Valor pronóstico de ST2 soluble en suero en deportistas profesionales (Prognostic value of serum soluble ST2 in professional athletes)
DOI:
https://doi.org/10.47197/retos.v43i0.87966Palabras clave:
soluble ST2, biomarcador, hipertrofia cardíaca, estrés, atletas, (solubleST2; biomarker; heart hypertrophy; stress; athletes.)Resumen
Antecedentes: El valor predictivo del biomarcador ST2 soluble en suero (sST2) en la enfermedad cardiovascular aún no se conoce bien, así como el papel del estrés psicológico en el riesgo de enfermedad cardiovascular. Objetivos: Este estudio tuvo como objetivo determinar la importancia diagnóstica del nivel de sST2 en atletas involucrados en deportes de velocidad-fuerza. Además, también se evaluó y analizó el estrés como factor de riesgo para el desarrollo de patología cardiovascular. Métodos: Se llevó a cabo un estudio prospectivo sobre luchadores grecorromanos en el Centro de Medicina y Rehabilitación del Deporte (Almaty, República de Kazajstán). Todos los participantes (n = 30) eran hombres de entre 20 y 34 años. El grupo de control estaba formado por voluntarios (VO) (n = 30). Se estudiaron los parámetros antropométricos y hemodinámicos de los atletas junto con las pruebas de electrocardiografía (ECG). El nivel de sST2 se determinó antes (BT) e inmediatamente después (AT) del entrenamiento. El nivel de estrés se determinó utilizando la Escala de Estrés Percibido-10 (PSS-10). Resultados: La edad promedio de los deportistas fue de 26,57 ± 3,6 años. La experiencia de formación total fue de 14,57 ± 4,02 años. Según los datos del ECG, se identificaron desviaciones menores de la norma (13,3%) y un ECG anormal (33,3%). Los datos de Echo-CG mostraron cambios "moderados" y "pronunciados" en el 23,3% y el 53,3% de los casos, respectivamente. El nivel de sST2 del grupo VO (337,1 ± 61,8 pg / mL) fue menor que el de BT (548,1 ± 32,6 pg / mL) (p ≤ 0,001),). El nivel de sST2 en AT fue significativamente mayor (830.01 ± 71.6 pg / mL) que en BT (p ≤ 0.001). El nivel medio y alto de estrés entre los deportistas fue del 43,3% y el 56,7% de los casos, respectivamente. El estrés aumentó la probabilidad de desarrollar un ECG claramente anormal (OR = 1,06; IC del 95%: 1,01-1,08; p = 0,02). El nivel de estrés mostró una correlación positiva con el nivel de sST2 (r = 0,752, p = 0,01). La concentración de sST2 y los datos de la ecocardiografía categórica demostraron una correlación positiva dependiente (r = 0,6, p = 0,01). Conclusión: Los niveles de sST2 de los atletas excedieron los umbrales tanto antes como después del entrenamiento. Además, se determinó la relación entre un aumento en los niveles de sST2 y anomalías anormales del ECG y un alto nivel de estrés en los atletas. La concentración de sST2 se asoció con el estrés cardiopulmonar desencadenado por la dosis acumulativa de ejercicio, así como con el estrés psicológico de por vida. Nuestros hallazgos indican que las concentraciones elevadas de sST2 en los atletas pueden usarse como valor predictivo. Sin embargo, se requieren más estudios.
Abstract. Background: The predictive value of serum soluble ST2 (sST2) biomarker for diagnostics of cardiovascular pathologies is still poorly understood as well as the role of psychological stress on the risk of heart disease. Aim: This study aimed at determining the diagnostic significance of the sST2 level in athletes involved in speed-strength sports. In addition, stress as a risk factor for the development of cardiovascular pathology was assessed and analysed as well. Methods: A prospective study on Greco-Roman wrestlers was carried out at the Centre for Sports Medicine and Rehabilitation (Almaty, Republic of Kazakhstan). All participants (n = 30) were males aged 20 to 34 years. The control group consisted of volunteers (VO) (n = 30). Anthropometric and hemodynamic parameters of athletes were studied along with electrocardiography (ECG) and ECG tests. The sST2 level was determined before (BT) and immediately after (AT) training. The stress level was determined using The Perceived Stress Scale-10 (PSS-10). Results: The average age of the athletes was 26.57 ± 3.6 years. The total training experience was 14.57 ± 4.02 years. According to the ECG data, minor deviations from the norm (13.3%) and an abnormal ECG (33.3%) were identified. Echo-CG data showed "moderate" and "pronounced changes" in 23.3% and 53.3% of cases, respectively. The sST2 level of VO (337.1 ± 61.8 pg / mL) was lower than that of BT (548.1 ± 32.6 pg / mL) (p ≤ 0.001). The sST2 level of AT, it was significantly higher (830.01 ± 71.6 pg / mL) than BT (p ≤ 0.001). The average and high level of stress among athletes was in 43.3% and 56.7% of cases, respectively. Stress increased the likelihood of developing distinctly abnormal ECG (OR = 1.06, 95% CI 1.01–1.08; p = 0.02). The stress level showed a positive correlation with the sST2 level (r = 0.752, p = 0.01). The sST2 concentration and categorical echocardiography data demonstrated a dependent positive correlation (r = 0.6, p = 0.01). Conclusions: Athletes' sST2 levels exceeded thresholds both before and after training. Moreover, the relationship between an increase in sST2 levels and abnormal ECG abnormalities and a high level of stress in athletes was determined. sST2 concentration was associated with cardio-pulmonary stress triggered by the cumulative exercise dose as well as with lifelong psychological stress. Our findings indicate that the elevated sST2 concentrations in athletes could be used as the predictive value. However, clinical relevance and results validity require further intensive studies.
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Derechos de autor 2021 Madina Baurzhan, Salim Berkinbayev, Kuat Abzaliyev, Zhanar Andassova, Yrysbubu Anvarbekova, Symbat Abzaliyeva, Karashash Absatarova, Shynar Tanabayeva, Ildar Fakhradiyev
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