the energy metabolism pattern. Metabolism, 114, 154400. https://doi.org/10.1016/j.metabol.2020.154400
Paganelli, F., Mottola, G., Fromonot, J., Marlinge, M., Deharo, P., Guieu, R., … & Ruf, J. (2021). Hyperhomocysteinemia and cardiovascular disease: Is the adenosinergic system the missing link? International Journal of Molecular Sciences, 22(4), 1690. https://doi.org/10.3390/ijms22041690
Parra, V. M., Macho, P., Sánchez, G., Donoso, P., & Domenech, R.J. (2015). Exercise preconditioning of myocardial infarct size in dogs is triggered by calcium. Journal of cardiovascular pharmacology, 65(3), 276-281. https://doi.org/10.1097/FJC.0000000000000191
Patterson, SD., Hughes, L., Warmington, S., Burr, J., Scott, BR.,…& Owens, J. (2019). Blood flow restriction exercise: considerations of methodology, application, and safety. Frontiers in Physiology, 10, 533. https://doi.org/10.3389/fphys.2019.00533
Peeri, M., & Azarbayjani, M.A. (2018). Effect of different resistance training modes on appetite and serum orexin, ghrelin, and neuropeptide Y levels in sedentary healthy males. Medical Journal of Mashhad University of Medical Sciences, 60(6), 804-15. [In Persian]. https://doi.org/10.22038/mjms.2018.10787
Ping, Z., Zhang, L.F., Cui, Y.J., Chang, Y.M., Jiang, C.W., Meng, Z.Z., ... & Cao, X.B. (2015). The protective effects of salidroside from exhaustive exercise-induced heart injury by enhancing the PGC-1α–NRF1/NRF2 pathway and mitochondrial respiratory function in rats. Oxidative Medicine and Cellular Longevity, 2015. https://doi.org/10.1155/2015/876825
Planellas, M., Cuenca, R., Tabar, M-D., Bertolani, C., Poncet, C.,…& Closa, J.M. (2012). Evaluation of C-reactive protein, Haptoglobin and cardiac troponin 1 levels in brachycephalic dogs with upper airway obstructive syndrome. BMC Veterinary Research, 8(1), 1-7. https://doi.org/10.1186/1746-6148-8-152
Renzi, C.P., Tanaka, H., & Sugawara, J. (2006). Effects of leg blood flow restriction during walking on cardiovascular function. Medicine and Science in Sports and Exercise, 42(4), 726. https://doi.org/10.1249/MSS.0b013e3181bdb454
Scott, B.R., Peiffer, J.J., Thomas, H.J., Marston, K.J., & Hill, K,D. (2018). Hemodynamic responses to low-load blood flow restriction and unrestricted high-load resistance exercise in older women. Frontiers in Physiology, 9, 1324. https://doi.org/10.3389/fphys.2018.01324
Sotgia, S., Carru, C., Caria, M.A., Tadolini, B., Deiana, L., Zinellu, A. (2007). Acute variations in homocysteine levels are related to creatine changes induced by physical activity. Clinical Nutrition, 26(4), 444-9. https://doi.org/10.1016/j.clnu.2007.05.003
Thijssen, D.H., Redington, A., George, K.P., Hopman, M.T., & Jones, H. (2018). Association of exercise preconditioning with immediate cardioprotection: a review. JAMA Cardiology, 3(2), 169-176. https://doi.org/10.1001/jamacardio.2017.4495
Thomas, H., Scott, B., & Peiffer, J. (2018). Acute physiological responses to low-intensity blood flow restriction cycling. Journal of Science and Medicine in Sport, 21(9), 969-74. https://doi.org/10.1016/j.jsams.2018.01.013 .
Woods, D.R., O’Hara, J.P., Boos, C.J., Hodkinson, P.D., Tsakirides, C.,.& Hill, N.E (2017). Markers of physiological stress during exercise under conditions of normoxia, normobaric hypoxia, hypobaric hypoxia, and genuine high altitude. European Journal of Applied Physiology, 117(5), 893-900. https://doi.org/10.1007/s00421-017-3573-5
Wooten, S.V., Stray-Gundersen, S., & Tanaka H. (2020). Hemodynamic and pressor responses to combination of yoga and blood flow restriction. International Journal of Sports Medicine, 41(11), 759-65. https://doi.org/10.1055/a-1171-1620
Wu, A.H. (2017). Release of cardiac troponin from healthy and damaged myocardium. Frontiers in Laboratory Medicine, 1(3), 144-50. https://doi.org/10.1055/a-1171-1620
Belmin, J. (2000). Prevention of cardiovascular disease in the elderly. Presse Medicale (Paris, France: 1983), 29(22),1234-9. https://doi.org/10.2165/00002512-200522100-00005
Blake, G., & Ridker, P. (2002). Inflammatory bio‐markers and cardiovascular risk prediction. Journal of Internal Medicine, 252(4), 283-94. https://doi.org/10.1046/j.1365-2796.2002.01019.x
Boos, C.J., Mellor, A., Begley, J., Stacey, M., Smith, C., Hawkins, A., … & Woods, D.R. (2014). The effects of exercise at high altitude on high-sensitivity cardiac troponin release and associated biventricular cardiac function. Clinical Research in Cardiology, 103(4), 291-9. https://doi.org/10.1007/s00392-013-0654-2
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R.L., Torre, L.A., …& Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal For Clinicians, 68(6), 394-424. https://doi.org/10.3322/caac.21492
Chambers, J.C., McGregor, A., Jean-Marie, J., Obeid, O.A., Kooner, J.S. (1999). Demonstration of rapid onset vascular endothelial dysfunction after hyperhomocysteinemia: an effect reversible with vitamin C therapy. Circulation, 99(9), 1156-60. https://doi.org/10.1161/01.cir.99.9.1156
Chen, C. (2021). Effects of exercise on myocardial damage and heart failure due to hypoxia induced by obstructive sleep apnea. International Journal of Gerontology. 15(1), 2-6. https://doi.org/10.6890/IJGE.202101_15(1).0001
Chen, Y., Serfass, R.C., Mackey-Bojack, S.M., Kelly, K.L., Titus, J.L., Apple, F.S. (2000). Cardiac troponin T alterations in myocardium and serum of rats after stressful, prolonged intense exercise. Journal of Applied Physiology, 88(5), 1749-55. https://doi.org/10.1152/jappl.2000.88.5.1749
Cleave, P., Boswell, T.D., Speedy, D.B., & Boswell, D.R. (2001). Plasma cardiac troponin concentrations after extreme exercise. Clinical Chemistry, 47(3), 608-10. https://doi.org/10.1093/clinchem/47.3.608
Cook, S.B., Clark, B.C., & Ploutz-Snyder, L.L. (2007). Effects of exercise load and blood-flow restriction on skeletal muscle function. Medicine and Science in Sports and Exercise, 39(10), 1708-13. https://doi.org/10.1249/mss.0b013e31812383d6
Daste Barhagh, H., Hovanloo, F., Ghorbani, O., & Bazgir, B. (2015). Effect of a period high intensity interval training in two condition hypoxia and normoxia on leukocyte and CBC in response incremental exercise. Sport Physiology, 7(25), 47-56. [In Persian]. https://doi.org/20.1001.1.2322164.1394.7.25.3.3
Deminice, R., Ribeiro, D.F., & Frajacomo, F.T.T. (2016). The effects of acute exercise and exercise training on plasma homocysteine: a meta-analysis. PloS One, 11(3) e0151653. https://doi.org/10.1371/journal.pone.0151653
Deminice, R., Vannucchi, H., Simões-Ambrosio, L.M., & Jordao, A.A. (2011). Creatine supplementation reduces increased homocysteine concentration induced by acute exercise in rats. European Journal of Applied Physiology, 111(11), 2663-70. https://doi.org/10.1007/s00421-011-1891-6
Dezhan, M., Azarbayjani, M.A., & Peeri, M. (2020). Effect of aerobic and octopamine supplementation on the expression of ACC and ACYL genes and HDL / LDL ratio in visceral visceral adipose tissue of DFO recipient. RJMS, 27(7), 109-119. [In Persian]. https://doi.org/10.22038/mjms.2021.19342
El-Magd, M.A., Abdo, W.S., El-Maddaway, M., Nasr, N.M., Gaber, R.A., El-Shetry, E.S., … & Abdelhady, D.H. (2017). High doses of S-methylcysteine cause hypoxia-induced cardiomyocyte apoptosis accompanied by engulfment of mitochondaria by nucleus. Biomedicine & Pharmacotherapy, 94, 589-97. https://doi.org/10.1016/j.biopha.2017.07.100
Fathi, M., & Pouryamehr, E. (2018). The effect of aerobic exercise on homocysteine, C-reactive protein and lipid profile in active and inactive men. Report of Health Care, 4(4), 38-46. [In Persian]. https://journals.marvdasht.iau.ir/article_3027.html
Ganguly, P., Alam, SF. (2015). Role of homocysteine in the development of cardiovascular disease. Nutrition Journal, 14(1), 1-10. https://doi.org/10.1186/1475-2891-14-6
Guo, Y. P., & Pan, S. S. (2022). Exercise preconditioning improves electrocardiographic signs of myocardial ischemic/hypoxic injury and malignant arrhythmias occurring after exhaustive exercise in rats. Scientific Reports, 12(1), 18772. https://doi.org/10.1038/s41598-022-23466-5
Hamedchaman, N.H., & Riahy, S. (2019). The effect of 8 weeks of combined, interval aerobic and continuous aerobic training on lipid profile, function and some cardiovascular inflammatory markers in 30-45-year-olds militaries in cold and mountainous climates. Journal of Military Medicine, 21(6), 606-17. [In Persian]. https://www.academia.edu/114748667/
Hao, Z., Pan, S. S., Shen, Y. J., & Ge, J. (2014). Exercise preconditioning-induced early and late phase of cardioprotection is associated with protein kinase C epsilon translocation. Circulation Journal, 78(7), 1636-1645. https://doi.org/10.1253/circj.cj-13-1525
Hosseini Kakhk, S.A.R., Zamand, P., Haghighi, A.H., & Khademosharie, M. (2015). Comparison of hormonal responses to strength training with and without blood flow restriction. Journal of Sport Biosciences, 7(3), 391-405. https://doi.org/10.22059/jsb.2015.56254
Huang, Y., Liu, H.T., Yuan, Y., Guo, Y-P., Wan, D-F., & Pan, S-S. (2021). Exercise preconditioning increases Beclin1 and induces autophagy to promote early myocardial protection via intermittent myocardial ischemia-hypoxia. International Heart Journal, 62(2), 407-15. https://doi.org/10.1536/ihj.20-597
Huang, Y., Pan, S.S., Guo, Y.P., Wang, J.Y., Wan, D.F., Chen, T.R., & Yuan, J.Q. (2021). Comparison of myocardial ischemic/hypoxic staining techniques for evaluating the alleviation of exhaustive exercise-induced myocardial injury by exercise preconditioning. Journal of Molecular Histology, 52, 373-383. https://doi.org/10.1007/s10735-021-09958-0
Humphrey, L.L., Fu, R., Rogers, K., Freeman, M., & Helfand, M. (2008). Homocysteine level and coronary heart disease incidence: a systematic review and meta-analysis. Mayo Clinic Proceedings Elsevier. https://doi.org/10.4065/83.11.1203
Jiang, H., Zhu, J., Liu, W., & Cao, F. (2017). High-sensitivity cardiac troponins I sandwich assay by immunomagnetic microparticle and quantum dots. Frontiers in Laboratory Medicine. 1(3):107-13. https://doi.org/10.1016/j.flm.2017.09.001
Joubert, L.M., & Manore, M.M. (2006). Exercise, nutrition, and homocysteine. International Journal of Sport Nutrition and Exercise Metabolism,16(4), 341-61. https://doi.org/10.1123/ijsnem.16.4.341
Kambič, T., Novaković, M., Tomažin, K., Strojnik, V., & Jug, B. (2019). Blood flow restriction resistance exercise improves muscle strength and hemodynamics, but not vascular function in coronary artery disease patients: a pilot randomized controlled trial. Frontiers in physiology, 10, 656. https://doi.org/10.3389/fphys.2019.00656
Karimi Ahmadabadi, Z., Nemati, J., Mousavinia, S.H … & Rezaei, R. (2022). Acute effect of single bout aerobic exercise with and without blood flow restriction on hemodynamic and coagulation indicators in hypertension disease. Journal of Sport and Exercise Physiology, 15(2), 52-63. https://doi.org/10.52547/joeppa.15.2.52
Kemp, M., Donovan, J., Higham, H., & Hooper, J. (2004). Biochemical markers of myocardial injury. British Journal of Anaesthesia, 93(1), 63-73. https://doi.org/10.1007/BF02912874
Korff, S., Katus, H. A., & Giannitsis, E. (2006). Differential diagnosis of elevated troponins. Heart, 92(7), 987-93. https://doi.org/10.1136/hrt.2005.071282
La Gerche, A., Boyle, A., Wilson, A., & Prior, D. (2004). No evidence of sustained myocardial injury following an Ironman distance triathlon. International Journal of Sports Medicine, 25(01), 45-9. https://doi.org/10.1055/s-2003-45236
Lammers, M.D., Anéli, N.M., de Oliveira, GG., de Oliveira, Maciel, SF., Zanini, D., … & Mânica, A (2020). The anti-inflammatory effect of resistance training in hypertensive women: the role of purinergic signaling. Journal of Hypertension, 38(12), 2490-500. https://doi.org/10.1097/HJH.0000000000002578 .
Li, J.Y., Pan, S.S., Wang, J.Y., & Lu, J. (2019). Changes in autophagy levels in rat myocardium during exercise preconditioning-initiated cardioprotective effects. International Heart Journal, 60(2), 419-428. https://doi.org/10.1536/ihj.18-310
Maroto-Sánchez, B., Lopez-Torres, O., Palacios, G., & González-Gross, M. (2016). What do we know about homocysteine and exercise? A review from the literature. Clinical Chemistry and Laboratory Medicine (CCLM), 54(10), 1561-1577. https://doi.org/10.1515/cclm-2015-1040
Morita, H., Kurihara, H., Yoshida, S., Saito, Y., Shindo, T., Oh-hashi, Y., … & Nagai, R. (2001). Diet-induced hyperhomocysteinemia exacerbates neointima formation in rat carotid arteries after balloon injury. Circulation, 103(1), 133-9. https://doi.org/10.1161/01.cir.103.1.133
Niazi, S., Mirdar, S., Bazar, R., Hamidian, G., & Talebi, V. (2021) Evaluation of hif-1α response and the rate of bronchial and bronchiole apoptosis in lung tissue of male wistar rats in case of decreased exercise load and hypobaric hypoxia conditions belonging to high-intensity interval training. Studies in Medical Sciences, 32(6), 437-47. [In Persian]. https://doi.org/10.52547/umj.32.6.437
Negaresh, R., Ranjbar, R., Gharibvand, MMm., Habibi, A., & Moktarzade, M. (2017). Effect of 8-week resistance training on hypertrophy, strength, and myostatin concentration in old and young men. Iranian Journal of Ageing, 12(1), 56-67. [In Persian]. https://doi.org/10.21859/sija-120154
Nemati, M., Tahmasebi, W., & Azizi, M. (2020). Influences of normobaric hypoxia training on Apelin serum levels and insulin resistance in healthy overweight men. Sport Physiology, 11(44), 73-88. [In Persian]. https://doi.org/10.22089/spj.2020.6936.1953
Neuman, J.C., Albright, K.A., Schalinske, K.L. (2013). Exercise prevents hyperhomocysteinemia in a dietary folate-restricted mouse model. Nutrition Research. 33(6), 487-93. https://doi.org/10.1016/j.nutres.2013.04.008
Olkowicz, M., Tomczyk, M., Debski, J., Tyrankiewicz, U., Przyborowski, K., Borkowski, T., ... & Smolenski, R. T. (2021). Enhanced cardiac hypoxic injury in atherogenic dyslipidaemia results from alterations in the energy metabolism pattern. Metabolism, 114, 154400. https://doi.org/10.1016/j.metabol.2020.154400
Paganelli, F., Mottola, G., Fromonot, J., Marlinge, M., Deharo, P., Guieu, R., … & Ruf, J. (2021). Hyperhomocysteinemia and cardiovascular disease: Is the adenosinergic system the missing link? International Journal of Molecular Sciences, 22(4), 1690. https://doi.org/10.3390/ijms22041690
Parra, V. M., Macho, P., Sánchez, G., Donoso, P., & Domenech, R.J. (2015). Exercise preconditioning of myocardial infarct size in dogs is triggered by calcium. Journal of cardiovascular pharmacology, 65(3), 276-281. https://doi.org/10.1097/FJC.0000000000000191
Patterson, SD., Hughes, L., Warmington, S., Burr, J., Scott, BR.,…& Owens, J. (2019). Blood flow restriction exercise: considerations of methodology, application, and safety. Frontiers in Physiology, 10, 533. https://doi.org/10.3389/fphys.2019.00533
Peeri, M., & Azarbayjani, M.A. (2018). Effect of different resistance training modes on appetite and serum orexin, ghrelin, and neuropeptide Y levels in sedentary healthy males. Medical Journal of Mashhad University of Medical Sciences, 60(6), 804-15. [In Persian]. https://doi.org/10.22038/mjms.2018.10787
Ping, Z., Zhang, L.F., Cui, Y.J., Chang, Y.M., Jiang, C.W., Meng, Z.Z., ... & Cao, X.B. (2015). The protective effects of salidroside from exhaustive exercise-induced heart injury by enhancing the PGC-1α–NRF1/NRF2 pathway and mitochondrial respiratory function in rats. Oxidative Medicine and Cellular Longevity, 2015. https://doi.org/10.1155/2015/876825
Planellas, M., Cuenca, R., Tabar, M-D., Bertolani, C., Poncet, C.,…& Closa, J.M. (2012). Evaluation of C-reactive protein, Haptoglobin and cardiac troponin 1 levels in brachycephalic dogs with upper airway obstructive syndrome. BMC Veterinary Research, 8(1), 1-7. https://doi.org/10.1186/1746-6148-8-152
Renzi, C.P., Tanaka, H., & Sugawara, J. (2006). Effects of leg blood flow restriction during walking on cardiovascular function. Medicine and Science in Sports and Exercise, 42(4), 726. https://doi.org/10.1249/MSS.0b013e3181bdb454
Scott, B.R., Peiffer, J.J., Thomas, H.J., Marston, K.J., & Hill, K,D. (2018). Hemodynamic responses to low-load blood flow restriction and unrestricted high-load resistance exercise in older women. Frontiers in Physiology, 9, 1324. https://doi.org/10.3389/fphys.2018.01324
Sotgia, S., Carru, C., Caria, M.A., Tadolini, B., Deiana, L., Zinellu, A. (2007). Acute variations in homocysteine levels are related to creatine changes induced by physical activity. Clinical Nutrition, 26(4), 444-9. https://doi.org/10.1016/j.clnu.2007.05.003
Thijssen, D.H., Redington, A., George, K.P., Hopman, M.T., & Jones, H. (2018). Association of exercise preconditioning with immediate cardioprotection: a review. JAMA Cardiology, 3(2), 169-176. https://doi.org/10.1001/jamacardio.2017.4495
Thomas, H., Scott, B., & Peiffer, J. (2018). Acute physiological responses to low-intensity blood flow restriction cycling. Journal of Science and Medicine in Sport, 21(9), 969-74. https://doi.org/10.1016/j.jsams.2018.01.013 .
Woods, D.R., O’Hara, J.P., Boos, C.J., Hodkinson, P.D., Tsakirides, C.,.& Hill, N.E (2017). Markers of physiological stress during exercise under conditions of normoxia, normobaric hypoxia, hypobaric hypoxia, and genuine high altitude. European Journal of Applied Physiology, 117(5), 893-900. https://doi.org/10.1007/s00421-017-3573-5
Wooten, S.V., Stray-Gundersen, S., & Tanaka H. (2020). Hemodynamic and pressor responses to combination of yoga and blood flow restriction. International Journal of Sports Medicine, 41(11), 759-65. https://doi.org/10.1055/a-1171-1620
Wu, A.H. (2017). Release of cardiac troponin from healthy and damaged myocardium. Frontiers in Laboratory Medicine, 1(3), 144-50. https://doi.org/10.1055/a-1171-1620
)