Response of Ischemia- Modified Albumin (IMA) Plasma to the Time of Intensive Exercise (Morning and Evening) in Male Patients with Cardiovascular Disease

Document Type : Original Article


1 Department of Sport Physiology, Larestan Branch, Islamic Azad University,Larestan, Iran

2 Department of Exercise Physiology, Shiraz University, Shiraz, Iran

3 Department of Exercise Biochemistry and Exercise Metabolism, Kish International Campus, University of Tehran, Kish, Iran

4 Department of Exercise Physiology, Shiraz University International Division, Shiraz University, Shiraz, Iran


assured diagnosis of heart problems. However, the amount of this factor in response to exercise and in different times of the day is not determined. Therefore, the present study aimed to investigate the effect of training time (morning and evening) on ischemia-modified albumin (IMA) plasma levels in male patients with cardiovascular disease. Methods: 15 male patients with cardiovascular disease were chosen to participate in this quasi-experimental study. Before the outset of exercise protocol under specialist supervision, pre-test blood samples were taken from subjects at 7:00 in the morning. After taking blood samples, all participants took part in an exercise test until exhaustion. This test was designed based on Bruce protocol including 7 stages and each of these 3 minute stages followed predetermined speed and grade. One week later, subjects went through the same process at 7:00 in the evening. Paired sample t- test was used to analyze and compare pre-test and post-test means of each training period (morning and evening) and compare the mean of both times in the morning and in the evening. SPSS.20 was used to analyze study data. Results: there is no significant difference between pre-test means during morning and evening exercises (P=0.292). In addition to this, no significant relation was observed between post-test mean and three-hour-after test in the morning and evening, (P=0.185) and (P=0.250), respectively. Conclusion: Based on this study it could be said that circadian rhythm and circadian cycle have no severe effect on chemical responds and cardiac risk factors. Thus, cardiovascular patients can engage in their desired exercise during morning and evening.


1.Filippatos G, Farmakis D, Parissis J, Greece A. Novel biomarkers in acute coronary syndromes new molecules, new concepts, but what about new treatment strategies?. J Am Coll Cardiol. 2013; (16): 1654- 1656.
2.Anderson K, Castelli W, Jama DL. Cholesterol and mortality: 30 years of follow-up from the Framingham Study. JAMA. 1987; 257 (16): 2176- 2180.
3.Grundy SM. Cholesterol and Coronary Heart Disease: A new era. JAMA J Am Med Assoc. 1986; 256 (20): 2849- 2858.
4.Lippi G, Schena F, Salvagno GL, Montagnana M. Comparison of the lipid profile and lipoprotein(a) between sedentary and highly trained subjects standardization of the colors of the blood tube closures view project acute cardiovascular care view project. Clin Chem Lab Med. 2006; 44 (3): 322- 326.
5.Buyukyazi G. The effects of eight-week walking programs of two different intensities on serum lipids and circulating markers of collagen remodelling in humans. Scie Sport. 2008; 23 (3-4): 162- 169.
6.Michielsen ECHJ, Wodzig WKWH, Van D, Visser MP. Cardiac troponin T release after prolonged strenuous exercise. Sport Med. 2008; 38 (5): 425- 435.
7.Chan D, Ng LL. Biomarkers in acute myocardial infarction. BMC Med. 2010; 8 (1): 34.
8.Charpentier S, Ducassé JL, Cournot M. Clinical assessment of ischemia-modified albumin and heart fatty acid-binding protein in the early diagnosis of non-ST-elevation acute coronary syndrome in the emergency department. Acad Emerg Med. 2010; 17 (1): 27- 35.
9. Gaze DC. Biomarkers of cardiac ischemia. in: ischemic heart disease. intech. 2013.
10.Patil SM, Banker MP, Padalkar RK. The clinical assessment of ischaemia modified albumin and troponin I in the early diagnosis of the acute coronary syndrome. J Clin Diagnostic Res. 2013; 7 (5): 804.
11.Sharma R, Gaze DC, Collinson PO. The evaluation of ischaemia-modified albumin as a marker of myocardial ischaemia in end stage renal disease. Clin Sci. 2007; 113 (1): 25- 32.
12. Ertekin B, Kocak S, Dundar ZD, Girisgin S. Diagnostic value of ischemia-modified albumin in acute coronary syndrome and acute ischemic stroke. Pakistan J Med Sci. 2013; 29 (4): 1003.
13. Kountana E,Tziomalos K, Semertzidis P. Comparison of the diagnostic accuracy of ischemia-modified albumin and echocardiography in patients with acute chest pain. Experim Clin Cardiol. 2013; 18 (2): 98.
14. Şeneş M, Kazan N, Coşkun Ö, Zengi O, Inan L, Yücel D, et al. Oxidative and nitrosative stress in acute ischaemic stroke. Ann Clin Biochem. 2007; 44 (1): 43- 47.
15.Abboud H, Labreuche J, Meseguer E, Lavallee PC, Simon O, Olivot J.M, et al. Ischemia- modified albumin in acute stroke. Cerebrovasc Dis. 2007; 23 (2-3): 216- 220.
16. Turedi S, Gunduz A, Mentese A. The value of ischemia-modified albumin compared with d-dimer in the diagnosis of pulmonary embolism. Respiratory Res. 2008; 9 (1): 49.
17.Apple FS, Fred S. Release characteristics of cardiac biomarkers and ischemia-modified albumin as measured by the albumin cobalt-binding test after a marathon race. Clin Chem. 2002; 48 (7): 1097- 1100.
18. Sbarouni E, Georgiadou P, Theodorakis GN, Kremastinos DT, Greece A. Ischemia-modified albumin in relation to exercise stress testing. J Am Coll Cardiol. 2006; 48 (12): 2482- 2484.
19.Falkensammer J, Stojakovic T, Huber K. Serum levels of ischemia-modified albumin in healthy volunteers after exercise-induced calf-muscle ischemia. Clin Chem Lab Med. 2007; 45 (4): 535- 540.
20.Aldemir H, Kiliç N. The effect of time of day and exercise on platelet functions and platelet-neutrophil aggregates in healthy male subjects. Mol Cell Biochem. 2005; 280 (1-2): 119- 124.
21.Piccione G, Grasso F, Fazio F, Giudice E. The effect of physical exercise on the daily rhythm of platelet aggregation and body temperature in horses. Veterinary J. 2008; 176 (2): 216- 220.
22. Pledge D, Grosset JF, Onambélé P. Is there a morning-to-evening difference in the acute IL-6 and cortisol responses to resistance exercise?. Cytokine. 2011; 55 (2): 318- 323.
23. Atkinson G, Drust B, Reilly T, Waterhouse J. The relevance of melatonin to sports medicine and science. Sport Med. 2003; 33 (11): 809- 831.
 24.Khosravani N, Soori R, Shahghelian S. Effect of exercise time in the day on maximal fat oxidation markers on healthy yong women. Sport Biosci. 2011; 11: 75- 88.
25.Ahmadizad S, Bassami M, Laren D. The effect of time of day on fat metabolism at rest and response to exercise. J Sports Sci. 2005; 23 (2): 150- 151.
26.Kudielka BM, Schommer NC, Hellhammer DH. Acute HPA axis responses, heart rate, and mood changes to psychosocial stress (TSST) in humans at different times of day. Psychoneuroendocrinol. 2004; 29 (8): 983- 992.
27.Pasavand P, Salesi M, MehrabiA, Divsalar K, Beigi MA. A comparison of the time of physical activities (morning and afternoon) on the amount of plasma myoglobin and creatine kinase of non- athletic men with cardiovascular diseases. Razi Med Sci J. 2015; 87 (1): 48- 55.
28.Mehrabi A, Salesi M, Pasavand P. Comparison of the effect of the exercise time (morning or evening) and the amount of troponin T in men with cardiovascular diseases. Razi Med Sci J. 2015; 134 (22): 108- 114.
29.Pan S, Tong C, Lin Q, Yao C, Zhao J. Ischemia-modified albumin measured with ultra-filtration assay in early diagnosis of acute coronary syndrome. World J Emergency Med. 2010; 1 (1): 37.
30. Collinson PO, Stubbs PJ, Kessler AC. Multicentre evaluation of the diagnostic value of cardiac troponin T, CK-MB mass, and myoglobin for assessing patients with suspected acute coronary syndromes in routine clinical practice. Heart. 2003; 89 (3): 280- 286.
31. Sinha MK, Vazquez JM, Calvino R, Gaze DC. Effects of balloon occlusion during percutaneous coronary intervention on circulating ischemia modified albumin and transmyocardial lactate extraction. Heart. 2006; 92 (12): 1852- 1853.
32.      Çolak T, Bamaç B, Çolak S, Duman C, Bayazit B. The influence of a single bout of wrestling exercise on serum levels of ischemia-modified albumin. J Exer Sci Fitness. 2010; 8 (2): 67- 72.
33. Roy D, Quiles J, Sharma R, Sinha M. Ischemia-modified albumin concentrations in patients with peripheral vascular disease and exercise-induced skeletal muscle ischemia. Clin Chem. 2004; 50 (9): 1656- 1660.
34.van der Zee PM, Verberne HJ. Ischemia-modified albumin measurements in symptom-limited exercise myocardial perfusion scintigraphy reflect serum albumin concentrations but not myocardial ischemia. Clin Chem. 2005; 51 (9): 1744- 1746.
35. Bakula M,Milicevic G, Kozic I, Rumenjak V. Kinetics of ischemia- modified albumin following exercise- induced myocardial ischemia. Clin Laboratory. 2016; 62 (4): 563- 571.