‌The‌‎ ‎‌effects‌‎ ‎‌of‌‎ ‎‌incremental‌‎ ‎‌aerobic‌‎ ‎‌training‌‎ ‎‌and‌‎ ‎‌electrical‌‎ ‎‌stimulation‌‎ ‎‌on‌‎ ‎‌sexual‌‎ ‎‌biomarkers‌‎ ‎‌in‌‎ ‎‌infarcted‌‎ ‎‌rats‌

Malekipooya, Mohammad‏‎; ‎‏Maleki, Hamide; Azari‏‎ ‎‏Hezave, Sara‏‎

doi:10.22034/26.4.19

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Volume 26, Issue 4 (Winter 2024)

EBNESINA 2024, 26(4): 19-30

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‌The‌‎ ‎‌effects‌‎ ‎‌of‌‎ ‎‌incremental‌‎ ‎‌aerobic‌‎ ‎‌training‌‎ ‎‌and‌‎ ‎‌electrical‌‎ ‎‌stimulation‌‎ ‎‌on‌‎ ‎‌sexual‌‎ ‎‌biomarkers‌‎ ‎‌in‌‎ ‎‌infarcted‌‎ ‎‌rats‌

Mohammad‏‎ Malekipooya

, Hamide ‎‏Maleki

, Sara‏‎ Azari‏‎ ‎‏Hezave ^*

Department‏‎ ‎‏of‏‎ ‎‏Exercise‏‎ ‎‏Physiology‏‎, ‎‏Ashtian‏‎ ‎‏Branch‏‎, ‎‏Islamic‏‎ ‎‏Azad‏‎ ‎‏University‏‎, ‎‏Ashtian‏‎, ‎‏Iran‏ , kiarash.sh79@gmail.com

Keywords: ‌Aerobic‌‎ ‎‌Exercise‌‎, ‎‌Myocardial‌‎ ‎‌Infarction‌‎, ‎‌Testosterone‌‎, ‎‌Gonadotropin‌‎-‎‌Releasing‌‎ ‎‌Hormone

Full-Text [PDF 1627 kb] (192 Downloads) | Abstract (HTML) (625 Views)

Type of Study: Original | Subject: Military Medicine
Received: 2024/07/19 | Revised: 2025/03/12 | Accepted: 2024/11/28 | Published: 2024/12/21

Extended Abstract: (215 Views)

Introduction

Cardiovascular disease (CVD) is the leading cause of death worldwide. Among its various causes, myocardial infarction (MI) is the most prevalent and poses the greatest treatment challenges as individuals age [1]. MI is a debilitating condition associated with numerous physical, psychological, and social issues [4]. Sexual problems are five times more common in patients with CVD than in healthy individuals, with a higher prevalence in men [6]. Testosterone secreted by Leydig cells in testicular tissue, is synthesized from cholesterol under the regulation of the hypothalamic-pituitary-gonadal axis. It is essential for cell growth and division to produce sperm [8]. Gonadotropin-releasing hormone (GnRH), a glycoprotein hormone primarily secreted by pituitary gonadotrope cells, plays a crucial role in growth, reproduction, and sexual function. The most well-known gonadotropins in humans include follicle-stimulating hormone (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), human chorionic gonadotropin (HCG), and human menopausal gonadotropin (HMG) [10].
Research by Parastesh et al. demonstrated that levels of testosterone and GnRH increase as a result of exercise [14]. Additionally, Baydil reported that exhaustive exercise significantly elevates testosterone levels in both sexes [15]. Another effective method considered in complementary medicine for treating diseases is electrical stimulation (ES), which is anticipated to be a rehabilitation technique for both sports training and patient recovery [17]. Notably, Malekipooya et al. conducted research indicating that electrical stimulation can reduce inflammation in patients with MI [18]. Therefore, this study aimed to investigate the effects of aerobic exercise combined with ES on sexual biomarkers in rats with induced MI.

Methods

In this experimental study, 28 eight-week-old male Wistar rats, averaging 220 ± 20 g, were utilized. After acclimatizing to the research environment, the animals were randomly divided into four groups: control (only MI), exercise (Ex), ES (ES), and exercise + ES (Ex.ES). To induce MI, a subcutaneous injection of isoproterenol was administered at a dose of 150 mg/kg body weight for two consecutive days. Following this, an exercise training protocol was implemented, succeeded by an ES program involving foot shock [20, 19]. After 48 hours, the rats were anesthetized, and blood was drawn from the right atrium. The blood was then centrifuged for 10 minutes, and the plasma was sent to the laboratory for chemical analysis of testosterone, GnRH, and cardiac troponin-I markers using the ELISA method. One-way analysis of variance (ANOVA) was employed for statistical analysis.

Results

The ANOVA test results indicated significant changes in both markers. The Tukey test revealed significant differences in testosterone levels between the Ex and ES groups (F=4.6, p=0.018), as well as the Ex and Ex.ES groups (F=4.6, p=0.017). Although exercise led to an increase in plasma testosterone concentration, this increase was not statistically significant compared to the control group (F=2.3, p=0.398).
The ANOVA test reported significant changes in the GnRH marker, with Tukey's test indicating significant differences between the control and Ex (F=24.2, p<0.0001), control and Ex.ES (F=6.1, p=0.002), Ex and ES (F=25.2, p<0.0001), Ex and Ex.ES (F=18.2, p<0.0001), and ES and Ex.ES groups (F=7, p=0.0004).

Discussion and Conclusion

The aim of this study was to investigate the effects of incremental aerobic activity combined with electrical stimulation on certain sexual markers in male rats with myocardial infarction. One key finding was a non-significant increase in plasma testosterone levels in the Ex group compared to the control group. However, a significant increase in plasma GnRH levels was observed in the Ex group compared to the control group. Sexual disorders are more prevalent in patients with heart disease than in healthy individuals, with the most significant issues being reduced sexual desire and avoidance of sexual activities, ultimately leading to sexual dissatisfaction [21]. Stepto et al. found that men with CVD experienced more difficulties with relationships, sexual activity, and erectile function than healthy individuals, resulting in a 38% decrease in sexual performance [22]. This is particularly important for cardiac patients due to increased inflammatory processes and their negative impact on sexual health. Crisostomo et al. demonstrated that p38 and SPAK/JNK signaling proteins associated with cardiac inflammation are linked to testosterone induction during inflammation [24]. Furthermore, Rateo et al. showed that TLR-4 has protective effects related to testosterone [25]. Some studies have reported its anti-inflammatory effects through the suppression of pro-inflammatory cytokines and the increase of anti-inflammatory cytokines [26]. Preclinical studies indicated that IL-6 and tumor necrosis factor can reduce testosterone levels, negatively affecting testosterone and GnRH secretion by increasing inflammatory factors [28]. The release of various hormones, including prolactin, corticotropin-releasing hormone, glucocorticoids, leptin, adiponectin, ghrelin, insulin, insulin-like growth factor, catecholamines, and neurotransmitters, are related to GnRH. It appears that aerobic exercise inhibits the NF-κB3 pathway, and the inhibition of NF-κB activation promotes GnRH secretion in the hypothalamus [30]. In another study, Grandys et al. found that testosterone levels fluctuate during the annual training program of sprinters, with higher testosterone levels observed during low-intensity training compared to other intensities [33].
Another significant finding of this study was a notable decrease in plasma levels of testosterone and GnRH hormones in the ES and Ex.ES groups compared to the Ex group. These groups did not show significant changes compared to the control group. Regarding the effects of ES with shock therapy and combination of aerobic exercise and ES on plasma levels of the examined sexual markers, no similar studies were found, particularly in MI patients. In the limited studies conducted, some researchers concluded that ES can lead to significant improvements in patients with moderate to severe heart failure [36]. Additionally, research by Dubsak et al. indicated that neuromuscular ES may have anti-inflammatory effects [37]. Given that this topic is relatively new, we need more research to investigate how training, stimulation, and varying intensities interact, particularly in terms of gene expressions.

Ethical Considerations

At all stages of the research, we adhered to ethical guidelines and made every effort to avoid any physical harm or unnecessary procedures on the laboratory animals.
This research was approved by the Research Ethics Committee of Arak Branch with code IR.IAU.ARAK.REC.1403.048.

Funding

This article is the result of a research project of Islamic Azad University, Arak Branch.

Authors’ Contribution

Authors contributed equally to the conceptualization and writing of the article. All of the authors approved the content of the manuscript and agreed on all aspects of the work.

Conflict of Interest

Authors declared no conflict of interest.

Acknowledgments

The authors would like to express their gratitude and appreciation to everyone who contributed to this research project

References

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Malekipooya M, ‎‏Maleki H, Azari‏‎ ‎‏Hezave S. ‌The‌‎ ‎‌effects‌‎ ‎‌of‌‎ ‎‌incremental‌‎ ‎‌aerobic‌‎ ‎‌training‌‎ ‎‌and‌‎ ‎‌electrical‌‎ ‎‌stimulation‌‎ ‎‌on‌‎ ‎‌sexual‌‎ ‎‌biomarkers‌‎ ‎‌in‌‎ ‎‌infarcted‌‎ ‎‌rats‌. EBNESINA 2024; 26 (4) :19-30
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