EXERCISE PRESCRIPTION AREA   

Medicina dello Sport 2019 September;72(3):422-38

DOI: 10.23736/S0025-7826.19.03517-8

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Ameliorative influence of concurrent training on cardiac and liver dysfunction and coagulation deficit in beta-thalassemia major patient

Golnaz ARBAB ✉, Kamal RANJBAR

Department of Physical Education and Sport Science, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran

BACKGROUND: Due to an iron overload, β-thalassemia major patients are particularly vulnerable to cardiac and liver complications and hypercoagulability. Inversely, exercise training decrease body iron store and promote cardiac and liver function in healthy subjects. Therefore, the aim of the present study was the effect of concurrent (endurance and resistance) training on cardiac and liver dysfunction and coagulation deficit in transfusion-dependent thalassemic young patients.
METHODS: To test this hypothesis, 18 β-thalassemia major patients were assigned into either an 8-week exercise intervention group or an 8-week non-exercise control group. Patients in the training group received three concurrent exercise sessions per week, for 8 weeks. Systolic and diastolic dysfunction, liver damage, coagulation deficit and inflammation were measured 72 hours before and after concurrent training.
RESULTS: Serum ferritin and NT-proBNP were significantly different between experimental groups at pre and post training. Serum ferritin and NT-proBNP did not change in control group, but in the training group it dropped respectively by 28% and 21%. Systolic (ejection fraction and stroke volume) and diastolic function (E, A, E/A, E’, E/E’, deceleration time, and end-diastolic pressure) was similar in training group in comparison to control group at pre- and post-exercise training. Concurrent training decreased AST, ALT, ALP and creatinine by 20% (P=0.04), 21% (P=0.001), 12% (P=0.04) and 12% (P=0.04), respectively. PT and PTT were not affected by training, but fibrinogen significantly decreased after concurrent training. In contrast, an increase in IL-1β (200%, P=0.004) and IL-12 (107%, P=0.03), while a reduction in CRP (30%, P=0.003), IL-6 (41%, P=0.0001), were noted in the training group but not the control group (P>0.05).
CONCLUSIONS: Our novel results provide evidence of multifocal benefits of concurrent training in β-thalassemia major patients by: 1) limiting serum ferritin and NP-proBNP; 2) reducing systemic inflammation; 3) decreasing liver damage. The results of this paper showed that 8 weeks of concurrent training helps reverse iron-induced organ damage in β-thalassemia major patients.

KEY WORDS: Beta-thalassemia; Exercise; Heart function tests; Liver failure; Blood coagulation disorders