پاسخ تروپونين قلبي T به يك مسابقه با شدت بالا و ارتباط آن با QT اصلاح شده در ورزشكاران تمرين كرده

Cardiac Troponin T Response during High-Intensity Competition and its Correlation with the Corrected QT Interval among the Trained Athletes

دستيابي به راهكارهاي جديد به منظور پايش بهتر علل مرگ ناگهاني قلبي در ورزشكاران و ايجاد روندهاي مراقبت پزشكي براي كنترل هزينه هاي پايش و درمان آن ها، ضروري به نظر مي رسد. هدف اين مقاله، بررسي تاثير يك مسابقه ورزشي با شدت بالا بر تروپونين قلبي T و ارتباط آن با QTc در ورزشكاران تمرين كرده مي باشد. ﺳﯽ و دو ﻣﺮد ورزﺷﮑﺎر ﺳﻦ: 26/4±9/7 ﺳﺎل، ﺷﺎﺧﺺ ﺗﻮده ﺑﺪن: 25/1±6/6 ﮐﯿﻠﻮﮔﺮم ﺑﺮ ﻣﺘﺮ ﻣﺮﺑﻊ در اﯾﻦ ﺗﺤﻘﯿﻖ ﺷﺮﮐﺖ ﮐﺮدﻧﺪ و ﺑﻪ ﻣﺴﺎﺑﻘﻪ ﺑﺎ ﺷﺪت ﺑﺎﻻ 8 دﻗﯿﻘﻪ اي ﺑﺎ آﯾﺘﻢ ﻫﺎي 400 ﻣﺘﺮ دوﯾﺪن ﺑﺮ روي ﻧﻮار ﮔﺮدان، ﺣﺮﮐﺖ ﻟﯿﻔﺖ ﻣﺮده ﺳﻪ ﮔﺎﻧﻪ، وزﻧﻪ ﻫﺎي 110 ﮐﯿﻠﻮﮔﺮم 5 ﺗﮑﺮار، 130 ﮐﯿﻠﻮﮔﺮم 3 ﺗﮑﺮار و 150 ﮐﯿﻠﻮﮔﺮم 1 ﺗﮑﺮار، ﺑﺎرﻓﯿﮑﺲ 30 ﺗﮑﺮار، ﺗﺎب دادن ﮐﺘﻠﺒﻞ 30 ﮐﯿﻠﻮﮔﺮﻣﯽ و ﭘﺮﺗﺎب 20 ﺗﻮپ ﺷﻨﯽ ﺑﺎ وزن ﻫﺎي ﻣﺘﻔﺎوت ﺑﻪ ﻓﺎﺻﻠﻪ 5 ﻣﺘﺮي ﭘﺸﺖ ﺟﻌﺒﻪ 75 ﺳﺎﻧﺘﯽ ﻣﺘﺮي ﭘﺮداﺧﺘﻨﺪ. ﺑﺮاي اﻧﺪازه ﮔﯿﺮي QTc اﺳﺘﺮاﺣﺖ از اﻟﮑﺘﺮوﮐﺎردﯾﻮﮔﺮام ﻟﯿﺪ II اﺳﺘﻔﺎده ﺷﺪ. ﻗﺒﻞ و ﺑﻼﻓﺎﺻﻠﻪ ﭘﺲ از ﻣﺴﺎﺑﻘﻪ، ﺧﻮن ورﯾﺪي ﺑﺮاي اﻧﺪازه ﮔﯿﺮي ﺗﺮوﭘﻮﻧﯿﻦ ﻗﻠﺒﯽ T اﻧﺪازه ﮔﯿﺮي ﺷﺪ. ﺑﺮاي ﺑﺮرﺳﯽ ﺗﻔﺎوت ﺑﯿﻦ ﺗﻤﺎﻣﯽ ﻣﺘﻐﯿﺮﻫﺎي در ﺣﺎﻟﺖ اﺳﺘﺮاﺣﺖ، ﭘﺲ از ﻣﺴﺎﺑﻘﻪ و ﺑﻌﺪ از اﺻﻼح داده ﻫﺎ ﺑﺎ ﺣﺠﻢ ﭘﻼﺳﻤﺎ از دﺳﺖ رﻓﺘﻪ از آزﻣﻮن ﺗﺤﻠﯿﻞ وارﯾﺎﻧﺲ اﻧﺪازه ﮔﯿﺮي ﻣﮑﺮر و آزﻣﻮن ﺗﻌﻘﯿﺒﯽ ﺑﻮﻧﻔﺮوﻧﯽ اﺳﺘﻔﺎده ﺷﺪ و ﻫﻢ ﭼﻨﯿﻦ ﺑﺮاي ﺑﺮرﺳﯽ راﺑﻄﻪ ﺗﻤﺎﻣﯽ ﻣﺘﻐﯿﺮﻫﺎ ﺑﺎ QTc از آزﻣﻮن ﭘﯿﺮﺳﻮن اﺳﺘﻔﺎده ﺷﺪ. يافته هاي پژوهش در مقايسه با استراحت، بلافاصله بعد از مسابقه با شدت بالا تروپونين قلبي T افزايش معناداري را نشان داد ولي پس از اصلاح داده هاي خام با حجم از دست رفته پلاسما، تغيير معناداري نداشت (F1.31=832, P<0.001). نتايج آزمون پيرسون نشان داد كه بين QTc استراحت با تروپونين قلبي T استراحت و پس از مسابقه ورزشي با شدت بالا رابطه معناداري وجود ندارد. بحث و نتيجه گيري رابطه معناداري بين QT اصلاح شده با تروپونين قلبي T در ورزشكاران تمرين كرده پس از مسابقه با شدت بالا وجود ندارد. احتمالا QT اصلاح شده نمي تواند ابزاري براي پيش بيني آسيب ميوكارد و آزاد شدن تروپونين قلبي T در جمعيت ورزشكاران باشد ولي نياز به تحقيقات بيشتري در ورزشكاران رشته هاي متفاوت ورزشي مي باشد.

It is highly crucial to develop novel strategies in order to further enhance the monitoring of sudden cardiac arrest in athletes and establish standard medical care procedures to control monitoring and treatment costs. Therefore, this study aimed to investigate the effects of a high-intensity competition on cardiac troponin T (cTnT) and its correlation with the corrected QT interval (QTc) in the trained athletes. Materials & Methods In total, 32 male athletes (mean age: 26.9±4.7 years, body mass index: 25.6±1.6 kg/m2) competed in 8-min high intensity competitions. The competition items included running on skillmill for 400 meters; three-stage deadlifting, weight lifting (110kg) with 5 repetitions; (130kg) with 3 repetitions; and (150kg) with 1 repetition, bar pulling up with 30 repetition, 30-kg kettlebell swinging, and 20 sandbag throwing with different weights at a distance of 5m behind a 75-cm box. Moreover, lead II electrocardiogram was utilized in order to measure the resting QTc. The intravenous blood test was performed to determine the level of troponin T before and immediately after the competition. In addition, ANOVA with repeated measures was used to examine the differences between variables in resting position, post competition, and after correction for the volume of plasma lost. In addition, Bonferroni post hoc test was used to identify which mean differences were statistically significant. The Pearson Correlation Coefficient was calculated to assess the level of correlations between the variables and QTc. Ethics code: IR.SRTTU.SSF.2018.103 Findings The results showed an immediate significant increase in the cardiac Troponin T after high-intensity competition, compared to the resting position (P<0.001). However, when raw post-exercise data were corrected for plasma volume loss, no significant difference was observed in this regard (F1,31= 832, P<0.001). Furthermore, the Pearson results indicated that there was no significant correlation between the resting QTc and cTnT before and after the high-intensity comoetition. Discussion & Conclusions There was no significant correlation between the QTc and cTnT among the trained atheletes after high-intensity competition. The QTc can not probably be ragrded as an independent high-risk predictor for myocardial damage and cTnT release in athletes. However, there is a need for more studies on athletes in different sports.