بررسی اثر یک دوره بازتوانی قلبی مبتنی بر تمرین ترکیبی بر بیان ژن VEGF در بیماران قلبی با سابقه عمل جراحی بای پس کرونری

محورهای موضوعی : فصلنامه زیست شناسی جانوری

سید عماد علوی نیا ¹ , امیر رشید لمیر ² , رامبد خواجه ای ³ , امنه برجسته یزدی ⁴

1 - گروه تربیت‌بدنی و علوم ورزشی، واحد نیشابور، دانشگاه آزاد اسلامی، نیشابور، ایران
2 - گروه تربیت‌بدنی و علوم ورزشی، دانشکده تربیت‌بدنی و علوم ورزشی، دانشگاه فردوسی مشهد، مشهد، ایران
3 - گروه تربیت‌بدنی و علوم ورزشی، واحد نیشابور، دانشگاه آزاد اسلامی، نیشابور، ایران
4 - گروه تربیت‌بدنی و علوم ورزشی، واحد نیشابور، دانشگاه آزاد اسلامی، نیشابور، ایران

تاریخ دریافت : 1399/08/25 تاریخ پذیرش : 1399/11/03 تاریخ انتشار : 1400/12/01

کلید واژه: بیان ژن, تمرین ترکیبی, VEGF, CABG, بازتوانی قلب,

چکیده مقاله :

بیماری‌های قلبی عروقی از علل اصلی مرگ ‌و میر در تمام کشورهای جهان به‌جز قاره افریقا است. هدف از پژوهش حاضر بررسی تأثیر هشت هفته تمرین ترکیبی بر بیان ژن‌های اندوستاتین و VEGF بیماران CABG بود. این پژوهش از نوع تحقیقات کاربردی و به روش نیمه تجربی با دو گروه (مداخله و کنترل) است که به صورت پیش آزمون و پس آزمون اجرا شد. تعداد 30 نفر مرد میان‌سال CABG شده به‌صورت نمونه هدفمند و بر اساس معیارهای ورود به پژوهش انتخاب شدند و به‌صورت تصادفی به دو گروه 15 نفری کنترل و تمرین ترکیبی تقسیم شدند. برنامه تمرین ترکیبی برای مدت هشت هفته با تواتر سه جلسه انجام شد. برای اندازه‌گیری سطوح بیان ژن‌های اندوستاتین و VEGF از روش Real time-PCR انجام شد. از آزمون t وابسته و مستقل برای تجزیه‌ و تحلیل داده‌ها استفاده گردید. تمرین ترکیبی به‌طور معنی‌دار بیان ژن VEGF را افزایش داد (001/0≥ p). اما این تغییرات در مورد بیان ژن اندوستاتین (38/0p = ) معنادار نیست. بررسی نتایج این پژوهش نشان می‌دهد یک دوره تمرین ترکیبی بازتوانی قلب با پروتکل مورداستفاده در پژوهش حاضر، توانست بر شاخص بیان ژن VEGF تغییر معناداری ایجاد کند. اما تمرین ترکیبی نتوانست بر بیان ژن اندوستاتین تأثیرگذار باشد. بنابراین می‌توان بیان کرد که افزایش ژن VEGF از نتایج سازگاری با فعالیت ورزش ترکیبی مورد استفاده در این پژوهش بوده، و به‌احتمال‌زیاد فعالیت بدنی یک عامل مهم و اثرگذار در فرایند آنژیوژنز محسوب می‌شود و می‌تواند نقش مهمی در پیشگیری از مشکلات قلبی داشته باشد

چکیده انگلیسی:

Cardiovascular diseases are the leading causes of mortality and death in all areas of the world except Africa. This study aimed at the effect of eight-week combined training on Endostatin and VEGF gene expression in CABG patients.This is an applied and semi-experimental research with two groups (interventional and control), which was conducted as a pretest and posttest. 30 middle-aged CABG men were selected using purposive sampling based on inclusion criteria. Participants were randomly divided into two groups of control and combined training. Quantitative Real-time PCR was utilized  to measure Endostatin and VEGF gene expression levels. The eight-week combined exercise training was conducted in three sessions per a week. Dependent t-test and independent t-test were used to data analysis. A significant increase was observed after eight weeks of combined training on VEGF gene expression in CABG  patients. (p=0.001), but it was not Significant on Endostatin gene expression( p=0.38) . Eight weeks of combined  Cardiac Rehabilitation training as the protocol used in  this research increased the expression of the VEGF gene in CABG patients , but there were not any significant changes on Endostatin gene expression by this way. As a result, the increase in the VEGF gene is one of the results of adaptation to the combined exercise activity used in this study, and it appears that physical activity is an important and effective factor in the process of angiogenesis, and can play a key role in the prevention of cardiovascular diseases.

منابع و مأخذ:

1.Ahmetov I, Khakimullina A, Popov D, Missina S, Vinogradova O, Rogozkin V. Polymorphism of the vascular endothelial growth factor gene (VEGF) and aerobic performance in athletes Human

2. Bashiri, J., A. Gaeini, and H. Hadi, Endurance training affects muscular angiogenesis and serum VEGF concentration in diabetic rats. Koomesh; Journal of semnan university of medical scinces.2015. 17(1): 18-26


3. Behjati, A A. Babai Mazrae No, Faramarzi M, The Effect of Resistance Training on Vascular Endothelial Growth Factor (VEGF) in Older Women.Iranian Journal of Aging, 2015;10(3): 156- 165


4. Bloor CM. Angiogenesis during exercise and training. Angiogenesis.DOIlnk sprnger,com 2005 1; 8(3):263-71.

5.Bovens A M, Van MB, Vrencken JG, Wijnen JA, Saris WH, Verstappen FT. Physical activity, fitness, and selected risk factors for CHD in active men and women. Medicine and science in sports and exercise. 1993; 25(5):572-576

6.Edward P. Weiss, and Luigi Fontana. Caloric restriction : powerful protection for the aging heart and vasculature . published online : 01 OCT 2011 . https://doi.org/.10.1152/.ajpheart.00685.2011

7. Elflein J. Research expert covering health and health care, Top causes of death in Africa in 2016. Published by John Elflein, Jul 18, 2019


8. Gaeini AA, Sattarifard S, CafiZadeh S, Nejatian M.The comparison of eight weeks of combined and aerobic training on functional capacity, body composition and strength in post-CABG cardiac patients. Cardiovascular Nursing Journal, 2013;2(1):34-41.

9.Gustafsson T, Knutsson A, Puntschart A, Kaijser L, Nordqvist SA, Sundberg C, Jansson E. Increased expression of vascular endothelial growth factor in human skeletal muscle in response to shortterm one-legged exercise training. Pflügers Archiv. 2002 Sep; 444(6):752-9.

10. Hadi H, Gaeini A, Mo'tamedi P, Rajabi H. The effect of aerobic training on VEGF expression in diabetic rats. Medical Journal of Tabriz University Medicine Scienses Health Serv. 2017; 39 (5): 81-90


11. Jian-Wei Gu, Gadonski G, Wang J, Makey I., Adair T.H., Exercise increases endostatin in circulation of healthy volunteers. BMC Physiology, 2004;4(2)


12. Kordi MR, Nekouei A, Shafiee AH, Hadidi V. The effect of eight weeks high intensity aerobic continuous and interval training on gene expression of vascular endothelial growth factor in soleus muscle of healthy male rats.Arak Medical University Journal. 2015; 18(8):53-62


13. Makey, K.L., Patterson, S.G., Robinson, J., Loftin, M., Waddell, D.E., Miele, L., Chinchar, E. Increased plasma levels of soluble vascular endothelial growth factor (VEGF) receptor 1 (sFlt-1) in women by moderate exercise and increased plasma levels of VEGF in overweight/obese women. European journal of cancer prevention. the official journal of the European Cancer Prevention Organisation (ECP) 2013., 22(1); 83


14. Mirnasuri R, Mokhtari G, Ebadifara M, Mokhtari Z. The effects of cardiac rehabilitation program on exercise capacity and coronary risk factors in CABG Patients aged 45-65. yafte. Journal of Scientific Research. 2014; 15 (5): 72-81


15. Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, Dolor RJ, Ganiats TG, Gomes AS. Evidence-based guidelines for cardiovascular disease prevention in women. Journal of the American College of Cardiology. 2007; 49(11):1230-50.


16. Motahhari Rad M, Attarzadeh Hosseini S.R,The effect of a selected wrestling training course with L-arginine supplementation on serum angiogenic and angiostatic markers of elite wrestlers. 2016; 31(8):1 53-173


17. Naghibi S, Ravasi A.A., Maleki J, Soori R, The Effect of Exercise-Based Cardiac Rehabilitation Program on Anaerobic Threshold and Hemodynamic Indexes in Patients with Coronary Artery Disease. Journal of Sport Biosciences, , 2012; 12(4): 23-41

18.Newby, L.K., Eisenstein EL, Califf RM, Thompson TD, Nelson CL, Peterson ED, Armstrong PW, et al., Cost effectiveness of early discharge after uncomplicated acute myocardial infarction. New England Journal of Medicine, 2000. 342(11): 749-755

19. Nourshahi, M., R. Fayaz-Milani, and M. Gholamali. Effects of acute eccentric exercise on serum vascular endothelial growth factor and endostatin concentration in male wistar rats. Journal 0f Sport Biomotor Scinces. 2011:3(5);286-296.


20. Nourshahi, M., R. Fayaz-Milani, and M. Gholamali. Effects of acute eccentric exercise on serum Nourishahi M and Ranjbar. the stimulus of angiogenesis during exercise and physical activity. Quarteriy of the Horizon of Medical Science.2013.:1, 286-294


21. Nourshahi M, Emamian Rostami M, Khodagholi F, Effect of eight weeks sprint interval training on VEGF rate in aged rats skeletal muscle tissue Medical Journal of Tabriz University of Medical Science & Health Service, 2018;40(2) .

22.Pinto Duane S, Windecker S, Cutlip D, SaperiaG.M. Coronavirus disease (COVID-19). Myocardial infarction and other coronary artery disease issues2019

23. Sagiv, Michael S, Exercise Cardiopulmonary Function in Cardiac Patients © 2012.


24. Shekarchizadeh P, Khazaei M, Gharakhanlou R, Karimian J, Safarzadeh AR. The Effects of Resistance Training on Plasma Angiogenic Factors in Normal Rats. Journal of Isfahan medical school. 2012; 30;176.


25. Sponder M, Sepiol K, Lankisch S, Priglinger M, Kampf S, Litschauer B, Fritzer-Szekeres M, Strametz-Juranek J. Endostatin and physical exercise in young female and male athletes and controls. Int J Sports Med. 2014;35(13):1138–42

26.Torres N, Guevara-Cruz M, Velázquez-Villegas LA, Tovar AR. Nutrition and Atherosclerosis. Arch Med Res. 2015; 46(5):408-26.

27.Tolouei Azar J, Ravasi A, Soori R, Akbarnejad A, Hemati Nafar M. The effect of 8 weeks aerobic training on angiogenesis (VEGF) and angiostatic (ES) factors in sedentary women. Studies in Medical SciencesThe Journal of Urmia University of Medical Sciences; 2017; 27(12): 1032- 40.

28. Vizvari, E. Farzanegi, P., Abaszade, H. Sourati, Effect of Moderate Aerobic Training on Serum Levels of Angiogenic and Angiostatic Factors in Women with Type 2 Diabetes. Scientific journal of Ilam University of medical sciences, 2019. 27(1): p. 112-121.

29.Wu G, Rana JS, Wykrzykowska J, Du Z, Ke Q, Kang P, Li J, Laham RJ. Exercise-induced expression of VEGF and salvation of myocardium in the early stage of myocardial infarction. American Journal of Physiology-Heart and Circulatory Physiology. 2009; 296(2): 389 95

30.Zhang H, Chang R. Effects of Exercise after Percutaneous Coronary Intervention on Cardiac Function and Cardiovascular Adverse Events in Patients with Coronary Heart Disease: Systematic Review and Meta-Analysis. J Sports Sci Med. 2019; 18(2):213-222.