Razi Journal of Medical Sciences

fa تأثیر هشت هفته تمرین هوازی بر سطوح پلاسمایی VEGF و NO بیماران قلبی پس از جراحی بای پس عروق کرونر Effect of Eight Weeks Aerobic Training on Plasma Level of VEGF and NO in Pa-tient's Cardiovascular Disease after Coronary Artery Bypass Graft Surgery فیزیوتراپی ورزشی Sports Physiotherapy پژوهشي Research زمینه و هدف: تمرینات ورزشی با شدتهای معین در روند بهبود و بازتوانی بیماران قلبی مؤثر است. پژوهش حاضر با هدف تعیین تأثیر هشت هفته تمرین هوازی بر سطوح پلاسمایی VEGF و NO بیماران قلبی پس از جراحی بایپس عروق کرونر انجام شد. روش کار: در این مطالعه نیمه تجربی16 بیمار قلبی مرد غیرورزشکار، بعد از عمل CABG با روش نمونهگیری در دسترس در بیمارستان فوق تخصصی قلب فاطمه زهرا ساری، بخش بازتوانی قلبی و ریوی انتخاب و بهطور تصادفی به دو گروه تمرین (8n=) و کنترل (8n=) تقسیم شدند. گروه تمرین برنامه تمرینی هوازی را به مدت 8 هفته، هر هفته 3 جلسه و هر جلسه 40 الی 50 دقیقه شامل دویدن روی تردمیل با شدت 60 الی 75 درصد ضربان قلب بیشینه به مدت 10 تا  20 دقیقه اجرا کرد. سپس تمرین با کارسنج دستی با شدت 30 الی 50  وات به مدت 8 تا 10 دقیقه و پس از آن تمرین روی دوچرخه ثابت با شدت 30 الی 50 وات به مدت 8 تا 10 دقیقه اجرا گردید. سطوح سرمیVEGF  و NO با روش الایزا اندازهگیری و دادهها با استفاده از آزمون t وابسته و t مستقل تجزیهوتحلیل شدند. یافتهها: نتایج نشان داد که سطوح VEGF، 72/52 درصد (001/0>P) و NO، 19/72 درصد (001/0>P) به طور معناداری افزایش یافتند، در حالی که در گروه کنترل VEGF، 24/0 درصد (982/0>P) کاهش غیرمعنادار و NO، 20/5 درصد (343/0>P) افزایش غیرمعنادار یافتند. نتیجهگیری: بر اساس نتایج تحقیق، میتوان این گونه بیان کرد که با توجه به نقش چندگانه ورزش بر بدن، احتمالا تمرین هوازی تناوبی علاوه بر این عوامل از طریق اعمال فشار لازم بر سیستم قلبی عروقی از مسیرهای دیگر پیام رسانی مرکزی سلول نیز میتوانند نقش ایفا کند که در این زمینه نیاز به تحقیق و مطالعه بیشتر احساس میشود. Background & Aims: Coronary heart disease is the most common disease among cardiovascular diseases and coronary artery bypass graft (CABG) surgery is the first treatment of choice for coronary artery disease. Bypass surgery is a traumatic event, and inflammation is the most common symptom that occurs widely afterwards. The presence of these symp-toms reduces patients' quality of life, and evidence suggests that these patients are at risk for new coronary events, readmission, and even death. Failure to treat inflamma-tion has a negative effect on the prognosis of the disease, reducing adherence to its treatment and this may lead to recurrence of the disease in these patients. However, there are modifiable factors such as physical activity that help prevent and treat the disease by regulating the inflammatory process. Studies have shown that the use of exercise interventions is effective in heart patients. Utilization of aerobic activity is considered as a treatment method for the disease and other stressful changes. Each ses-sion of exercise leads to the production and release of cytokines from skeletal muscle contraction. One of the challenges that has attracted the attention of sports profession-als today is the identification of new training methods on physical factors and physio-logical factors on performance. Increasing exercise, especially aerobic exercise in car-diovascular patients by reducing plasma lipid and blood glucose levels, reducing oxi-dative stress and bone density can increase physical function and improve controlled cardiovascular disease and prevent sarcopenia and Osteoporosis is effective. The aim of this study was to determine the effect of eight weeks of aerobic exercise on plasma levels of VEGF and NO in cardiac patients after coronary artery bypass graft surgery. Methods: In quasi experimental design 16 male non-athlete heart patients, after CABG surgery, were selected and randomly divided into two groups of exercise (n=8) and control (n=8). The exercise group performed an aerobic exercise program for 8 weeks, 3 sessions per week and 40 to 50 minutes per session, including running on a treadmill with an intensity of 60 to 75% of maximum heart rate for 10 to 20 minutes. Then the exercise was going on with a manual ergometer with an intensity of 30 to 50 watts for 8 to 10 minutes and then the exercise was performed on a stationary bicycle ergometer. In addition to routine care, the intervention group participated in an 8-week aerobic program. Aerobic exercise for eight weeks (three sessions per week) including 6 to 14 intensity (RPE) intensity training on the Borg pressure scale, for 10 to 20 minutes on a treadmill, then exercise with a manual ergometer at 30 to 50 watts for 8 to 10 minutes and then exercise on a stationary bike with an intensity of 30 to 50 watts for 8 to 10 minutes, under the supervision of a sports medicine specialist, exercise physiologist and nurse. The control group received only daily care under the supervi-sion of a physician for 8 weeks. Blood samples were taken in both groups before and after 8 weeks and their VEGF and NO variables were measured by ELISA. Initial blood sampling was performed 48 hours before the first training session of all subjects in the fasting state in which 5 cc of blood was taken from the brachial vein of the samples. Also, 48 hours after the last training session, 5 cc of blood was taken from the brachial vein of the subjects in order to eliminate the effect of training on all fasting subjects. Subjects were asked to abstain from food for 12 hours before blood sampling until blood sampling. Serum levels of VEGF and NO were measured by ELIZA and the data were analyzed using Paired sample t-test and independent sample t-test (α0.05). Results: The results showed that VEGF, 52.72% (p <0.001) and NO, 72.19% (p <0.001) levels increased significantly. While in VEGF control group, 0.24% (p <0.982) decreased non-significant and NO, 5.20% (p <0.343) increased non-significant. Conclusion: According to the results of the study, eight weeks of moderate-intensity aerobic exercise increases serum VEGF and NO and accelerates the rehabilitation of cardiac patients after coronary artery bypass graft surgery. Among the possible physio-logical stimuli for oxidantric production is known to be increased blood flow in the venous duct, which in its acute effect increases oxidative nitric synthase and modu-lates vasodilation to balance pressure. These findings reinforce the possibility that be-cause regular exercise repeatedly increases pulse pressure and pulsation, it may in-crease the bioavailability of nitric oxide. In addition, several studies have focused on the interaction between HSP-90 and endothelial oxidase synthase. HSP-90, which acts as an intracellular protector, is present in most cells, including endothelial cells, and is released in response to various stimuli, including stress and mechanical shock, and the production of free radicals and oxidative damage. Exercise is also a physiological stimulus for HSP90. In this regard, HSP-90 increases endothelial oxidase synthase en-zyme in endothelial cells in response to exercise-induced stimulation, and as a result, exercise improves vascular endothelial function.   جراحی بای پس عروق کرونر, بازتوانی قلبی, VEGF, NO Coronary Artery Bypass Graft Surgery, Cardiac Rehabilitation, VEGF, NO 281 289 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5857-1&slc_lang=fa&sid=1 Rohollah Ahmadi روح اله احمدی rohallahahmadi069@gmail.com 3900319475328460083702 3900319475328460083702 No Student of Master of Science Exercise Physiology, Department of Sport Sciences, Faculty of Humanities, Semnan University, Semnan, Iran. دانشجوی کارشناسی ارشد فیزیولوژی ورزش، گروه علوم ورزشی، دانشکده علوم انسانی، دانشگاه سمنان، سمنان، ایران Rouhollah Haghshenas روح الله حق شناس rhm@semnan.ac.ir 3900319475328460083703 3900319475328460083703 Yes Associate Professor of Exercise Physiology, Department of Sport Sciences, Faculty of Humanities, Semnan University, Semnan, Iran دانشیار فیزیولوژی ورزش، گروه علوم ورزشی، دانشکده علوم انسانی، دانشگاه سمنان، سمنان، ایران