1
|
Richardson LA, Basu A, Chien LC, Alman AC, Snell-Bergeon JK. Longitudinal associations of physical activity with inflammatory markers in US adults with and without type 1 diabetes. Diabetes Res Clin Pract 2023; 206:110978. [PMID: 37890704 PMCID: PMC10841646 DOI: 10.1016/j.diabres.2023.110978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/28/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
AIMS To investigate the longitudinal associations of different levels of moderate-to-vigorous physical activity (MVPA) with C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1), and fibrinogen. METHODS We conducted longitudinal analyses with data from the Coronary Artery Calcification in T1D (CACTI) cohort, which included individuals with type 1 diabetes (T1D, n = 563) and without diabetes mellitus (non-DM, n = 692) with ∼ 3 years follow-up. Individuals were divided into groups to perform two analyses: 1) those who performed any MVPA and those who were sedentary (0 mins/week) and 2) those who performed 1-149 mins/week, ≥150 mins/week, or who were sedentary. Mixed effect models with an unstructured covariance structure were applied. RESULTS Compared to sedentary individuals, any MVPA was associated with a -2.96 % decrease in fibrinogen (p-value = 0.0043) and a -11.23 % decrease in PAI-1 (p-value = 0.0007) in combined analyses. Stratified analyses found 1-149 mins/week and ≥ 150 mins/week were associated with significant decreases in fibrinogen, -5.31 % and -3.44 %, respectively, in those with T1D. Both the non-DM and T1D groups had significant decreases in PAI-1 associated with ≥ 150 mins/week (-9.11 % and -16.96 %, respectively). CONCLUSIONS Our findings highlight that meeting ≥ 150 mins/week of MVPA is inversely associated with inflammatory markers linked with increased CVD risk.
Collapse
Affiliation(s)
- Leigh Ann Richardson
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, United States
| | - Arpita Basu
- Department of Kinesiology and Nutrition Sciences, University of Nevada at Las Vegas, United States.
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, University of Nevada at Las Vegas, United States
| | - Amy C Alman
- College of Public Health, University of South Florida, United States
| | - Janet K Snell-Bergeon
- Barbara Davis Center for Diabetes, University of Colorado, Anschutz Medical Campus, United States
| |
Collapse
|
2
|
Barale C, Melchionda E, Tempesta G, Morotti A, Russo I. Impact of Physical Exercise on Platelets: Focus on Its Effects in Metabolic Chronic Diseases. Antioxidants (Basel) 2023; 12:1609. [PMID: 37627603 PMCID: PMC10451697 DOI: 10.3390/antiox12081609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Chronic disorders are strongly linked to cardiovascular (CV) diseases, and it is unanimously accepted that regular exercise training is a key tool to improving CV risk factors, including diabetes, dyslipidemia, and obesity. Increased oxidative stress due to an imbalance between reactive oxygen species production and their scavenging by endogenous antioxidant capacity is the common ground among these metabolic disorders, and each of them affects platelet function. However, the correction of hyperglycemia in diabetes and lipid profile in dyslipidemia as well as the lowering of body weight in obesity all correlate with amelioration of platelet function. Habitual physical exercise triggers important mechanisms related to the exercise benefits for health improvement and protects against CV events. Platelets play an important role in many physiological and pathophysiological processes, including the development of arterial thrombosis, and physical (in)activity has been shown to interfere with platelet function. Although data reported by studies carried out on this topic show discrepancies, the current knowledge on platelet function affected by exercise mainly depends on the type of applied exercise intensity and whether acute or habitual, strenuous or moderate, thus suggesting that physical activity and exercise intensity may interfere with platelet function differently. Thus, this review is designed to cover the aspects of the relationship between physical exercise and vascular benefits, with an emphasis on the modulation of platelet function, especially in some metabolic diseases.
Collapse
Affiliation(s)
| | | | | | | | - Isabella Russo
- Department of Clinical and Biological Sciences of Turin University, Regione Gonzole, 10, Orbassano, I-10043 Turin, Italy; (C.B.); (E.M.); (G.T.); (A.M.)
| |
Collapse
|
3
|
Skouras AZ, Antonakis-Karamintzas D, Tsolakis C, Tsantes AE, Kourlaba G, Zafeiris I, Soucacos F, Papagiannis G, Triantafyllou A, Houhoula D, Savvidou O, Koulouvaris P. Pre- and Postoperative Exercise Effectiveness in Mobility, Hemostatic Balance, and Prognostic Biomarkers in Hip Fracture Patients: A Study Protocol for a Randomized Controlled Trial. Biomedicines 2023; 11:biomedicines11051263. [PMID: 37238934 DOI: 10.3390/biomedicines11051263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Hip fractures are a major health concern, particularly for older adults, as they can reduce life quality, mobility loss, and even death. Current evidence reveals that early intervention is recommended for endurance in patients with hip fractures. To our knowledge, preoperative exercise intervention in patients with hip fractures remains poorly researched, and no study has yet applied aerobic exercise preoperatively. This study aims to investigate the short-term benefits of a supervised preoperative aerobic moderate-intensity interval training (MIIT) program and the added effect of an 8-week postoperative MIIT aerobic exercise program with a portable upper extremity cycle ergometer. The work-to-recovery ratio will be 1-to-1, consisting of 120 s for each bout and four and eight rounds for the pre- and postoperative programs, respectively. The preoperative program will be delivered twice a day. A parallel group, single-blinded, randomized controlled trial (RCT) was planned to be conducted with 58 patients each in the intervention and control groups. This study has two primary purposes. First, to study the effect of a preoperative aerobic exercise program with a portable upper extremity cycle ergometer on immediate postoperative mobility. Second, to investigate the additional effect of an 8-week postoperative aerobic exercise program with a portable upper extremity cycle ergometer on the walking distance at eight weeks after surgery. This study also has several secondary objectives, such as ameliorating surgical and keeping hemostatic balance throughout exercise. This study may expand our knowledge of preoperative exercise effectiveness in hip fracture patients and enhance the current literature about early intervention benefits.
Collapse
Affiliation(s)
- Apostolos Z Skouras
- 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Dimitrios Antonakis-Karamintzas
- 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Charilaos Tsolakis
- 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Sports Performance Laboratory, School of Physical Education & Sports Science, National and Kapodistrian University of Athens, 17237 Athens, Greece
| | - Argirios E Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Georgia Kourlaba
- Faculty of Health, Department of Nursing, University of Peloponnese, 23100 Sparta, Greece
| | - Ioannis Zafeiris
- 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Fotini Soucacos
- 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Georgios Papagiannis
- 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Biomechanics Laboratory, Department of Physiotherapy, University of the Peloponnese, 23100 Sparta, Greece
| | - Athanasios Triantafyllou
- 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
- Biomechanics Laboratory, Department of Physiotherapy, University of the Peloponnese, 23100 Sparta, Greece
| | - Dimitra Houhoula
- Department of Food Science and Technology, University of West Attica, 12244 Egaleo, Greece
| | - Olga Savvidou
- 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Panagiotis Koulouvaris
- 1st Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| |
Collapse
|
4
|
Skouras AZ, Antonakis-Karamintzas D, Tsantes AG, Triantafyllou A, Papagiannis G, Tsolakis C, Koulouvaris P. The Acute and Chronic Effects of Resistance and Aerobic Exercise in Hemostatic Balance: A Brief Review. Sports (Basel) 2023; 11:sports11040074. [PMID: 37104148 PMCID: PMC10143125 DOI: 10.3390/sports11040074] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Hemostatic balance refers to the dynamic balance between blood clot formation (coagulation), blood clot dissolution (fibrinolysis), anticoagulation, and innate immunity. Although regular habitual exercise may lower the incidence of cardiovascular diseases (CVD) by improving an individual’s hemostatic profile at rest and during exertion, vigorous exercise may increase the risk of sudden cardiac death and venous thromboembolism (VTE). This literature review aims to investigate the hemostatic system’s acute and chronic adaptive responses to different types of exercise in healthy and patient populations. Compared to athletes, sedentary healthy individuals demonstrate similar post-exercise responses in platelet function and coagulatory and fibrinolytic potential. However, hemostatic adaptations of patients with chronic diseases in regular training is a promising field. Despite the increased risk of thrombotic events during an acute bout of vigorous exercise, regular exposure to high-intensity exercise might desensitize exercise-induced platelet aggregation, moderate coagulatory parameters, and up-regulate fibrinolytic potential via increasing tissue plasminogen activator (tPA) and decreasing plasminogen activator inhibitor (PAI-1) response. Future research might focus on combining different types of exercise, manipulating each training characteristic (frequency, intensity, time, and volume), or investigating the minimal exercise dosage required to maintain hemostatic balance, especially in patients with various health conditions.
Collapse
|
5
|
Zheng A, Zhang L, Yang J, Yin X, Zhang T, Wu X, Ma X. Physical activity prevents tumor metastasis through modulation of immune function. Front Pharmacol 2022; 13:1034129. [PMID: 36313283 PMCID: PMC9596782 DOI: 10.3389/fphar.2022.1034129] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/20/2022] [Indexed: 01/10/2023] Open
Abstract
Metastasis is responsible for 90% of deaths in cancer patients. Most patients diagnosed with metastatic cancer will die within 5 years. PA is good for health and has become an emerging adjuvant therapy for cancer survivors. Regular moderate exercise substantially lowers the incidence and recurrence of several cancers, alleviates cancer-related adverse events, enhances the efficacy of anti-cancer treatments, and improves the quality of life of cancer patients. Revealing the mechanisms of PA inhibiting tumor metastasis could upgrade our understanding of cancer biology and help researchers explore new therapeutic strategies to improve survival in cancer patients. However, it remains poorly understood how physical activity prevents metastasis by modulating tumor behavior. The immune system is involved in each step of tumor metastasis. From invasion to colonization, immune cells interact with tumor cells to secret cytokines and proteases to remodel the tumor microenvironment. Substantial studies demonstrated the ability of physical activity to induce antitumor effects of immune cells. This provides the possibility that physical activity can modulate immune cells behavior to attenuate tumor metastasis. The purpose of this review is to discuss and summarize the critical link between immune function and exercise in metastasis prevention.
Collapse
Affiliation(s)
- Aiping Zheng
- Division of Biotherapy, Cancer Center, West China Hospital, Cancer Center, Sichuan University, Chengdu, China
- Head and Neck Oncology Ward, Cancer Center, West China Hospital, Cancer Center, Sichuan University, Chengdu, China
| | - Lei Zhang
- Department of Obstetrics & Gynecology, Chengdu First People’s Hospital & Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, China
| | - Jiaqing Yang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaomeng Yin
- Division of Biotherapy, Cancer Center, West China Hospital, Cancer Center, Sichuan University, Chengdu, China
| | - Tao Zhang
- Division of Biotherapy, Cancer Center, West China Hospital, Cancer Center, Sichuan University, Chengdu, China
| | - Xin Wu
- Head and Neck Oncology Ward, Cancer Center, West China Hospital, Cancer Center, Sichuan University, Chengdu, China
- Head and Neck Oncology Ward, Division of Radiotherapy Oncology, Cancer Center, West China Hospital, Chengdu, China
- *Correspondence: Xin Wu, ; Xuelei Ma,
| | - Xuelei Ma
- Division of Biotherapy, Cancer Center, West China Hospital, Cancer Center, Sichuan University, Chengdu, China
- *Correspondence: Xin Wu, ; Xuelei Ma,
| |
Collapse
|
6
|
Regan-Smith S, Fritzen R, Hierons SJ, Ajjan RA, Blindauer CA, Stewart AJ. Strategies for Therapeutic Amelioration of Aberrant Plasma Zn2+ Handling in Thrombotic Disease: Targeting Fatty Acid/Serum Albumin-Mediated Effects. Int J Mol Sci 2022; 23:ijms231810302. [PMID: 36142215 PMCID: PMC9499645 DOI: 10.3390/ijms231810302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 11/16/2022] Open
Abstract
The initiation, maintenance and regulation of blood coagulation is inexorably linked to the actions of Zn2+ in blood plasma. Zn2+ interacts with a variety of haemostatic proteins in the bloodstream including fibrinogen, histidine-rich glycoprotein (HRG) and high molecular weight kininogen (HMWK) to regulate haemostasis. The availability of Zn2+ to bind such proteins is controlled by human serum albumin (HSA), which binds 70–85% of plasma Zn2+ under basal conditions. HSA also binds and transports non-esterified fatty acids (NEFAs). Upon NEFA binding, there is a change in the structure of HSA which leads to a reduction in its affinity for Zn2+. This enables other plasma proteins to better compete for binding of Zn2+. In diseases where elevated plasma NEFA concentrations are a feature, such as obesity and diabetes, there is a concurrent increase in hypercoagulability. Evidence indicates that NEFA-induced perturbation of Zn2+-binding by HSA may contribute to the thrombotic complications frequently observed in these pathophysiological conditions. This review highlights potential interventions, both pharmaceutical and non-pharmaceutical that may be employed to combat this dysregulation. Lifestyle and dietary changes have been shown to reduce plasma NEFA concentrations. Furthermore, drugs that influence NEFA levels such as statins and fibrates may be useful in this context. In severely obese patients, more invasive therapies such as bariatric surgery may be useful. Finally, other potential treatments such as chelation therapies, use of cholesteryl transfer protein (CETP) inhibitors, lipase inhibitors, fatty acid inhibitors and other treatments are highlighted, which with additional research and appropriate clinical trials, could prove useful in the treatment and management of thrombotic disease through amelioration of plasma Zn2+ dysregulation in high-risk individuals.
Collapse
Affiliation(s)
| | - Remi Fritzen
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK
| | | | - Ramzi A. Ajjan
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UK
| | | | - Alan J. Stewart
- School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK
- Correspondence: ; Tel.: +44-(0)1334-463546
| |
Collapse
|
7
|
Huang SC, Hsu CC, Fu TC, Chen CPC, Liao MF, Hsu CY, Wang JS. Stepper-Based Training Improves Monocyte-Platelet Aggregation and Thrombin Generation in Nonambulatory Hemiplegic Patients. Med Sci Sports Exerc 2022; 54:821-829. [PMID: 34935707 DOI: 10.1249/mss.0000000000002846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Nonambulatory stroke patients are extremely sedentary, but most available data concerning exercise training in stroke patients are related to ambulatory patients. This study aimed to investigate the efficacy of stepper-based exercise training on cardiopulmonary fitness, monocyte subtypes, and associated monocyte-platelet aggregates (MPA) and thrombin generation (TrG) in nonambulatory hemiplegic patients with ischemic stroke. METHOD Thirty-eight patients were randomized into exercise training (ET, n = 20) and usual care (UC, n = 18) groups. The ET underwent supervised exercise training (60% peak work rate) using a recumbent stepper for two to four sessions per week and 36 sessions in total. In addition, 12 healthy participants were enrolled as healthy controls. Monocyte characteristics, MPA, and plasma TrG kinetics were determined before and after intervention by flow cytometry and calibrated automated thrombogram® (CAT). RESULTS Seventeen and 15 patients completed the protocol in the ET and UC groups. Peak V̇O2 improved in ET (15.7 ± 4.8 vs 18.9 ± 5.3 mL·min-1·kg-1, +20%), so did the phase angle of the hemiplegic limbs. The counts of total MPA and MPA associated with three monocyte subtypes, alongside CD42b expression all declined in ET with subtypes 2 and 1 being the most prominent. Macrophage inflammatory protein 1β (MIP-1 β) level also declined. The TrG kinetics was attenuated after ET by delaying initiation and reducing the rising slope and peak of thrombin production. In UC, no difference was revealed in the pre-post comparison. CONCLUSIONS Stepper-based ET is feasible in nonambulatory hemiplegic patients and is effective in improving aerobic fitness. Moreover, it decreases heteroaggregation of monocytes with platelets, especially in monocyte subtypes 2 and 1. Thrombin generation was also attenuated. Hence, stepper-based ET may be incorporated in the rehabilitation of nonambulatory hemiplegic patients.
Collapse
Affiliation(s)
| | | | | | | | - Ming-Feng Liao
- Department of Neurology, Chang Gung Memorial Hospital, Linkuo, TAIWAN
| | - Chien-Ya Hsu
- Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital, Linkou, TAIWAN
| | | |
Collapse
|
8
|
Exposito Ordóñez E, Roldán Conesa D, Vicente Vera T. Prognostic effects of cardiovascular rehabilitation: facts and myths. Panminerva Med 2021; 63:160-169. [PMID: 33755389 DOI: 10.23736/s0031-0808.21.04267-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Since CR was introduced, studies have been carried out to discover the effect of CRHPs on cardiovascular morbidity and mortality and on heart-disease patients' quality of life. The first meta-analyses showed improvement in cardiovascular morbidity and mortality, although the studies were conducted in the coronary pre-reperfusion era, before the generalized use in secondary prevention of drugs such as statins, beta-blockers, or renin-angiotensin-system inhibitors, which have produced a decrease in cardiovascular mortality. In Europe, analyzing 25 studies with more than 200,000 patients. It concluded that, in spite of the great heterogeneity of the programs, CR clearly decreases mortality after ACS. Nevertheless, a strategy of CRHP standardization and evaluation is needed. In 2017, a study was carried out in our hospital to evaluate the effectiveness of multidisciplinary CRHP intervention on cardiovascular morbidity and mortality, recurrence of cardiovascular events, the control of RFCV and lifestyle changes in patients after ACS. A total of 442 patients were included who had presented an acute cardiovascular event in the previous six months; 306 patients from the CR group and 136 others with standard cardiology follow-up were used as controls. 405 patients completed follow-up for a median of 60 months. Compared to the usual treatments in cardiology, the patients who underwent CRHPs presented fewer readmissions for cardiovascular reasons (17% vs. 43.38%, P<0.001), fewer major cardiovascular events (11.9% vs. 27.2%, P<0.001) and new revascularizations (9.3% vs. 21.32%, P=0.001), with lower cardiovascular mortality (0 vs. 2.2%, P=0.014). It also led to better control of the RFCV (66% vs. 19.85%, P<0.001) and favored lifestyle changes in these patients (91% vs. 61%, P<0.001). Therefore, in our setting, the performance of CRHPs was shown to be effective in reducing cardiovascular morbidity and mortality and in the secondary prevention of coronary patients.
Collapse
Affiliation(s)
| | - Diego Roldán Conesa
- Cardiac Rehabilitation Unit, Reina Sofia de Murcia University Hospital, Murcia, Spain
| | - Tomás Vicente Vera
- Cardiac Rehabilitation Unit, Reina Sofia de Murcia University Hospital, Murcia, Spain - .,Catholic University of San Antonio de Murcia, Department of Cardiology, Reina Sofia de Murcia University Hospital, Murcia, Spain
| |
Collapse
|
9
|
Lin ML, Fu TC, Hsu CC, Huang SC, Lin YT, Wang JS. Cycling Exercise Training Enhances Platelet Mitochondrial Bioenergetics in Patients with Peripheral Arterial Disease: A Randomized Controlled Trial. Thromb Haemost 2021; 121:900-912. [PMID: 33421964 DOI: 10.1055/s-0040-1722191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Exercise training influences the risk of vascular thrombosis in patients with peripheral arterial disease (PAD). Mitochondrial functionalities in platelets involve the cellular bioenergetics and thrombogenesis. This study aimed to elucidate the effect of cycling exercise training (CET) on platelet mitochondrial bioenergetics in PAD patients. Forty randomly selected patients with PAD engaged in general rehabilitation (GR) with CET (i.e., cycling exercise at ventilation threshold for 30 minute/day, 3 days/week) (GR + CET, n = 20) or to a control group that only received GR course (n = 20) for 12 weeks. Systemic aerobic capacity and platelet mitochondrial bioenergetics that included oxidative phosphorylation (OXPHOS) and electron transport system (ETS) were measured using automatic gas analysis and high-resolution respirometry, respectively. The experimental results demonstrated that GR + CET for 12 weeks significantly (1) elevated VO2peak and lowered VE-VCO2 slope, (2) raised resting ankle-brachial index and enhanced cardiac output response to exercise, (3) increased the distance in 6-minute walk test and raised the Short Form-36 physical/mental component scores, and (4) enhanced capacities of mitochondrial OXPHOS and ETS in platelets by activating FADH2 (complex II)-dependent pathway. Moreover, changes in VO2peak levels were positively associated with changes in platelet OXPHOS and ETS capacities. However, no significant changes in systemic aerobic capacity, platelet mitochondrial bioenergetics, and health-related quality of life (HRQoL) occurred following GR alone. Hence, we conclude that CET effectively increases the capacities of platelet mitochondrial bioenergetics by enhancing complex II activity in patients with PAD. Moreover, the exercise regimen also enhanced functional exercise capacity, consequently improving HRQoL in PAD patients.
Collapse
Affiliation(s)
- Ming-Lu Lin
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Tao-Yuan, Taiwan
| | - Tieh-Cheng Fu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chih-Chin Hsu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shu-Chun Huang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Yu-Ting Lin
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Tao-Yuan, Taiwan
| | - Jong-Shyan Wang
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Tao-Yuan, Taiwan.,Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan.,Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan
| |
Collapse
|
10
|
Hsu CC, Fu TC, Huang SC, Wang JS. High-intensity interval training recuperates capacity of endogenous thrombin generation in heart failure patients with reduced ejection fraction. Thromb Res 2020; 187:159-165. [PMID: 32004876 DOI: 10.1016/j.thromres.2020.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 01/07/2020] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Consumptive coagulopathy is associated with increased mortality in patients with heart failure (HF). Physical activity influences the risk of major vascular thrombotic events. This study investigates how high-intensity interval training (HIIT) affects the capacity of endogenous thrombin generation (TG) by modulating circulatory procoagulant microparticles (MPs) in HF patients. METHODS Thirty-eight HF patients with reduced ejection fraction (HFrEF) and 38 age- and gender-matched normal counterparts (NC) were recruited into this study. The HFrEF group performed HIIT (3-min intervals at 40% and 80%VO2peak) on a bicycle ergometer for 30 min/day, 3 days/week for 12 weeks, whereas the NC group did not receive any form of intervention. Plasma TG kinetics, procoagulant MPs, coagulation-related factors, and oxidative stress/proinflammatory status were analyzed. RESULTS The HFrEF group exhibited (i) less endogenous thrombin potential (ETP) and TG rate, (ii) lower concentration/activity of tissue factor (TF) and counts of TF-rich MPs derived from blood cells, and (iii) higher vascular endothelial shedding and plasma myeloperoxidase and interleukin-6 concentrations, compared to the NC group did. However, HIIT elevated TG rate and TF concentration/activity in plasma, as well as, TF-rich MP counts derived from blood cells in patients with HFrEF. Moreover, the exercise regimen also decreased vascular endothelial shedding and plasma myeloperoxidase and interleukin-6 concentrations in HFrEF patients. CONCLUSION HFrEF reduces the capacity of endogenous TG in plasma, which is associated with decreased (or consumed) circulatory procoagulant MP levels. However, HIIT alleviates HFrEF-declined endogenous TG capacity and vascular endothelial damage through recuperating TF-related coagulation activity and suppressing oxidative stress/proinflammatory status.
Collapse
Affiliation(s)
- Chih-Chin Hsu
- Heart Failure Center, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Tieh-Cheng Fu
- Heart Failure Center, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shu-Chun Huang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Jong-Shyan Wang
- Heart Failure Center, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan; Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Tao-Yuan, Taiwan; Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.
| |
Collapse
|
11
|
Exercise Training Enhances Platelet Mitochondrial Bioenergetics in Stroke Patients: A Randomized Controlled Trial. J Clin Med 2019; 8:jcm8122186. [PMID: 31835774 PMCID: PMC6947198 DOI: 10.3390/jcm8122186] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 12/27/2022] Open
Abstract
Exercise training (ET) may impact physical fitness by affecting mitochondrial functions. This study aimed to elucidate the effect of ET on aerobic capacity and platelet mitochondrial bioenergetics (MTB) in stroke patients. Among the 30 stroke patients who underwent the traditional rehabilitation program (TRP), 15 were randomly assigned to have ET (50-60% VO2peak for 30 min/day, 5 days/week for 4 weeks), and those remaining received only the TRP (control group). The peak exercise capacity (VO2peak) and platelet MTB, including oxidative phosphorylation (OXPHOS) and the electron transport chain (ETC), were measured through automatic gas analysis and high-resolution respirometry, respectively. The results demonstrated that ET significantly increased the VO2peak (17.7%) and O2 uptake efficiency slope (31.9%) but decreased the ventilation versus CO2 production slope (-7.65%). Patients who underwent ET also had significantly enhanced platelet mitochondrial OXPHOS and ETC by activating the FADH2 (Complex II)-dependent pathway, but depressed plasma myeloperoxidase (-28.4%) and interleukin-6 levels (-29.9%). Moreover, changes in VO2peak levels were positively correlated with changes in platelet OXPHOS and ETC capacities. In conclusion, ET increases the platelet MTB by enhancing Complex II activity in stroke patients. The exercise regimen also enhances aerobic fitness and depresses oxidative stress/pro-inflammatory status in stroke patients.
Collapse
|
12
|
Sobhani V, Taghizadeh M, Moshkani-Farahani M. Platelet indices and function response to two types of high intensity interval exercise and comparison with moderate intensity continuous exercise among men after coronary artery bypass graft: A randomized trial. ARYA ATHEROSCLEROSIS 2019; 14:188-195. [PMID: 30783408 PMCID: PMC6368198 DOI: 10.22122/arya.v14i5.1780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND It has been indicated that the acute exercise increases the thrombotic events that stem from platelet hyper-reactivity. The present randomized controlled trial study was carried out with the aim to compare high-intensity interval exercise (HIIE) with moderate intensity continuous exercise (MICE) in terms of platelet indices and function in patients who had undergone post coronary artery bypass graft (CABG). METHODS 30 men with a history of CABG were recruited and divided into 3 groups (MICE, HIIE-1, and HIIE-2). The MICE protocol consisted of running for 40 minutes with 65% of maximal heart rate (HRmax). Subjects in HIIE-1 group performed an interval exercise with work to rest ratio of 1:1 in which 10 rounds of running (95% HRmax) were followed by active recovery (35% HRmax). HIIE-2 subjects performed an interval exercise with work to rest ratio of 2:1 in which 7 rounds of running (85% HRmax) were followed by active recovery (45% HRmax). Before and immediately after the exercise protocols, blood samples were taken from subjects and analyzed to measure the variables. RESULTS Although platelet count (PLT) and hematocrit (HCT) were increased significantly after HIIE-1 and HIIE-2 in comparison to MICE (P < 0.050), the other platelet indices [mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT)] were not significantly changed among groups (P > 0.050). The platelet aggregation and fibrinogen were further increased after HIIE-1 and HIIE-2 as compared with MICE; however, such increment were significant between HIIE-2 and MICE (P < 0.050). CONCLUSION It seems that HIIE, regardless of the type, has higher thrombotic potentials compared with MICE. Accordingly, MICE is safer than HIIE for rehabilitation in patients undergoing CABG.
Collapse
Affiliation(s)
- Vahid Sobhani
- Associate Professor, Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahmoudreza Taghizadeh
- Exercise Physiologist, Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Maryam Moshkani-Farahani
- Associate Professor, Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| |
Collapse
|
13
|
Ljungkvist M, Olofsson H, Funding E, Berntorp E, Zetterberg E. Coagulation factor VIII is vital for increasing global coagulation after physical exercise. Haemophilia 2019; 25:e86-e93. [PMID: 30664315 DOI: 10.1111/hae.13652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 11/05/2018] [Accepted: 11/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND In a previous smaller study, we found evidence of a diminished global coagulation capacity after maximal exercise in patients with severe haemophilia A (HA). AIM To validate these results, we repeated the study in a larger cohort. We also examined if the exercise-induced increased levels of von Willebrand factor (VWF) might prolong the effect of factor concentrate administered just before exercise. METHODS We studied individual and global coagulation parameters after maximal physical exercise in 10 persons with severe HA and 10 healthy matched control subjects. Blood samples were taken before, 10 minutes, 60 minutes and 4 hours after exercise. RESULTS Rotational thromboelastometry (ROTEM) and thrombin generation assay-calibrated automated thrombogram (TGA-CAT) showed significantly increased coagulation capacity after maximal exercise in healthy controls but not in patients with severe HA. VWF antigen and activity levels increased significantly in both groups, whereas FVIII:C only showed a significant increase in the control group. No statistically significant differences were seen between FVIII pharmacokinetic results obtained with and without exercise. CONCLUSION Our findings do not support the presence of a FVIII-independent mechanism that increases global coagulation, but rather underscores the importance of FVIII in mediating the increased coagulation capacity seen after exercise. Our results could not support the hypothesis that exercise-induced increased levels of VWF for patients with severe HA lead to a prolonged effect of factor concentrate administered just before exercise.
Collapse
Affiliation(s)
- Marcus Ljungkvist
- Department of Translational Medicine & Centre for Thrombosis and Haemostasis, Lund University, Lund, Sweden
| | - Henric Olofsson
- Department of Translational Medicine & Centre for Thrombosis and Haemostasis, Lund University, Lund, Sweden
| | - Eva Funding
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Erik Berntorp
- Department of Translational Medicine & Centre for Thrombosis and Haemostasis, Lund University, Lund, Sweden
| | - Eva Zetterberg
- Department of Translational Medicine & Centre for Thrombosis and Haemostasis, Lund University, Lund, Sweden
| |
Collapse
|
14
|
Chou CH, Fu TC, Tsai HH, Hsu CC, Wang CH, Wang JS. High-intensity interval training enhances mitochondrial bioenergetics of platelets in patients with heart failure. Int J Cardiol 2019; 274:214-220. [DOI: 10.1016/j.ijcard.2018.07.104] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 06/25/2018] [Accepted: 07/20/2018] [Indexed: 11/27/2022]
|
15
|
Sakr HF, Abbas AM, Haidara MA. Swimming, but not vitamin E, ameliorates prothrombotic state and hypofibrinolysis in a rat model of nonalcoholic fatty liver disease. J Basic Clin Physiol Pharmacol 2018; 29:61-71. [PMID: 29161233 DOI: 10.1515/jbcpp-2017-0069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 09/25/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is associated with a systemic procoagulant hypofibrinolysis state that is considered as a risk factor for microangiopathy and peripheral vascular diseases. Swimming exercise ameliorates the metabolic dysfunction in type 2 diabetes. Vitamin E is a natural antioxidant that reduces the risk of endothelial dysfunction in metabolic syndrome. The aim of the present study is to investigate the effect of combined swimming exercise with vitamin E on coagulation as well as blood fibrinolysis markers in rats with NAFLD. METHODS Eighty male rats were divided into control, control+vitamin E, control+exercise, high-fat diet (HFD), HFD+vitamin E, HFD+exercise, and HFD+vitamin E+exercise groups. Glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), triglycerides, cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL), alanine transaminase (ALT) and aspartate transaminase (AST), intercellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1), endothelin-1, von Willebrand factor (vWF), fibrinogen, plasminogen activator inhibitor (PAI-1), fibrin degradation products (FDP), platelet count and aggregation, bleeding and clotting times, activated partial thromboplastin time (aPTT), and prothrombin time (PT) were determined. RESULTS HFD increased lipid profile, insulin, glucose, HOMA-IR, liver enzymes, adhesion molecules, endothelin-1, vWF, platelet aggregation, fibrinogen, FDP, and PAI-1, and decreased clotting and bleeding times and HDL. Although exercise reduced lipid profile, glucose, insulin, HOMA-IR, vWF, platelet aggregation, fibrinogen, FDP, and PAI-1 and increased PT, aPTT, bleeding and clotting times, and HDL, vitamin E had no effect. CONCLUSIONS Exercise, but not vitamin E, ameliorated the HFD-induced prothrombotic state and enhanced fibrinolytic activity.
Collapse
Affiliation(s)
- Hussein F Sakr
- Faculty of Medicine, Medical Physiology Department, Mansoura University, P.O. Box 35516, Mansoura, Egypt
| | - Amr M Abbas
- Faculty of Medicine, Medical Physiology Department, Mansoura University, Mansoura, Egypt
| | - Mohamed A Haidara
- Kasr Al-Aini Faculty of Medicine, Medical Physiology Department, Cairo University, Cairo, Egypt
| |
Collapse
|
16
|
Liu K, Zhou Y, Xie W, Gu Z, Jin Y, Ye X, Chen X, Fan B, Wang H, Cui Y. Handgrip exercise reduces peripherally-inserted central catheter-related venous thrombosis in patients with solid cancers: A randomized controlled trial. Int J Nurs Stud 2018; 86:99-106. [PMID: 29982097 DOI: 10.1016/j.ijnurstu.2018.06.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 06/02/2018] [Accepted: 06/06/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Peripherally-inserted central catheter-related venous thrombosis has serious complications including the loss of vascular access, recurrent venous thrombosis, and post-thrombotic syndrome. Current guidelines recommend non-pharmacological strategies to prevent peripherally-inserted central catheter-related venous thrombosis. There is little evidence for the effectiveness of handgrip exercise on the prevention of peripherally-inserted central catheter-related venous thrombosis. OBJECTIVES To examine the effectiveness of handgrip exercise using an elastic ball to prevent peripherally-inserted central catheter-related venous thrombosis in patients with solid cancers. DESIGN A randomized controlled trial. SETTINGS One teaching hospital in Nanjing, China. PARTICIPANTS In total, 120 subjects with solid cancers were eligible; each had a new peripherally-inserted central catheter. They were recruited and randomly assigned into two exercise groups and one control group. METHODS Subjects from exercise groups 1 and 2 performed a 3-week, 25-repetition handgrip exercise, 3 and 6 times daily, respectively. The control group subjects performed a gentle limb exercise with no frequency and intensity requirements. Ultrasound was used to detect venous thrombosis development and examine axillary vein blood flow over the three points. RESULTS There were 32 cases of peripherally-inserted central catheter-related venous thrombosis detected. Two venous thrombosis cases in the control group were symptomatic, but all venous thrombosis cases in the exercise groups were asymptomatic. All venous thromboses were partial. There were significant differences in the incidence of venous thrombosis among the three groups (χ2 = 12.813, p = 0.002; χ2 = 9.340, p = 0.009; χ2 = 11.480, p = 0.003; and χ2 = 10.534, p = 0.005, respectively) at days 2, 3 and 21. The incidence of venous thrombosis in the two exercise groups was lower than that in the control group over the 3 time points (all, p < 0.05). The between-group effects and interaction effect in vein maximum velocity and time-mean flow velocity showed significant differences (F = 4.180, p = 0.025; F = 4.010, p = 0.045; and F = 2.928, p = 0.025) at days 2, 3, and 21, respectively. The axillary vein blood flow parameters in the control group were lower than those in the two exercise groups at day 21 (all, p < 0.05). However, no significant differences occurred in the incidence of venous thrombosis and axillary vein blood flow parameters between the two exercise groups. CONCLUSION Handgrip exercise using an elastic ball daily for three weeks could decrease the incidence of peripherally-inserted central catheter-related venous thrombosis. The method is simple, with no negative consequence reported. Further studies are required to confirm this conclusion and to explore the optimal frequency of handgrip exercise.
Collapse
Affiliation(s)
- Kouying Liu
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China; School of Nursing, Nanjing Medical University, Nanjing, China.
| | - Ye Zhou
- School of Nursing, Nanjing Medical University, Nanjing, China; Chinese Nursing Association, Beijing, China.
| | - Weiping Xie
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Zejuan Gu
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Yu Jin
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Xinhua Ye
- Department of Ultrasonography, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Xuesong Chen
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Boqiang Fan
- Department of Oncology Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Hong Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, China.
| |
Collapse
|
17
|
Kupchak BR, Kazman JB, Vingren JL, Levitt DE, Lee EC, Williamson KH, Armstrong LE, Deuster PA. Blood Hemostatic Changes During an Ultraendurance Road Cycling Event in a Hot Environment. Wilderness Environ Med 2017; 28:197-206. [DOI: 10.1016/j.wem.2017.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 05/03/2017] [Accepted: 05/05/2017] [Indexed: 10/19/2022]
|
18
|
High-intensity Interval Training Improves Mitochondrial Function and Suppresses Thrombin Generation in Platelets undergoing Hypoxic Stress. Sci Rep 2017. [PMID: 28646182 PMCID: PMC5482849 DOI: 10.1038/s41598-017-04035-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
This study elucidates how high-intensity interval training (HIT) and moderate-intensity continuous training (MCT) affect mitochondrial functionality and thrombin generation (TG) in platelets following hypoxic exercise (HE, 100 W under 12% O2 for 30 min). Forty-five healthy sedentary males were randomized to engage either HIT (3-minute intervals at 40% and 80%VO2max, n = 15) or MCT (sustained 60%VO2max, n = 15) for 30 minutes/day, 5 days/week for 6 weeks, or to a control group (CTL, n = 15) that did not received exercise intervention. Before the intervention, HE (i) reduced the ATP-linked O2 consumption rate (OCR), the reserve capacity of OCR, and the activities of citrate synthase (CS) and succinate dehydrogenase (SDH), (ii) lowered mitochondrial membrane potential (MP) and elevated matrix oxidant burden (MOB) in platelets, and (iii) enhanced dynamic TG in platelet-rich plasma (PRP), which responses were attenuated by pretreating PRP with oligomycin or rotenone/antimycin A. However, 6-week HIT (i) increased mitochondrial OCR capacity with enhancing the CS and SDH activities and (ii) heightened mitochondrial MP with depressing MOB in platelets following HE, compared to those of MCT and CTL. Moreover, the HIT suppressed the HE-promoted dynamic TG in PRP. Hence, we conclude that the HIT simultaneously improves mitochondrial bioenergetics and suppresses dynamic TG in platelets undergoing hypoxia.
Collapse
|
19
|
Davies N, Llwyd O, Brugniaux J, Davies G, Marley C, Hodson D, Lawrence M, D'Silva L, Morris R, Hawkins K, Williams P, Bailey D, Evans P. Effects of exercise intensity on clot microstructure and mechanical properties in healthy individuals. Thromb Res 2016; 143:130-6. [DOI: 10.1016/j.thromres.2016.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 05/11/2016] [Accepted: 05/18/2016] [Indexed: 11/30/2022]
|
20
|
Zoeller RF. Physical Activity: Depression, Anxiety, Physical Activity, and Cardiovascular Disease: What's the Connection? Am J Lifestyle Med 2016. [DOI: 10.1177/1559827607300518] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Depression and anxiety are major public health problems and have been shown to be associated with increased risk for cardiovascular disease. The prevalence and incidence of depression and anxiety are lower in those who are regularly active. Regular physical activity has also been shown to reduce symptoms of depression and anxiety in those who already suffer from these disorders. Depression and anxiety may increase the risk for cardiovascular disease by a number of mechanisms, including hypertension and reduced vascular function, autonomic nervous system dysfunction, and increased platelet activity and aggregation. Regular physical activity has been demonstrated to lower blood pressure and improve nitric oxide— mediated vascular function, increase heart rate variability and baroreflex sensitivity, increase fibrinolysis, and, possibly, decrease platelet activity. Little or no work has been done to determine the optimal amount or intensity of exercise to prevent or reduce the symptoms of depression and anxiety. Based on the limited data available, a physical activity routine consistent with the 1996 Surgeon General's Report on Physical Activity and Health is appropriate—specifically, at least 30 minutes of moderate-intensity activity on most days, if not every day, of the week. Little evidence supports a dose-response relation between physical activity and depression or any of the physiological mechanisms discussed here. This is not to say that there is no such relationship but, rather, that well-controlled studies are lacking. Studies on anxiety, especially, are lacking. This includes the link with cardiovascular disease, physiological mechanisms, and the effects of regular physical activity.
Collapse
Affiliation(s)
- Robert F. Zoeller
- Department of Exercise Science & Health Promotion, Florida Atlantic University, Davie, Florida,
| |
Collapse
|
21
|
Kasawara KT, Cotechini T, Macdonald-Goodfellow SK, Surita FG, Pinto e Silva JL, Tayade C, Othman M, Ozolinš TRS, Graham CH. Moderate Exercise Attenuates Lipopolysaccharide-Induced Inflammation and Associated Maternal and Fetal Morbidities in Pregnant Rats. PLoS One 2016; 11:e0154405. [PMID: 27124733 PMCID: PMC4849647 DOI: 10.1371/journal.pone.0154405] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/13/2016] [Indexed: 12/21/2022] Open
Abstract
Fetal growth restriction (FGR) and coagulopathies are often associated with aberrant maternal inflammation. Moderate-intensity exercise during pregnancy has been shown to increase utero-placental blood flow and to enhance fetal nutrition as well as fetal and placental growth. Furthermore, exercise is known to reduce inflammation. To evaluate the effect of moderate-intensity exercise on inflammation associated with the development of maternal coagulopathies and FGR, Wistar rats were subjected to an exercise regime before and during pregnancy. To model inflammation-induced FGR, pregnant rats were administered daily intraperitoneal injections of E. coli lipopolysaccharide (LPS) on gestational days (GD) 13.5–16.5 and sacrificed at GD 17.5. Control rats were injected with saline. Maternal hemostasis was assessed by thromboelastography. Moderate-intensity exercise prevented LPS-mediated increases in white blood cell counts measured on GD 17.5 and improved maternal hemostasis profiles. Importantly, our data reveal that exercise prevented LPS-induced FGR. Moderate-intensity exercise initiated before and maintained during pregnancy may decrease the severity of maternal and perinatal complications associated with abnormal maternal inflammation.
Collapse
Affiliation(s)
- Karina T. Kasawara
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
- Department of Obstetrics and Gynaecology, University of Campinas, Campinas, SP, Brazil
| | - Tiziana Cotechini
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | | | - Fernanda G. Surita
- Department of Obstetrics and Gynaecology, University of Campinas, Campinas, SP, Brazil
| | - João L. Pinto e Silva
- Department of Obstetrics and Gynaecology, University of Campinas, Campinas, SP, Brazil
| | - Chandrakant Tayade
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Maha Othman
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Terence R. S. Ozolinš
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
| | - Charles H. Graham
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, ON, Canada
- * E-mail:
| |
Collapse
|
22
|
Interval and continuous exercise regimens suppress neutrophil-derived microparticle formation and neutrophil-promoted thrombin generation under hypoxic stress. Clin Sci (Lond) 2015; 128:425-36. [PMID: 25371035 DOI: 10.1042/cs20140498] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Acute hypoxic exposure increases vascular thrombotic risk. The release of procoagulant-rich microparticles from neutrophils accelerates the pathogenesis of inflammatory thrombosis. The present study explicates the manner in which interval and continuous exercise regimens affect neutrophil-derived microparticle (NDMP) formation and neutrophil/NDMP-mediated thrombin generation (TG) under hypoxic condition. A total of 60 sedentary males were randomized to perform either aerobic interval training [AIT; 3-min intervals at 40% and 80% V̇O2max (maximal O2 consumption)] or moderate continuous training (MCT; sustained 60% V̇O2max) for 30 min/day, 5 days/week for 5 weeks, or to a control (CTL) group who did not receive any form of training. At rest and immediately after hypoxic exercise test (HE, 100 W under 12% O2 for 30 min), the NDMP characteristics and dynamic TG were measured by flow cytometry and thrombinography respectively. Before the intervention, HE (i) elevated coagulant factor VIII/fibrinogen concentrations and shortened activated partial thromboplastin time (aPTT), (ii) increased total and tissue factor (TF)-rich/phosphatidylserine (PS)-exposed NDMP counts and (iii) enhanced the peak height and rate of TG promoted by neutrophils/NDMPs. Following the 5-week intervention, AIT exhibited higher enhancement of V̇O2max than did MCT. Notably, both MCT and AIT attenuated the extents of HE-induced coagulant factor VIII/fibrinogen elevations and aPTT shortening. Furthermore, the two exercise regimens significantly decreased TF-rich/PS-exposed NDMP formation and depressed neutrophil/NDMP-mediated dynamic TG at rest and following HE. Hence, we conclude that AIT is superior to MCT for enhancing aerobic capacity. Moreover, either AIT or MCT effectively ameliorates neutrophil/NDMP-promoted TG by down-regulating expression of procoagulant factors during HE, which may reduce thrombotic risk evoked by hypoxia. Moreover, either AIT or MCT effectively ameliorates neutrophil/NDMP-promoted TG by down-regulating expression of procoagulant factors during HE, which may reduce thrombotic risk evoked by hypoxia.
Collapse
|
23
|
|
24
|
Chen YW, Apostolakis S, Lip GYH. Exercise-induced changes in inflammatory processes: Implications for thrombogenesis in cardiovascular disease. Ann Med 2014; 46:439-55. [PMID: 25012964 DOI: 10.3109/07853890.2014.927713] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Sedentary lifestyle is a risk factor and a strong predictor for chronic disease and premature death. Low-grade inflammation has been proved a key player in the pathogenesis of cardiovascular disease. Inflammatory processes have been also involved in maintaining the balance between coagulation and fibrinolysis. In addition, an inverse linear dose-response relation between physical activity and mortality risks has also been reported. However, the favorable effects of structured exercise programs and the independent contribution of physical activity to cardiovascular risk are still under investigation. In response to heavy exercise, interleukin-6 (IL-6) is secreted by contracting skeletal muscles, followed by an acute reactant release of C-reactive protein (CRP). Both CRP and IL-6 can stimulate monocyte tissue factor production, provoke platelet hyperreactivity, promote fibrinogen biosynthesis, and enhance microparticle formation and erythrocyte aggregability, thus triggering prothrombotic state. By contrast, regular exercise and physical activity are protective against all-cause mortality through suppressing pro-inflammatory cytokine production, enhancing anti-inflammatory mediators and antioxidant development, and promoting fibrinolytic activity. Low-load resistance exercise also plays an advantageous role in thrombogenesis by reducing inflammatory processes and potentiating fibrinolytic features. In the present review article, we provide an overview of the impact of different modes and intensities of physical activity on vascular inflammation and thrombogenesis.
Collapse
Affiliation(s)
- Yu-Wen Chen
- Haemostasis, Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Science, City Hospital , Birmingham , United Kingdom
| | | | | |
Collapse
|
25
|
Lou BS, Wu PS, Liu Y, Wang JS. Effects of Acute Systematic Hypoxia on Human Urinary Metabolites Using LC-MS-Based Metabolomics. High Alt Med Biol 2014; 15:192-202. [DOI: 10.1089/ham.2013.1130] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Bih-Show Lou
- Chemistry Division, Center for General Education, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - Pei-Shan Wu
- Chemistry Division, Center for General Education, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - Yitong Liu
- Chemistry Division, Center for General Education, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - Jong-Shyan Wang
- Graduate Institute of Rehabilitation Science and Center for Healthy Aging Research, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| |
Collapse
|
26
|
Mawatari K, Yoshioka E, Toda S, Yasui S, Furukawa H, Shimohata T, Ohnishi T, Morishima M, Harada N, Takahashi A, Sakaue H, Nakaya Y. Enhancement of endothelial function inhibits left atrial thrombi development in an animal model of spontaneous left atrial thrombosis. Circ J 2014; 78:1980-8. [PMID: 24859498 DOI: 10.1253/circj.cj-13-1398] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Left atrial (LA) thrombosis is an important cause of systemic embolization. The SPORTS rat model of LA thrombi (Spontaneously-Running Tokushima-Shikoku), which have a unique characteristic of high voluntary wheel running, was previously established. The aim of the present study was to investigate how SPORTS rats develop LA thrombi. METHODS AND RESULTS Nitric oxide (NO) produced from cardiovascular endothelial cells plays an important protective role in the local regulation of blood flow, vascular tone, and platelet aggregation. No evidence of atrial fibrillation or hypercoagulability in SPORTS rats regardless of age was found; however, SPORTS rats demonstrated endothelial dysfunction and a decrease of NO production from a young age. In addition, endothelial NO synthase activity was significantly decreased in the LA and thoracic aorta endothelia of SPORTS rats. While voluntary wheel running was able to intermittently increase NO levels, running did not statistically decrease the incidence of LA thrombi at autopsy. However, L-arginine treatment significantly increased NO production and provided protection from the development of LA thrombi in SPORTS rats. CONCLUSIONS They present study results indicate that NO has an important role in the development of LA thrombus, and endothelia pathways could provide new targets of therapy to prevent LA thrombosis.
Collapse
Affiliation(s)
- Kazuaki Mawatari
- Department of Nutrition and Metabolism, Institute of Health Biosciences, the University of Tokushima Graduate School
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Piccione G, Bazzano M, Giannetto C, Marafioti S, Fazio F. Training-induced changes in clotting parameters of athletic horses. J Vet Sci 2013; 15:45-9. [PMID: 24136203 PMCID: PMC3973765 DOI: 10.4142/jvs.2014.15.1.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 07/09/2013] [Indexed: 12/03/2022] Open
Abstract
The purpose of this study was to investigate the effects of training on prothrombin time, activated partial thromboplastin time, and fibrinogen (Fb) concentrations in horses to assess potential adaptive response to training. Fifteen clinically healthy horses were enrolled in the present study and equally divided into three groups. Group A completed an intense training program, group B participated in a light training program, and group C included sedentary horses. After 5 weeks, group B was subjected to the same training program completed by group A and renamed group B1. Blood samples were collected by jugular venipuncture from each animal at rest and analyzed within 2 h after sampling. A two-way ANOVA for repeated measures showed a significant effect of training (p < 0.05) on Fb concentrations in group B1 alone during the first week after changing the training program. Our findings demonstrated that Fb is a parameter susceptible to training. Fb plasma levels increase with a more intense training program. However, Fb plasma levels decreased after the first week and returned to basel levels, suggesting that the horses had adapted to the new training program.
Collapse
Affiliation(s)
- Giuseppe Piccione
- Department of Veterinary Science, University of Messina, Polo Universitario dell'Annunziata, 98168 Messina,
| | | | | | | | | |
Collapse
|
28
|
Cimenti C, Schlagenhauf A, Leschnik B, Schretter M, Tschakert G, Gröschl W, Seibert FJ, Hofmann P, Muntean WE. Low endogenous thrombin potential in trained subjects. Thromb Res 2013; 131:e281-5. [PMID: 23628230 DOI: 10.1016/j.thromres.2013.04.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 03/19/2013] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION A paradox seems to exist: exercising leads to clotting activation in conventional clotting tests, but exercising persons have a low risk of thrombosis. In this study we tried to evaluate the effect of exercise performance status on in vitro plasma thrombin generation, which represents an overall function test of hemostasis. MATERIALS AND METHODS We compared 56 trained subjects to 98 healthy age matched sedentary volunteers. Blood samples were analyzed for thrombin generation using calibrated automated thrombography. Microparticles were quantified using ELISA. Additionally prothrombin fragments 1 + 2, thrombin-antithrombin complex, tissue factor pathway inhibitor, antithrombin and prothrombin were measured. The group of the trained subjects performed an incremental cycle-ergometer exercise test after taking the blood sample. RESULTS A significantly lower endogenous thrombin potential was observed in the group of the trained subjects compared to the sedentary individuals (p = 0.007). Microparticles (ELISA) were significantly lower in the trained subjects compared to the sedentary subjects (p = 0.001). Prothrombin fragments 1 + 2 (p < 0.001) and thrombin-antithrombin complex (p = 0.01) were significant higher in the trained subjects and antithrombin (p = 0.02) as well as prothrombin (p < 0.0001) were significantly lower in this group, whereas tissue factor pathway inhibitor values did not show significant differences. Both maximal and submaximal power output was significantly negatively related to endogenous thrombin potential (r = -0.43, r = -0.45) and thrombin peak (r = -0.44, r = -0.42). CONCLUSIONS Trained subjects have a lower endogenous thrombin potential than sedentary subjects possibly explaining the lower incidence of thrombosis in this group despite a higher acute clotting activation during strenuous exercise.
Collapse
Affiliation(s)
- Christina Cimenti
- Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Austria
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Absolute hypoxic exercise training enhances in vitro thrombin generation by increasing procoagulant platelet-derived microparticles under high shear stress in sedentary men. Clin Sci (Lond) 2013; 124:639-49. [DOI: 10.1042/cs20120540] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
HS (high shear) stress associated with artery stenosis facilitates TG (thrombin generation) by increasing the release of procoagulant PDMPs (platelet-derived microparticles). Physical exercise and hypoxia may paradoxically modulate vascular thrombotic risks. The aim of the present study was to investigate how exercise training with/without hypoxia affected TG mediated by PDMPs under physio-pathological shear flows. A total of 75 sedentary males were randomly divided into five groups (n=15 in each group): 21% O2 [NC (normoxic control)] or 15% O2 [HC (hypoxic control)] at rest or were trained at 50% of peak work rate under 21% O2 [NT (normoxic training)] or 15% O2 [HAT (hypoxic-absolute training)], or 50% of HR (heart rate) reserve under 15% O2 [HRT (hypoxic-relative training)] for 30 min/day, 5 days/week for 4 weeks. The PDMP characteristics and dynamic TG were measured by flow cytometry and thrombinography respectively. Before the intervention, strenuous exercise markedly increased the PDMP count (14.8%) and TG rate (19.5%) in PDMP-rich plasma at 100 dynes/cm2 of shear stress (P<0.05). After the interventions, both NT and HRT significantly attenuated the enhancement of HS-induced PDMPs (4.7 and 4.9%) and TG rate (3.8 and 3.0%) (P<0.05) by severe exercise. Conversely, HAT notably promoted the PDMP count (37.3%) and TG rate (38.9%) induced by HS (P<0.05), concurrent with increasing plasma TF (tissue factor) and coagulation factor V levels at rest or following exercise. We conclude that both HRT and NT depress similarly HS-mediated TG during exercise, but HAT accelerates the prothrombotic response to vigorous exercise. These findings provide new insights into how exercise training under a hypoxic condition influences the risk of thrombosis associated with stenotic arteries.
Collapse
|
30
|
Hilberg T, Menzel K, Wehmeier UF. Endurance training modifies exercise-induced activation of blood coagulation: RCT. Eur J Appl Physiol 2012; 113:1423-30. [PMID: 23238930 DOI: 10.1007/s00421-012-2564-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 11/27/2012] [Indexed: 10/27/2022]
Abstract
Randomized controlled trials (RCTs) on the topic of physical training and blood coagulation are rare and the effects are unclear. The aim of this study was to investigate whether endurance training adjusts blood coagulation and fibrinolysis at rest and after exercise. The study included 50 healthy untrained non-smokers randomized into training (TR 49 ± 6 years) or control group (CO 48 ± 6 years). Each subject performed an exercise test adjusted at 80 % individual anaerobic threshold (IAT) for 60 min before and after 12 weeks (80 % IAT: before TR 123 ± 20, CO 125 ± 26 W; after TR 148 ± 23 W, CO 127 ± 25 W; mean ± SD). Blood was taken at rest and after exercise to determine coagulation (e.g., aPTT, thrombin potential, TAT, F1+2, several coagulation factors) and fibrinolytic (e.g., tPA, PAI) parameters. The training intervention induced an elevation of physical capacity in TR by 17 % (rel. VO2max) that led to a statistical relevant prolongation of aPTT at rest. Although absolute power output during the second exercise test was 20 % higher in TR, we detected an attenuated exercise-induced decrease of aPTT and attenuated increase of F1+2 after training. Resting levels of tPA- and PAI-Ag decreased slightly but not significantly after training. Exercise-induced changes were comparable after training in spite of higher power output in TR. Although the effects are small in healthy men, training modifies exercise-induced blood coagulation positively. The fact that exercise-induced changes in blood coagulation and fibrinolysis are rather attenuated or unchanged in the training group, in spite of a 20 % higher absolute power output during exercise, substantiates the adjusting effect of endurance training and the importance of physical fitness in primary prevention.
Collapse
Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, University of Wuppertal, Pauluskirchstr. 7, 42285 Wuppertal, Germany.
| | | | | |
Collapse
|
31
|
Bauer NB, Er E, Moritz A. Effect of submaximal aerobic exercise on platelet function, platelet activation, and secondary and tertiary hemostasis in dogs. Am J Vet Res 2012; 73:125-33. [DOI: 10.2460/ajvr.73.1.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
32
|
Sossdorf M, Otto GP, Claus RA, Gabriel HHW, Lösche W. Cell-derived microparticles promote coagulation after moderate exercise. Med Sci Sports Exerc 2011; 43:1169-76. [PMID: 21131870 DOI: 10.1249/mss.0b013e3182068645] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
UNLABELLED Cell-derived procoagulant microparticles (MP) might be able to contribute to exercise-induced changes in blood hemostasis. PURPOSES This study aimed to examine (i) the concentration and procoagulant activity of cell-derived MP after a moderate endurance exercise and (ii) the differences in the release, clearance, and activity of MP before and after exercise between trained and untrained individuals. METHODS All subjects performed a single bout of physical exercise on a bicycle ergometer for 90 min at 80% of their individual anaerobic threshold. MP were identified and quantified by flow cytometry measurements. Procoagulant activity of MP was measured by a prothrombinase activity assay as well as tissue factor-induced fibrin formation in MP-containing plasma. RESULTS At baseline, no differences were observed for the absolute number and procoagulant activities of MP between trained and untrained subjects. However, trained individuals had a lower number of tissue factor-positive monocyte-derived MP compared with untrained individuals. In trained subjects, exercise induced a significant increase in the number of MP derived from platelets, monocytes, and endothelial cells, with maximum values at 45 min after exercise and returned to basal levels at 2 h after exercise. Untrained subjects revealed a similar increase in platelet-derived MP, but their level was still increased at 2 h after exercise, indicating a reduced clearance compared with trained individuals. Procoagulant activities of MP were increased immediately after exercise and remained elevated up to 2 h after exercise. CONCLUSIONS We conclude that increased levels of MP were found in healthy individuals after an acute bout of exercise, that the amount of circulating MP contributes to an exercise-induced increase of hemostatic potential, and that there were differences in kinetic and dynamic characteristics between trained and untrained individuals.
Collapse
Affiliation(s)
- Maik Sossdorf
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, and Department of Sports Medicine, Institute of Sports Science, Jena Friedrich-Schiller University, Jena, Germany.
| | | | | | | | | |
Collapse
|
33
|
Zwart B, van Werkum JW, Heestermans AACM, Kelder JC, Zomer AC, van 't Hof AWJ, Verheugt FWA, Ten Berg JM. Triggering mechanisms of stent thrombosis. EUROINTERVENTION 2011; 6:722-8. [PMID: 21205595 DOI: 10.4244/eijv6i6a122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS The aim of this study was to determine the role of potential triggers of stent thrombosis. METHODS AND RESULTS Patients (n = 437) with "definite" ST were recruited consecutively in the setting of a large multicentre observational cohort study. Patients were interviewed with validated questionnaires to identify one of the following triggers: i) timing of onset of ST, ii) performance of vigorous ( ≥ 6 MET) physical activity in the two hours preceding ST, iii) presence of emotional stress (experiencing a serious life event in the 14 days preceding the ST or feelings of anger in the 12 hours of ST) and iv) presence of a documented active infection at the time of ST. A total of 363 patients (83.1%) were able to supply adequate information. A significant trigger was identified in 83 patients (22.9%). Analysis of the different categories according to timing of ST revealed a higher prevalence of triggers with an increasing time-interval between index PCI and ST. Analysis of circadian variation showed a steep peak incidence from 7 am-12 pm. CONCLUSIONS Triggering mechanisms such as time of the day, physical exertion, emotional stress and infection may play an important role in a considerable number of patients presenting with ST, in particular in patients with (very) late ST.
Collapse
Affiliation(s)
- Bastiaan Zwart
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Ellingsen DG, Ulvestad B, Andersson L, Barregard L. Pneumoproteins and inflammatory biomarkers in asphalt pavers. Biomarkers 2010; 15:498-507. [PMID: 20528258 DOI: 10.3109/1354750x.2010.490305] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Pneumoproteins, biomarkers of systemic inflammation and endothelial activation were studied across a season in 72 asphalt pavers, 32 asphalt plant operators and 19 asphalt engineers. Smokers had lower concentrations of Clara cell protein (CC-16) and surfactant protein A, but higher concentrations of surfactant protein D, interleukin 6, C-reactive protein, fibrinogen and intercellular adhesion molecule (ICAM)-1 than non-smokers. Smokers reporting wheezing had lower mean CC-16 concentration than smokers not reporting wheezing (5.7 vs 8.6 microg l(-1); p = 0.05). Cholesterol, P-selectin and ICAM-1 were lower in pavers and operators at the end compared with the start of the season. This may be related to increased physical activity during the season.
Collapse
|
35
|
Abstract
Thrombophilia refers to the increased tendency to form blood clots (thrombosis), which is a major cause of morbidity and mortality. Thrombosis is associated with various chronic conditions such as cancer, diabetes, renal disorders, and cardiovascular disease. The incidence and associated complications of thrombosis are likely to increase significantly in the next few decades because of aging populations. Regular exercise has been proposed to decrease the risk of developing thrombosis, although there are inconsistent data from studies investigating its effects, with reports of both increased and decreased thrombotic risk across a variety of subject cohorts. Confounders such as age, gender, hormonal variations, physical activity, underlying disease and treatment, and body composition also contribute to the difficulty in assessing and defining the precise effects of exercise in preventing thrombotic events. However, there is evidence suggesting that physical activity is beneficial for reducing thrombotic risk in younger individuals and those with chronic conditions. This article aims to summarize the known risk factors for thrombosis and briefly review the benefits of exercise in the general population. Furthermore, this article highlights the additional factors in a cohort of individuals that would (at first) appear unlikely to be at risk of thrombosis--elite athletes.
Collapse
Affiliation(s)
- Murray Adams
- School of Human Life Sciences, University of Tasmania, Tasmania 7250, Australia.
| | | | | |
Collapse
|
36
|
Zwart B, Van Kerkvoorde TC, Van Werkum JW, Breet NJ, Ten Berg JM, Van ‘T Hof AWJ. Vigorous exercise as a triggering mechanism for late stent thrombosis: A description of three cases. Platelets 2009; 21:72-6. [DOI: 10.3109/09537100903388367] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Bastiaan Zwart
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | | | | | - Nicoline J. Breet
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Jurriën M. Ten Berg
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | | |
Collapse
|
37
|
Menzel K, Hilberg T. Coagulation and fibrinolysis are in balance after moderate exercise in middle-aged participants. Clin Appl Thromb Hemost 2009; 15:348-55. [PMID: 19022797 DOI: 10.1177/1076029608326306] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Increased age is associated with a higher risk of thrombotic events. The aim of this study was to investigate the age-related changes in hemostasis before and after moderate exercise controlled by individual anaerobic threshold as recommended for rehabilitation training. In this study, 24 young (25 +/- 1 years) and 24 middle-aged healthy nonsmokers (48 +/- 1 years) underwent an individualized exercise test with 80% of individual anaerobic threshold (young individuals: 127 +/- 6 W; middle-aged individuals: 128 +/- 5 W; values are expressed as mean +/- standard error of mean) for 60 minutes. The blood samples were collected before and after the exercise. The age-related higher (P < or = .05) levels could be detected in factors II, VII, VIII, IX, XI, XII, prothrombin fragment 1+2, in tissue plasminogen activator antigen and activity, as well as in plasminogen. The relative exercise-induced increases in these parameters were similar in both groups, although beginning at a higher level for those in the middle-aged group.A statistically enhanced increase after exercise in the middle-aged group could be shown in prothrombin fragment 1+2 (young individuals: 98 +/- 6 to 102 +/- 6 pmol/L; middle-aged individuals: 138 +/- 7 to 156 +/- 8 pmol/L) and in thrombin-antithrombin complex (young individuals: 2.2 +/- 0.1 to 3.1 +/- 0.2 microg/L; middle-aged individuals: 2.4 +/- 0.3 to 3.9 +/- 0.6 microg/L); the latter only showing a tendency. The data show the age-related changes with a rise in blood coagulation and fibrinolysis in a healthy middle-aged group compared with younger participants. Moderate exercise leads to comparably relative increases in hemostatic parameters but starting at higher levels. However, the exercise-induced thrombin generation (prothrombin fragment 1+2) is enhanced in the middle-aged participants in comparison with younger participants, but may be compensated by a sufficient fibrinolysis, and therefore the hemostatic system remains in balance.
Collapse
Affiliation(s)
- Kathleen Menzel
- Department of Sports Medicine, Bergische Universität Wuppertal Pauluskirchstr. 7, D-42285 Wuppertal, Germany.
| | | |
Collapse
|
38
|
WANG JONGSHYAN, CHUNG YEE, CHOW SHUER. Exercise Affects Platelet-Impeded Antitumor Cytotoxicity of Natural Killer Cell. Med Sci Sports Exerc 2009; 41:115-22. [DOI: 10.1249/mss.0b013e3181831f27] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
39
|
Chen YW, Chen JK, Wang JS. Exercise affects platelet-promoted tumor cell adhesion and invasion to endothelium. Eur J Appl Physiol 2008; 105:393-401. [PMID: 18998154 DOI: 10.1007/s00421-008-0916-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2008] [Indexed: 12/11/2022]
Abstract
This investigation explored how exercise intensity impacts platelet-mediated interactions of nasopharyngeal carcinoma cells (NPCs) and vascular endothelial cells (ECs) under shear flow in 33 males. Our results showed that (a) platelet-NPC aggregates (PNA) were associated with higher shear-induced P-selectin expression and glycoprotein alpha(II)beta(3) activation than platelet-platelet aggregates (PPA); (b) strenuous exercise (SE, up to VO2max), but not moderate exercise (ME, 60% VO2max for 30 min), increased both PPA and PNA in mimicked venous and arterial circuits and enhanced PNA in mimicked flow of stenotic vessels; (c) the percentages of PNA that remained bound to ECs in mimicked flow of post-capillary venules increased, while platelet-induced CD44 cleavage on NPC and trans-endothelial migration of NPC were enhanced following SE, but were unchanged in response to ME. We conclude that SE, but not ME, enhances the capacity of PNA to adhere to ECs, withstand flowing blood, and facilitate the invasion of NPCs toward ECs.
Collapse
Affiliation(s)
- Yu-Wen Chen
- Graduate Institute of Basic Medical Sciences, Chang-Gung University, Tao-Yuan, Taiwan
| | | | | |
Collapse
|
40
|
Hilberg T, Menzel K, Gläser D, Zimmermann S, Gabriel HHW. Exercise intensity: platelet function and platelet-leukocyte conjugate formation in untrained subjects. Thromb Res 2007; 122:77-84. [PMID: 17945332 DOI: 10.1016/j.thromres.2007.08.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2007] [Revised: 08/30/2007] [Accepted: 08/30/2007] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Strenuous and exhaustive exercise intensifies platelet activity as shown in the literature but effects of moderate exercise are still in discussion. The present study investigated effects of two different standardised exercise intensities controlled by individual anaerobic threshold (IAT) on platelet function and conjugate formation. METHODS 20 healthy male non-smokers underwent two exercises at 80% (moderate) of IAT which corresponded to about 57% of peak oxygen consumption (peak VO(2)) in our subjects and 100% (strenuous) of IAT, corresponding to about 69% peak VO(2). Blood samples were taken after 30 min rest and immediately after exercise. CD62P expression and differentiated platelet-leukocyte conjugates (CD45, CD14, CD41) as well as microparticles and platelet-platelet aggregates were detected flow cytometrically with and without TRAP-6-stimulation. RESULTS CD62P expression and the number of aggregates were increased (P< or =0.05) after exercise in the TRAP-stimulation experiment independent of exercise intensity. The number of platelet-granulocyte (rest 5.7+/-1.8 to post 8.1+/-1.7 (80%) vs. 6.2+/-1.9 to 10.3+/-2.0 (100%)), platelet-monocyte (5.3+/-3.6 to 8.5+/-3.7 (80%) vs. 7.4+/-3.5 to 11.7+/-4.8 (100%)), and platelet-lymphocyte conjugates (4.4+/-1.2 to 6.4+/-1.3 (80%) vs. 4.6+/-1.7 to 7.8+/-1.8% positive cells (100%)) were also higher after both exercises but increased significantly weaker (P< or =0.05) after moderate exercise. These results were confirmed by the TRAP-stimulation experiment. CONCLUSION Although moderate exercise led to an increase in platelet reactivity and platelet-leukocyte conjugate formation the changes in conjugate formation were significantly weaker compared to strenuous exercise. Therefore it is recommended that submaximal endurance performance should be individually developed in order for everyone to be able to carry out normal daily activities and also to exercise well below the IAT.
Collapse
Affiliation(s)
- Thomas Hilberg
- Department of Sports Medicine, Friedrich-Schiller-University Jena, Wöllnitzerstr. 42, D-07749 Jena, Germany.
| | | | | | | | | |
Collapse
|
41
|
Gaesser GA. Does physical activity reduce the risk of cardiovascular disease in overweight and obese individuals? CURRENT CARDIOVASCULAR RISK REPORTS 2007. [DOI: 10.1007/s12170-007-0036-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
42
|
Wang JS, Chang CY, Chow SE, Chen YW, Yang CM. Exercise modulates platelet-nasopharyngeal carcinoma cell aggregation and subsequent tissue factor and matrix metalloproteinase activities. J Appl Physiol (1985) 2007; 103:763-70. [PMID: 17495120 DOI: 10.1152/japplphysiol.00165.2007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Interaction between platelet and carcinoma cell contributes to pathogenesis of cancer-related thrombosis and metastasis. This study investigated whether physical exercise affects platelet-nasopharyngeal carcinoma cell (NPC) interaction and platelet-promoted tissue factor (TF) and matrix metalloproteinase (MMP) activities of NPC. Thirty sedentary men performed on three occasions moderate-intensity exercise [MIE, 60% maximal oxygen consumption (V(.)o(2max)) for 40 min] and high-intensity exercise (HIE, up to V(.)o(2max)), with and without warm-up exercise (WUE, 60% V(.)o(2max) for 20 min) on a bicycle ergometer. Before and immediately after exercise, platelet-NPC aggregation, the TF, MMP-2 and MMP-9 expressions and activities, and TF pathway inhibitor (TFPI) and tissue inhibitor of MMP-1 levels of NPC and platelet were measured. The results of this study demonstrated that HIE enhanced platelet-NPC aggregation in the presence of fibrinogen and was accompanied by increased platelet-promoted TF activity, expression of NPC, decreased platelet-promoted MMP-2 and MMP-9 activities, and TFPI release of NPC, whereas these alterations to HIE on platelet-NPC interactions were ameliorated by WUE pretreatment. Conversely, MIE reduced the formation of platelet-NPC aggregates, but did not change the TF, TFPI, MMP-2, MMP-9, tissue inhibitor of MMP activities, and/or levels of NPC mediated by platelet. It is concluded that HIE may enhance aggregation and coagulation and reduce MMP bioactivity related to platelet-NPC interactions, by raising the binding affinity to fibrinogen and TF activity and expression and lowering TFPI release and MMP-2 and -9 activities. These effects on HIE diminish after WUE. However, MIE minimizes the risk of thrombosis induced by platelet-NPC interactions.
Collapse
Affiliation(s)
- Jong-Shyan Wang
- Graduate Institute of Rehabilitation Science, Chang Gung University, 259 Wen-Hwa 1st Rd., Kwei-Shan, Tao-Yuan 333, Taiwan.
| | | | | | | | | |
Collapse
|