The Effect of Rehabilitation with Selected Concurrent Training on the Expression of Thrombospondin-1 and Interleukin-1 Beta in Blood Mononuclear Cells in Male Patients After Coronary Artery Bypass Graft Surgery

Document Type : Original Article


1 PhD student, Department of Sports Physiology, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran.

2 Associated Professor, Department of Sports Physiology, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran.

3 Assistant Professor, Department of Sports Physiology, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran.



Introduction and purpose: Coronary artery bypass graft (CABG) is a common therapeutic intervention that is performed in patients suffering from coronary heart diseases. The aim of this study was to determine the effect of selected combined rehabilitation exercises on the expression of thrombospondin-1 (TSP-1) and interleukin-1 beta (IL-1β) genes in patients after coronary artery bypass surgery.
Method: In this semi-experimental study, 20 male patients from Afshar Hospital (Yazd city) after coronary artery surgery were purposefully selected and available and randomly divided into two groups of combined exercise and control. Combined exercise program group performed aerobic (15-20 minutes with an intensity of 50-60% of the maximum heart rate) and resistance exercise (10-20 minutes, including three movements of the upper limbs and two movements of the lower limbs, each movement includes three sets and each set with 10 repetitions and 30 to 60 percent of a maximum repetition) for 10 weeks (30 sessions) and three sessions per week. Gene expression was measured by Real Time PCR method.. The data were analyzed using the Paired t-test and One-Way ANOVA at the P<0.05.
Results: After the intervention period, a significant decrease in the expression of IL-1β was observed, but no significant difference was observed in the expression of TSP-1.
Conclusion: Combined exercises as a non-pharmacological rehabilitation intervention can be useful in patients who have undergone CABG by reducing systemic inflammation.


Maryam Monjezi [PumMed] [Google Scholar]

Alireza Barari [PumMed] [Google Scholar]

Ahmad Abdi [PumMed] [Google Scholar]


Main Subjects

[1] Jokar M, Ghalavand A. [Improving endothelial function following regular pyramid aerobic training in patients with type 2 diabetes (Persian)]. Razi Journal of Medical Sciences. 2021;28(6):60-9. [Link]
[2] Fan M, Sun D, Zhou T, Heianza Y, Lv J, Li L, et al. Sleep patterns ,
genetic susceptibility, and incident cardiovascular disease: a prospective study of 385 292 UK biobank participants. Eur Heart J. 2020;41(11):1182-9. [DOI: 10.1093/eurheartj/ehz849] [PMID] [PMCID]
[3] Kushwaha P, Moiz JA, Mujaddadi A. Exercise training and cardiac autonomic function following coronary artery bypass grafting: a systematic review and meta-analysis. Egypt Heart J. 2022;74(1):67. [DOI: 10.1186/s43044-022-00306-5] [PMID] [PMCID]
[4] Kim H, Bae SH, Lim SH, Park JH. Predictors of health-related quality of life after coronary artery bypass graft surgery. Sci Rep. 2022;12(1):16119. [DOI: 10.1038/s41598-022-20414-1] [PMID] [PMCID]
[5] Dogdus M, Dindas F, Yenercag M, Yildirim A, Ozcan Abacioglu O, Kilic S, et al. The role of systemic immune inflammation index for predicting saphenous vein graft disease in patients with coronary artery bypass grafting. Angiology. 2023;74(6):579-86. [DOI: 10.1177/00033197221129356] [PMID]
[6] Cabaro S, Conte M, Moschetta D, Petraglia L, Valerio V, Romano S, et al. Epicardial adipose tissue-derived IL-1β triggers postoperative atrial fibrillation. Front Cell Dev Biol. 2022;10:893729. [DOI: 10.3389/fcell.2022.893729] [PMID]
[7] Plicner D, Stoliński J, Wąsowicz M, Gawęda B, Hymczak H, Kapelak B, et al. Preoperative values of inflammatory markers predict clinical outcomes in patients after CABG, regardless of the use of cardiopulmonary bypass. Indian Heart J. 2016;68 (Suppl 3):S10-15. [DOI: 10.1016/j.ihj.2016.10.002] [PMID] [PMCID]
[8] Krishna SM, Golledge J. The role of thrombospondin-1 in cardiovascular health and pathology. Int J Cardiol. 2013; 168(2):692-706. [DOI: 10.1016/j.ijcard.2013.04.139] [PMID]
[9] Ma Z, Wang M, Xu X, Zhang Y, Zhong J, Chen M, et al. Thrombospondin-1 plasma levels associated with in-hospital major adverse cardiovascular events in patients with acute coronary syndrome. Int J Cardiol. 2023;375:98-103. [DOI: 10.1016/j.ijcard.2023.01.011] [PMID]
[10] Garoffolo G, Ruiter MS, Piola M, Brioschi M, Thomas AC, Agrifoglio M, et al. Coronary artery mechanics induces human saphenous vein remodelling via recruitment of adventitial myofibroblast-like cells mediated by Thrombospondin-1. Theranostics. 2020;10(6): 2597-611. [DOI: 10.7150/thno.40595] [PMID] [PMCID]
[11] Tian D, Meng J. Exercise for prevention and relief of cardiovascular disease: prognoses, mechanisms ,and approaches. Oxid Med Cell Longev. 2019;2019:3756750. [DOI: 10.1155/2019/3756750] [PMID]
[12] Jokar M, Ghalavand A. [The effect of twelve weeks of aerobic interval training on liver complications and cardiovascular risk factors in men with type 2 diabetes (Persian)]. Razi Journal of Medical Sciences. 2022;29(3):26-36. [Link]
[13] Moholdt TT, Amundsen BH, Rustad LA, Wahba A, Løvø KT, Gullikstad LR, et al. Aerobic interval training versus continuous
moderate exercise after coronary artery bypass surgery: a randomized study of cardiovascular effects and quality of life. Am Heart J. 2009;158(6):1031-7. [DOI: 10.1016/j.ahj.2009. 10.003] [PMID]
[14] De Jesus Furtado Almeida F, Gambassi BB, Schwingel PA, Almeida AERAF, Sauaia BA, da Silva Sousa TM, et al. Possible benefits of different physical exercise programs after coronary artery bypass graft surgery: a minireview of selected randomized controlled trials. Sport Sciences for Health. 2017;13:477-83. [DOI: 10.1007/s11332-017-0400-7]
[15] Taylor JL, Bonikowske AR, Olson TP. Optimizing outcomes in cardiac rehabilitation: the importance of exercise intensity. Front Cardiovasc Med. 2021;8:734278. [DOI: 10.3389/fcvm. 2021.734278] [PMID] [PMCID]
[16] Bilinska M, Kosydar-Piechna M, Gasiorowska A, Mikulski T, Piotrowski W, Nazar K, et al. Influence of dynamic training on hemodynamic, neurohormonal responses to static exercise and on inflammatory markers in patients after coronary artery bypass grafting. Circ J. 2010;74(12):2598-604. [DOI: 10.1253/ circj.cj-10-0104] [PMID]
[17] Khameslo MB, Tofighi A, Azar JT, Hosseini SH, Mehdirji HA, Khameslo MB. The effects of aerobic exercise and sertraline on pro-inflammatory indices and amelioration of neurotrophic factors in patients who have undergone CABG. Sport Sci Health. 2023;19:969–78. [DOI: 10.1007/s11332-022-00992-3]
[18] Almasi J, Azizbeigi K, Mohammad Zade Salamat K, Naghshtabrizi B, Azarbayjani MA. [Effect of Resveratrol supplementation during cardiac rehabilitation exercise training on inflammatory systemic factors in patients undergoing coronary artery bypass surgery: Clinical trial Study (Persian)]. Journal of Gorgan University of Medical Sciences. 2019;21(4):14-21. [Link]
[19] Williams MA, Haskell WL, Ades PA, Amsterdam EA, Bittner V, Franklin BA, et al. Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2007;116(5):572-84. [DOI: 10.1161/CIRCULATIONAHA.107.185214] [PMID]
[20] Sadeghi M, Khosravi-Broujeni H, Salehi-Abarghouei A, Heidari R, Masoumi G, Roohafza H. Effect of cardiac rehabilitation on inflammation: A systematic review and meta-analysis of controlled clinical trials. ARYA Atheroscler. 2018;14(2):85-94. [DOI: 10.22122/arya.v14i2.1489] [PMID]
[21] Sellami M, Bragazzi NL, Aboghaba B, Elrayess MA. The impact of acute and chronic exercise on immunoglobulins and cytokines in elderly: insights from a critical review of the literature. Sellami M, Bragazzi NL, Aboghaba B, Elrayess MA. The impact of acute and chronic exercise on immunoglobulins and cytokines in elderly: insights from a critical review of the literature. Front Immunol. 2021;12:631873. [DOI: 10.3389/fimmu.2021.631873] [PMID] [PMCID]
[22] Parhizi F, Rashidlamir A, Khajei R, Ramzanpour MR, Vazifehdoost M. [The Effect of Eight Weeks of Aerobic Resistance Training on LXR Gene Expression and Serum TNFα Levels in CABG Patients (Persian)]. Journal of Animal Biology. 2020;12(2):23-33. [Link]
[23] Committee WE. Physical status: the use and interpretation of anthropometry. World Health Organ Tech Rep Ser.
Journal of Medical Sciences
November & December 2024. Vol 22. No 5
Monjezi M, et al. Expression of Thrombospondin-1 and Interleukin-1 Beta in Blood Mononuclear Cells. JSMJ. 2023; 22(5):639-649
1995;854:1-452. [PMID]
[24] Yoshikane H, Yamamoto T, Ozaki M, Matsuzaki M. Clinical significance of high-sensitivity C-reactive protein in lifestyle-related disease and metabolic syndrome. J Cardiol. 2007; 50(3):175-82. [PMID]
[25] Ridker PM. Inflammatory biomarkers and risks of myocardial infarction, stroke, diabetes, and total mortality: implications for longevity. Nutr Rev. 2007;65(12 Pt 2):S253-9. [DOI: 10. 1111/j.1753-4887.2007.tb00372.x] [PMID]
[26] Roncada G, Dendale P, Linsen L, Hendrikx M, Hansen D. Reduction in pulmonary function after CABG surgery is related to postoperative inflammation and hypercortisolemia. Int J Clin Exp Med. 2015;8(7):10938-46. [PMID]
[27] Mai W, Liao Y. Targeting IL-1β in the Treatment of Atherosclerosis. Front Immunol. 2020;11:589654. [DOI: 10. 3389/fimmu.2020.589654] [PMID] [PMCID]
[28] Pourheydar B, Biabanghard A, Azari R, Khalaji N, Chodari L. Exercise improves aging-related decreased angiogenesis through modulating VEGF-A, TSP-1 and p-NF-Ƙb protein levels in myocardiocytes. J Cardiovasc Thorac Res. 2020;12(2):129-35. [DOI: 10.34172/jcvtr.2020.21] [PMID]
[29] Olfert IM, Breen EC, Gavin TP, Wagner PD. Temporal thrombospondin-1 mRNA response in skeletal muscle exposed to acute and chronic exercise. Growth Factors. 2006;24(4):253-9. [DOI: 10.1080/08977190601000111] [PMID]
[30] Chen X, Xie K, Sun X, Zhang C, He H. The Mechanism of miR-21-5p/TSP-1-Mediating Exercise on the Function of Endothelial Progenitor Cells in Aged Rats. Int J Environ Res Public Health. 2023;20(2):1255. [DOI: 10.3390/ijerph20021255] [PMID] [PMCID]
[31] Lawler PR, Lawler J. Molecular basis for the regulation of angiogenesis by thrombospondin-1 and-2. Cold Spring Harb Perspect Med. 2012;2(5):a006627. [DOI: 10.1101/cshperspect. a006627] [PMID]