Table 3.

Biomarker responses to exercise in special populations. Studies on COPD, stroke, diving, blood flow restriction training, and sleep deprivation, briefly mentioned in the main text, are summarized here for completeness.

Population	Study design	Sample size	Intervention	Key biomarker findings	Clinical implication	Ref
COPD	Observational	Not specified (review article)	ET in COPD patients	NT-proBNP correlates with right heart strain and pulmonary hypertension severity; ET improves RV systolic function by echocardiography	A certain threshold may identify early cardiovascular damage in COPD; NT-proBNP predicts a poorer prognosis and future exacerbation risk.	(Şahin Özdemirel et al., 2014; Aritakulu Badrinath et al., 2025; Avdeev et al., 2025)
Post-Stroke	Single-masked RCT	50 patients (age 50-80, >1 year post-stroke)	6 months high-intensity AE vs. low-intensity BF training (3×/week, 60 min)	Right atrial emptying fraction improved in the AE group (30%→37% vs. BF: 35%→31%, p=0.04); lipids, glucose, and homocysteine improved in both groups (p<0.04)	Both forms of exercise enhance metabolic indicators, and HES improves right atrial function after a stroke.	(Tang et al., 2014)
Post-Stroke (Very Early)	Prospective single-masked RCT	48 patients with mild-to-moderate first-ever ischemic stroke	VEE initiated within 24h (45 min twice daily ×7 days) vs. standard care	VEE reduced IL-6, leukocytes, neutrophils, monocytes; increased lymphocytes (days 4-7); 3-month outcomes correlated with IL-6 changes (rs = -0.33 to -0.33, p=0.019-0.021)	Within a day, moderate-intensity VEE enhances recovery and effectively controls inflammatory markers, particularly IL-6.	(Ademoyegun et al., 2025)
SCUBA Diving	Observational	16 male recreational divers	30-minute SCUBA dive to 30 meters	Gal-3, NT-proBNP, hs-TnI, Mb, and VEGF increase immediately post-dive; Gal-3 and Mb returned to baseline; NT-proBNP and hs-TnI continued rising during recovery	Changes in biomarkers indicate a transient adaptation of the muscular and circulatory systems to diving; the long-term effects are unclear.	(Žarak et al., 2020)
Blood Flow Restriction (BFR) Training	Three-arm randomized crossover	Not specified (crossover design)	High-intensity (70% 1RM) vs. low-intensity without BFR (30% 1RM) vs. LI-BFR (30% 1RM + 300 mmHg cuff)	High-intensity up-regulated 6 miRNAs (miR-139-5p, -143-3p, -195-5p, -197-3p, -30a-5p, -10b-5p); LI-BFR down-regulated miR-143-3p; miR-143-3p correlated with lactate (r=0.52, p=0.009)	Arteriogenesis-associated miRNA-143-3p is impacted by both LI-BFR and HES; BFR may mimic arterial obstruction to increase collateral flow.	(Vogel et al., 2019)
Sleep Deprivation	Experimental	Not specified (crossover design)	Low-intensity (LES) vs. high-intensity (HES) AE after 3 days of sleep deprivation	SD increased cortisol, hs-CRP, and oxidative stress (D-ROM); LES reduced cortisol and oxidative stress; HES further increased both; no significant change in hs-CRP after any exercise intervention	For those who are sleep deprived, LES is suitable and safe; HES intensifies adverse consequences.	(Park et al., 2023)