ФИЗИЧЕСКИЕ НАГРУЗКИ И КАРДИОМАРКЕРЫ. ЧАСТЬ 1
Ключевые слова:
физическая нагрузка, кардиомаркеры, сердечные тропонины, белок, связывающий жирные кислоты, копептин
Аннотация
Цель исследования – рассмотреть влияние тяжелых физических нагрузок на концентрацию наиболее известных кардиомаркеров, используемых в диагностике сердечно-сосудистых заболеваний: сердечных тропонинов; белка, связывающего жирные кислоты; копептина, а также обсудить возможные механизмы изменения сывороточных уровней данных кардиомаркеров. Материалы и методы исследования: анализ отечественной и зарубежной литературы по базам данным PubMed/Medline, Embase и e-library. Результаты. Согласно проведенному литературному анализу у здоровых людей и спортсменов, занимающихся спортом, часто наблюдается повышение кардиомаркеров (сердечных тропонинов; сердечного белка, связывающего жирные кислоты; копептина) в ответ на физическую нагрузку. Концентрации кардиомаркеров, определяемые у спортсменов после тяжелых физических нагрузок, могут превышать референтные пределы (99 перцентиль) от нескольких до 10 и более раз. Механизмы высвобождения данных кардиомаркеров окончательно не установлены. За повышение сердечных тропонинов при интенсивных тяжелых нагрузках могут быть ответственны следующие механизмы: перекрестная (неспецифическая) реактивность со скелетными изоформами тропонинов; высвобождение цитозольной фракции тропонинов посредством блебинг-везикул, повышение мембранной проницаемости кардиомиоцитов, деградация целостных тропониновых белков на более мелкие пептидные фрагменты и их высвобождение через интактную мембрану кардиомиоцитов. Механизмы высвобождения сердечного белка, связывающего жирные кислоты (сБСЖК) при физической нагрузке, учитывая его размер, вероятно, связаны с повышением мембранной проницаемости. Предположительными механизмами повышения копептина при физических нагрузках может быть влияние стрессовых реакций и изменений электролитного баланса на гипоталамус и гипофиз. Заключение. Клиническое значение повышенных уровней кардиомаркеров при физических нагрузках остается противоречивым. Тогда как одни исследователи отрицают вредное влияние интенсивных физических нагрузок на миокард, другие, напротив, полагают, что избыточное физические нагрузки в долгосрочной перспективе ведут к фиброзу, сердечной недостаточности и повышению риска внезапной смерти. Следовательно, необходимы дополнительные исследования для уточнения.
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Опубликован
2022-08-29
Как цитировать
Чаулин, А., & Дупляков, Д. (2022). ФИЗИЧЕСКИЕ НАГРУЗКИ И КАРДИОМАРКЕРЫ. ЧАСТЬ 1. Человек. Спорт. Медицина, 22(2), 15-28. https://doi.org/10.14529/hsm220202
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Физиология
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