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Teixeira BC, Boeno FP, Geremia JM, Correa CDS, Lopes AL, Macedo RCO, Carteri RBK, Bandinelli E, Vaz MA, Ribeiro JL, Reischak-Oliveira A. Eccentric, but not concentric muscle contraction induce inflammation and impairs fibrinolysis in healthy young men. Appl Physiol Nutr Metab 2023; 48:386-392. [PMID: 36800893 DOI: 10.1139/apnm-2022-0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Different types of muscle contraction can cause different damage to the musculature and differences in inflammatory responses. Acute increases in circulatory inflammation markers can influence the crosstalk between coagulation and fibrinolysis processes, increasing the risk of thrombus formation and detrimental cardiovascular events. The aim of this study was to analyze the effects of concentric and eccentric exercise on hemostasis markers, C-reactive protein (CRP), and the relationship between these variables. Eleven healthy subjects with a mean age of 25.4 ± 2.8, non-smokers, with no history of cardiovascular disease and blood type O, randomly performed an isokinetic exercise protocol consisting of 75 concentric (CP) or eccentric (EP) contractions of knee extension, divided into five sets of 15 repetitions combined with 30-s rest. Blood samples for analysis of FVIII, von Willebrand factor, tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-1), and CRP were collected pre, post, 24 h, and 48 h after each protocol. Increased levels of CRP at 48 h in EP versus CP (p = 0.002), increased PAI-1 activity 48 h in EP versus CP (p = 0.044), and a reduction in t-PA at 48 h when compared with post-protocol in both protocols (p = 0.001). A correlation was found between CRP and PAI-1 at 48 h of PE (r2 = 0.69; p = 0.02). This study showed that both EP and CP increase the clotting process, albeit only the exercise performed eccentrically induces inhibition of fibrinolysis. This is possibly due to the increase in PAI-1 48 h after the protocol, which correlates with the increase in inflammation as demonstrated by the CRP levels.
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Affiliation(s)
- Bruno Costa Teixeira
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil.,Department of Human Movement Sciences (DCHM), Faculty of Physical Education, State University of Minas Gerais (UEMG), 3996 São Paulo Avenue, Ibirité 32412-190, Brazil
| | - Franccesco Pinto Boeno
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil.,Department of Applied Physiology and Kinesiology, University of Florida, 3226, Gainesville, FL, USA
| | - Jeam Marcel Geremia
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil
| | - Cleiton da Silva Correa
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil
| | - André Luiz Lopes
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil
| | - Rodrigo Cauduro Oliveira Macedo
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil.,University of Santa Cruz do Sul (UNISC), 2293 Independence Avenue, Santa Cruz do Sul 96815-900, Brazil
| | - Randhall Bruce Kreismann Carteri
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil.,Methodist University Center (IPA), 80 Joaquim Pedro Salgado Street, Poro Alegre 90420-060, Brazil
| | - Eliane Bandinelli
- Institute of Bioscience - Genetics Department, Federal University of Rio Grande do Sul (UFRGS), 9500 Bento Gonçalves Avenue, Porto Alegre 91501-970, Brazil
| | - Marco Aurélio Vaz
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil
| | - Jerri Luiz Ribeiro
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil
| | - Alvaro Reischak-Oliveira
- Program of Human Movement Sciences, Faculty of Physical Education, Physiotherapy and Dance (ESEFID), Federal University of Rio Grande do Sul (UFRGS), 750 Felizardo Street, Porto Alegre 90690-200, Brazil
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Nagelkirk PR, Soave K, Altherr C, Del Pozzi A. Regular Resistance Training Enhances Fibrinolytic Potential but Does Not Affect Coagulation. Med Sci Sports Exerc 2021; 53:2318-2323. [PMID: 34115732 DOI: 10.1249/mss.0000000000002724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to identify effects of an 8-wk, whole-body RT program on coagulation and fibrinolysis. METHODS Sixteen healthy women and men (23 ± 5 yr) completed an RT program three times per week for 8 wk. Exercises included 2-3 sets of 8-12 repetitions performed at approximately 60%-80% of a one repetition maximum. Strength, body composition, and body circumferences were assessed before and after training. Plasma samples were obtained before and after training, and analyzed for active tissue plasminogen activator (tPA activity), total tissue plasminogen activator (tPA antigen), active plasminogen activator inhibitor-1 (PAI-1 activity), total plasminogen activator inhibitor-1 (PAI-1 antigen), fibrinogen, and coagulation factors VII (FVII) and VIII (FVIII). RESULTS Significant increases in lean mass, arm and thigh circumferences, maximal chest press (PRE: 57.8 ± 37.5 kg, POST: 73.3 ± 43.2 kg), and leg press (PRE: 189.5 ± 96.0 kg, POST: 256.7 ± 97.9 kg) were observed (P < 0.05 for all). PAI-1 activity (PRE: 20.3 ± 32.5 IU·mL-1, POST 9.5 ± 20.9 IU·mL-1) and PAI-1 antigen decreased (PRE: 10.2 ± 9.0 ng·dL-1, POST: 7.2 ± 5.7 ng·dL-1; both, P < 0.05). No change in tPA activity or tPA antigen occurred. Fibrinogen, FVII, and FVIII did not change after training. CONCLUSIONS Inhibition of fibrinolysis was decreased after training, and coagulation was unaffected. These results suggest that regular RT may beneficially influence the risk of a thrombotic event. More research is warranted to understand the mechanisms through which RT affects hemostasis.
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Affiliation(s)
- Paul R Nagelkirk
- Integrative Exercise Physiology Laboratory, Ball State University, Muncie, IN
| | - Kayla Soave
- Integrative Exercise Physiology Laboratory, Ball State University, Muncie, IN
| | | | - Andrew Del Pozzi
- Integrative Exercise Physiology Laboratory, Ball State University, Muncie, IN
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Pillard F, Pécourneau V, Pereira O, Gérard S, Voisin S, Clayessens-Donadel S. Home-based and personalized endurance training program for patients with mild to moderate hemophilia A: What can be expected? Sci Sports 2021. [DOI: 10.1016/j.scispo.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zakavi I, Nayebifar S, Ghasemi E, Valipour A. Therapeutic Efficacy of Aerobic Exercise Training along with Oak Husk Hydroalcoholic Extract for Amelioration of Inflammation in Obese Elderly Male Mice. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5585077. [PMID: 33997019 PMCID: PMC8112923 DOI: 10.1155/2021/5585077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/03/2021] [Accepted: 04/20/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Fibrinogen and interleukin-1β as a proinflammatory cytokine and interleukin-10 and nesfatin-1 as an anti-inflammatory cytokine have an important role in the development and prevention of systemic inflammation and incidence of obesity-induced diseases. Thus, this study is aimed at the interaction effects of aerobic training and oak husk hydroalcoholic extract consumption on plasma levels of fibrinogen, interleukin-1β, nesfatin-1, and interleukin-10 in obese elderly male mice. MATERIALS AND METHODS In this experimental study, 40 fat male mice were fed a high-fat diet for 4 weeks to induce obesity, and subsequently, they were divided randomly into four groups: control, supplement, exercise-placebo, and exercise-supplement. The training groups performed aerobic exercise 5 days a week for 6 weeks (approximately 80-75% VOmax 2). The supplement groups received a solution of oak husk hydroalcoholic extract at a dose of 20 milligram per kilogram of body weight for 6 weeks. Blood samples were taken 48 h after the last training session, and the levels of IL-10, fibrinogen, IL-1β, and nesfatin-1 were measured. Data were analyzed using one-way ANOVA and LSD post hoc tests. RESULTS The results showed that six-week training and oak husk hydroalcoholic extract consumption significantly increased the levels of IL-10 and nesfatin-1 in experimental groups (P < 0.001). Also, the levels of fibrinogen and IL-1β decreased significantly in training groups. Averages between group variations of all indicators were statistically significant, and they were more meaningfully pronounced in the exercise-supplement group than other groups (P ≤ 0.05). CONCLUSIONS Considering the results of the present study, the use of moderate aerobic exercise and oak husk hydroalcoholic extract is recommended to reduce the risk of obesity; it may also have a positive effect on inflammatory factors.
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Affiliation(s)
- Iman Zakavi
- Department of Public Health, Abadan Faculty of Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Shila Nayebifar
- Department of Sport Sciences, Faculty of Educational Sciences and Psychology, University of Sistan and Baluchestan, Zahedan, Iran
| | - Elham Ghasemi
- Department of Sport Sciences, Faculty of Literature and Humanities, University of Zabol, Zabol, Iran
| | - Aliasghar Valipour
- Department of Public Health, Abadan Faculty of Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran
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Olsen LN, Fischer M, Evans PA, Gliemann L, Hellsten Y. Does Exercise Influence the Susceptibility to Arterial Thrombosis? An Integrative Perspective. Front Physiol 2021; 12:636027. [PMID: 33708141 PMCID: PMC7940832 DOI: 10.3389/fphys.2021.636027] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/01/2021] [Indexed: 12/14/2022] Open
Abstract
Arterial thrombosis is the primary cause of death worldwide, with the most important risk factors being smoking, unhealthy diet, and physical inactivity. However, although there are clear indications in the literature of beneficial effects of physical activity in lowering the risk of cardiovascular events, exercise can be considered a double-edged sword in that physical exertion can induce an immediate pro-thrombotic environment. Epidemiological studies show an increased risk of cardiovascular events after acute exercise, a risk, which appear to be particularly apparent in individuals with lifestyle-related disease. Factors that cause the increased susceptibility to arterial thrombosis with exercise are both chemical and mechanical in nature and include circulating catecholamines and vascular shear stress. Exercise intensity plays a marked role on such parameters, and evidence in the literature accordingly points at a greater susceptibility to thrombus formation at high compared to light and moderate intensity exercise. Of importance is, however, that the susceptibility to arterial thrombosis appears to be lower in exercise-conditioned individuals compared to sedentary individuals. There is currently limited data on the role of acute and chronic exercise on the susceptibility to arterial thrombosis, and many studies include incomplete assessments of thrombogenic clotting profile. Thus, further studies on the role of exercise, involving valid biomarkers, are clearly warranted.
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Affiliation(s)
- Line Nørregaard Olsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Mads Fischer
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Phillip Adrian Evans
- Haemostasis Biomedical Research Unit, Welsh Centre for Emergency Medicine Research, Morriston Hospital, SBU Health Board, Swansea, United Kingdom
- College of Medicine, Swansea University, Swansea, United Kingdom
| | - Lasse Gliemann
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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Sackett JR, Farrell DP, Nagelkirk PR. Hemostatic Adaptations to High Intensity Interval Training in Healthy Adult Men. Int J Sports Med 2020; 41:867-872. [PMID: 32634847 DOI: 10.1055/a-1165-2040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Regular exercise is theorized to reduce cardiovascular risk by attenuating coagulation and augmenting fibrinolysis. However, these adaptations have not been consistently observed during traditional exercise programs. The purpose of this study was to examine hemostatic adaptations in healthy men following four (4W) and eight (8W) weeks of high intensity interval training. Twenty-one men (age=25±1 y; body mass index=26.5±6.4 kg/m2) completed eight weeks, three days/week of high intensity interval training on a cycle ergometer. Activated partial thromboplastin time, prothrombin time, and plasma concentrations of thrombin-antithrombin III, fibrinogen, tissue plasminogen activator, and plasminogen activator inhibitor-1 were assessed at baseline (BL), 4W, and 8W. Repeated measures ANOVA were used to determine potential effects of training. There were no significant changes observed for activated partial thromboplastin time (BL=43.3±5.5, 4W=43.2±5.1, 8W=44.2±6.4 s); prothrombin time (BL=13.2±0.9, 4W=13.0±0.6, 8W=13.1±0.8 s); thrombin-antithrombin III (BL=6.0±2.3, 4W=5.8±2.3, 8W=5.6±3.1 ng/mL); tissue plasminogen activator (BL=9.7±3.3, 4W=9.4±3.2, 8W=8.7±2.8 ng/mL); and plasminogen activator inhibitor-1 (BL=19.0±17.5, 4W=19.3±17.0, 8W=18.9±18.9 ng/mL) (all p>0.05). Fibrinogen was significantly lower at 4W (238.6±70.3 mg/dL) compared to BL (285.0±82.1 mg/dL; p<0.05) and 8W (285.3±83.2 mg/dL; p<0.05). These findings indicate that eight weeks of high intensity interval training does not influence coagulation potential and/or stimulate fibrinolysis.
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Affiliation(s)
- James R Sackett
- Integrative Exercise Physiology Laboratory, Ball State University, Muncie, United States
| | - Dan P Farrell
- Integrative Exercise Physiology Laboratory, Ball State University, Muncie, United States
| | - Paul R Nagelkirk
- Integrative Exercise Physiology Laboratory, Ball State University, Muncie, United States
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Coppel J, Gilbert-Kawai E, Bottomley T, Sugarman J, Martin D. The effect of normobaric hypoxic exposure on coagulation as measured by thromboelastography. Thromb Res 2019; 184:105-109. [PMID: 31715543 DOI: 10.1016/j.thromres.2019.10.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 10/28/2019] [Accepted: 10/31/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The physiological impact of hypoxia on coagulation has significant importance in the clinical setting, but it is not yet fully understood. Various static methods exist to investigate the process of coagulation, however, thromboelastography (TEG) provides a dynamic assessment of clot formation that can be quantitatively assessed. METHOD Twenty-five participants were exposed to normobaric hypoxia (12.5% oxygen) for 8 h. Venous blood was taken from the participants directly pre- and post-hypoxic exposure, and coagulation was tested using TEG. Coagulation variables assessed included reaction time, split point, alpha angle, kinetics and maximum amplitude. RESULTS Time taken for clot initiation, (assessed using the split point and reaction time) was significantly reduced after 8 h of hypoxic exposure. The split point reduced from a mean of 5.20 to 4.23 min (p = 0.022), whilst the reaction time reduced from 6.09 to 4.94 min (p = 0.004). Maximum amplitude, alpha angle and kinetics did not change significantly after hypoxic exposure. CONCLUSION The results demonstrate that subacute normobaric hypoxic exposure increases the tendency for whole blood to coagulate, as demonstrated by a reduced split and reaction time using TEG.
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Affiliation(s)
- Jonny Coppel
- University College London Centre for Altitude, Space, and Extreme Environment Medicine, University College London Hospitals National Institute for Health Research Biomedical Research Centre, Institute of Sport and Exercise Health, London, United Kingdom.
| | - Edward Gilbert-Kawai
- University College London Centre for Altitude, Space, and Extreme Environment Medicine, University College London Hospitals National Institute for Health Research Biomedical Research Centre, Institute of Sport and Exercise Health, London, United Kingdom
| | - Tom Bottomley
- University College London Centre for Altitude, Space, and Extreme Environment Medicine, University College London Hospitals National Institute for Health Research Biomedical Research Centre, Institute of Sport and Exercise Health, London, United Kingdom
| | - Joel Sugarman
- University College London Centre for Altitude, Space, and Extreme Environment Medicine, University College London Hospitals National Institute for Health Research Biomedical Research Centre, Institute of Sport and Exercise Health, London, United Kingdom
| | - Daniel Martin
- University College London Centre for Altitude, Space, and Extreme Environment Medicine, University College London Hospitals National Institute for Health Research Biomedical Research Centre, Institute of Sport and Exercise Health, London, United Kingdom
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Braschi A. Acute exercise-induced changes in hemostatic and fibrinolytic properties: analogies, similarities, and differences between normotensive subjects and patients with essential hypertension. Platelets 2019; 30:675-689. [DOI: 10.1080/09537104.2019.1615611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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9
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Stepien EL, Kwaśniewska M, Rębowska E, Golański J, Drygas W. Modified thrombin formation and fibrinolysis in an ultra-endurance marathon swimmer. Scand J Med Sci Sports 2018; 27:567-570. [PMID: 28387013 DOI: 10.1111/sms.12836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E L Stepien
- Department of Medical Physics, M. Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland
| | - M Kwaśniewska
- Department of Social and Preventive Medicine, Medical University of Łódź, Łódź, Poland
| | - E Rębowska
- Department of Social and Preventive Medicine, Medical University of Łódź, Łódź, Poland
| | - J Golański
- Department of Haemostasis and Haemostatic Disorders, Medical University of Łódź, Łódź, Poland
| | - W Drygas
- Department of Social and Preventive Medicine, Medical University of Łódź, Łódź, Poland.,Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, The Cardinal Stefan Wyszyński Institute of Cardiology, Warsaw, Poland
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Kumar R, Bouskill V, Schneiderman J, Pluthero F, Kahr W, Craik A, Clark D, Whitney K, Zhang C, Rand M, Carcao M. Impact of aerobic exercise on haemostatic indices in paediatric patients with haemophilia. Thromb Haemost 2017; 115:1120-8. [DOI: 10.1160/th15-09-0757] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 02/11/2016] [Indexed: 11/05/2022]
Abstract
SummaryThis study investigated the impact of aerobic exercise on laboratory assessments of haemostatic activity in boys (5–18 years of age) with haemophilia A (HA) or B (HB), examining the hypothesis that laboratory coagulation parameters temporarily improve with exercise. Thirty subjects meeting eligibility criteria (19 HA; 11 HB; mean age: 12.8 years) were invited to participate. They underwent a replacement factor washout period and were advised against strenuous activity for three days prior to the planned intervention. At study visit, baseline blood samples were drawn prior to exercise on a stationary cycle ergometer, aiming to attain 3 minutes (min) of cycling at 85 % of predicted maximum heart rate. Blood work was repeated 5 min (t5) and 60 min (t60) post exercise completion. Samples were assessed for platelet count (PC), factor VIII activity (FVIII:C), von Willebrand antigen (VWF:Ag), ristocetin cofactor activity (VWF:RCo) and platelet function analysis (PFA-100); maximum rate of thrombus generation (MRTG) in blood was measured via thromboelastography and plasma peak thrombin generation (PTG) via calibrated automated thrombography. Mean duration of exercise was 13.9 (± 2.6) min. On average, t5 samples showed significant elevation, relative to baseline in PC, FVIII:C, VWF:Ag, VWF:RCo and PTG, while FVIII:C, VWF:Ag, VWF:RCo and MRTG were significantly elevated in t60 samples. Within the cohort, participants with severe HA showed no change in FVIII:C levels with exercise. The greatest improvement in haemostatic indices was observed in post-adolescent males with mild-moderate HA, who thus represent the group most likely to benefit from a reduction of bleeding risk in the setting of exercise.
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Sholzberg M, Floros G, Schneiderman JE, Kahr WHA, Rand M, Pluthero F, Hossain T, Mahamad S, Nisenbaum R, Zhang C, O'Neill NE, Teitel J, Carcao M. Effect of moderate intensity exercise on haemostatic capacity in adults with haemophilia A and B: pilot study. Haemophilia 2017; 23:e162-e165. [PMID: 28111839 DOI: 10.1111/hae.13181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2016] [Indexed: 11/27/2022]
Affiliation(s)
- M Sholzberg
- Division of Haematology/Oncology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Haematology/Oncology Clinical Research Group, St. Michael's Hospital, Toronto, ON, Canada
| | - G Floros
- Department of Nursing, St. Michael's Hospital, Toronto, ON, Canada
| | - J E Schneiderman
- Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada.,Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - W H A Kahr
- Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Division of Haematology-Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - M Rand
- Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Division of Haematology-Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Department of Biochemistry, University of Toronto, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - F Pluthero
- Division of Haematology-Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - T Hossain
- Division of Haematology-Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - S Mahamad
- Haematology/Oncology Clinical Research Group, St. Michael's Hospital, Toronto, ON, Canada
| | - R Nisenbaum
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - C Zhang
- Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - N E O'Neill
- Haematology/Oncology Clinical Research Group, St. Michael's Hospital, Toronto, ON, Canada
| | - J Teitel
- Division of Haematology/Oncology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - M Carcao
- Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.,Division of Haematology-Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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Moderate-intensity exercise improves the thromboelastography coagulation index in children with severe hemophilia A. Blood Coagul Fibrinolysis 2016; 27:797-803. [PMID: 26656895 DOI: 10.1097/mbc.0000000000000493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This pilot study explored the effect of moderate-intensity exercise on factor VIII (FVIII) activity and global hemostatic status of the children with severe hemophilia A. Eleven children aged 6 to 15 years with severe hemophilia A participated in a moderate-intensity exercise test by using Recumbent Cross Trainer (NuStep, T5XR) for at least 10 min after reaching the target heart rate or until volitional exhaustion within a safety framework. Blood samples were collected pre and postexercise for plasma FVIII: C and thromboelastography (TEG) parameters and coagulation index. The average duration of exercise was 11.8 min (10-13 min). There was no report on bleeding events or adverse symptoms requiring termination of the exercise test. The average FVIII activity of the 11 children was 0.66 (0.5-0.8) IU/dl before and 0.93 (0.5-2.3) IU/dl after exercise. The increase of FVIII in the 11 children as a group was not statistically significant (P = 0.052). There were significant changes of TEG measurements, with shortening of R (P < 0.05), and increase in K decrease (P < 0.05), alpha angle (P < 0.05), maximum amplitude (P < 0.05), and coagulation index (P < 0.01). Among the 11 children, the relative coagulation index increase after exercise was greater than 50% in seven (63.6%), less than 20% in three (27.3%), and less than 10% in one (9.1%). TEG analysis showed that the global hemostatic function for the children with severe hemophilia A can be enhanced after moderate-intensity exercise.
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13
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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]
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14
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Ninivaggi M, de Laat M, Lancé MMD, Kicken CH, Pelkmans L, Bloemen S, Dirks ML, van Loon LJC, Govers-Riemslag JWP, Lindhout T, Konings J, de Laat B. Hypoxia Induces a Prothrombotic State Independently of the Physical Activity. PLoS One 2015; 10:e0141797. [PMID: 26516774 PMCID: PMC4627841 DOI: 10.1371/journal.pone.0141797] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/13/2015] [Indexed: 11/23/2022] Open
Abstract
Hypoxia (oxygen deprivation) is known to be associated with deep vein thrombosis and venous thromboembolism. We attempted to get a better comprehension of its mechanism by going to high altitude, thereby including the potential contributing role of physical activity. Two groups of 15 healthy individuals were exposed to hypoxia by going to an altitude of 3900 meters, either by climbing actively (active group) or transported passively by cable car (passive group). Both groups were tested for plasma fibrinogen, von Willebrand factor and factor VIII levels, fibrinolysis, thrombin generating capacity, heart rate, oxygen saturation levels and blood pressure. As a control for the passive group, 7 healthy volunteers stayed immobile in bed for 7 days at normoxic conditions. The heart rate increased and oxygen saturation levels decreased with increasing altitude. Fibrinolysis and fibrinogen levels were not affected. Factor VIII and von Willebrand factor levels levels increased significantly in the active group, but not in the passive group. Plasma thrombin generation remained unchanged in both the active and passive group with increasing altitude and during 7 days of immobility in healthy subjects. However, by applying whole blood thrombin generation, we found an increased peak height and endogenous thrombin potential, and a decreased lagtime and time-to-peak with increasing levels of hypoxia in both groups. In conclusion, by applying whole blood thrombin generation we demonstrated that hypoxia causes a prothrombotic state. As thrombin generation in plasma did not increase, our results suggest that the cellular part of the blood is involved in the prothrombotic phenotype induced by hypoxia.
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Affiliation(s)
- Marisa Ninivaggi
- Department of Synapse bv, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Biochemistry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marieke de Laat
- Department of Synapse bv, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marcus M. D. Lancé
- Department of Anesthesiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Cécile H. Kicken
- Department of Synapse bv, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Anesthesiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Leonie Pelkmans
- Department of Synapse bv, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Biochemistry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Saartje Bloemen
- Department of Synapse bv, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Biochemistry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marlou L. Dirks
- Department of NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Luc J. C. van Loon
- Department of NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | - Theo Lindhout
- Department of Synapse bv, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Joke Konings
- Department of Synapse bv, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Biochemistry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bas de Laat
- Department of Synapse bv, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Biochemistry, Maastricht University Medical Center, Maastricht, The Netherlands
- * E-mail:
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Rydz N, Grabell J, Lillicrap D, James PD. Changes in von Willebrand factor level and von Willebrand activity with age in type 1 von Willebrand disease. Haemophilia 2015; 21:636-41. [PMID: 25756206 DOI: 10.1111/hae.12664] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED In a normal population, VWF plasma levels (VWF:Ag) and VWF activity (VWF:RCo) increase by approximately 0.17 and 0.15 IU mL(-1) per decade, but the influence of age is unknown in patients with type 1 von Willebrand disease (VWD). In a retrospective cohort study, the medical records of 31 type 1 VWD patients over the age of 30, who had been followed for ≥5 years, were reviewed for baseline clinical data and previously performed VWF:Ag, VWF:RCo and factor VIII levels ( FVIII C). VWF multimer analysis was normal in 28/31 cases performed. Mean age at diagnosis was 33 (range 16-60 years), and duration of follow-up ranged from 5 to 26 years (mean 11 years). Patients had 2-10 time points of VWD testing (mean of 5.2). The mean VWF:Ag, VWF:RCo and FVIII C at time of diagnosis were 0.44 IU mL(-1) 0.34 IU mL(-1) and 0.75 IU mL(-1) . At last follow-up, the mean VWF:Ag, VWF:RCo and FVIII C were significantly increased to 0.71 IU L(-1) , 0.56 IU mL(-1) and 0.90 IU mL(-1) (P ≤ 0.001, <0.001, and 0.0081 respectively). Here 18/31 patients had VWF:Ag, VWF:RCo and FVIII C levels that increased into the normal range. The rate of change in VWF:Ag, VWF:RCo and FVIII was 0.30 IU mL(-1) (0.21-0.39, CI 95%, P < 0.0001), 0.20 IU mL(-1) per decade (0.13-0.27, CI 95%, P = 0.0001) and 0.20 IU mL(-1) (0.11-0.29, CI 95%, P = 0.0011). Patients with type 1 VWD experience age-related increases to VWF:Ag and VWF:RCo which can result in normalization of VWF levels. Further studies are required to determine if the bleeding phenotype resolves with the increases in VWF:Ag and VWF:RCo levels.
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Affiliation(s)
- N Rydz
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - J Grabell
- Department of Medicine, Queen's University, Kingston, ON, Canada
| | - D Lillicrap
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, ON, Canada
| | - P D James
- Department of Medicine, Queen's University, Kingston, ON, Canada
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16
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Piccione G, Marafioti S, Giannetto C, Panzera M, Fazio F. Effect of dietary supplementation with omega 3 on clotting time, fibrinogen concentration and platelet aggregation in the athletic horse. Livest Sci 2014. [DOI: 10.1016/j.livsci.2013.12.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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The moderate physical exercise significantly increases von Willebrand's factor's activity and concentration in the blood. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.poamed.2013.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Balaoing LR, Post AD, Liu H, Minn KT, Grande-Allen KJ. Age-related changes in aortic valve hemostatic protein regulation. Arterioscler Thromb Vasc Biol 2013; 34:72-80. [PMID: 24177329 DOI: 10.1161/atvbaha.113.301936] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although valvular endothelial cells have unique responses compared with vascular endothelial cells, valvular regulation of hemostasis is not well-understood. Heart valves remodel throughout a person's lifetime, resulting in changes in extracellular matrix composition and tissue mechanical properties that may affect valvular endothelial cell hemostatic function. This work assessed valvular endothelial cell regulation of hemostasis in situ and in vitro as a function of specimen age. APPROACH AND RESULTS Porcine aortic valves were assigned to 1 of 3 age groups: Young (YNG) (6 weeks); Adult (ADT) (6 months); or Elderly (OLD) (2 years). Histological examination of valves showed that secreted thrombotic/antithrombotic proteins localize at the valve endothelium and tissue interior. Gene expression and immunostains for von Willebrand factor (VWF), tissue factor pathway inhibitor, and tissue plasminogen activator in YNG porcine aortic valve endothelial cells were higher than they were for OLD, whereas plasminogen activator inhibitor 1 levels in OLD were higher than those for YNG and ADT. Histamine-stimulated YNG porcine aortic valve endothelial cells released higher concentrations of VWF proteins than OLD, and the fractions of VWF-140 fragments was not different between age groups. A calcific aortic valve disease in vitro model using valvular interstitial cells confirmed that VWF in culture significantly increased valvular interstitial cell nodule formation and calcification. CONCLUSIONS Hemostatic protein regulation in aortic valve tissues and in valvular endothelial cells changes with age. The presence of VWF and other potential hemostatic proteins increase valvular interstitial cell calcification in vitro. Therefore, the increased capacity of elderly valves to sequester the hemostatic proteins, together with age-associated loss of extracellular matrix organization, warrants investigation into potential role of these proteins in the formation of calcific nodules.
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Affiliation(s)
- Liezl R Balaoing
- From the Department of Bioengineering, Rice University, Houston, TX
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19
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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: 4] [Impact Index Per Article: 0.4] [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.
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Affiliation(s)
- Giuseppe Piccione
- Department of Veterinary Science, University of Messina, Polo Universitario dell'Annunziata, 98168 Messina,
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20
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Assenza A, Tosto F, Casella S, Fazio F, Giannetto C, Piccione G. Changes in blood coagulation induced by exercise training in young athletic horses. Res Vet Sci 2013; 95:1151-4. [PMID: 23911053 DOI: 10.1016/j.rvsc.2013.07.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 04/04/2013] [Accepted: 07/08/2013] [Indexed: 11/24/2022]
Abstract
Prothrombin Time (PT), Activated Partial Prothrombin Time (APTT), Fibrinogen concentration (Fbg) and Platelet number (Plt) were evaluated in 20 young athletic horses during a training program. A standardized exercise test (SET) was performed every month for three months. The V4 variations (the speed, in m/min, reached at the blood lactate concentration of 4 mmol/l) obtained for each test were calculated to assess the effect of training program on athletic performance. Blood samples were collected at 20-day intervals over a period of 80 days from the beginning of the training program. The V4 (P < 0.001), PT (P < 0.001), APTT (P < 0.01), Fbg (P < 0.01) and Plt (P < 0.001) varied throughout the training period showing that the modifications of clotting mechanism in response to training period may be considered as a normal physiological response of the hemostatic system to training exercise.
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Affiliation(s)
- A Assenza
- Dipartimento di Scienze Sperimentali e Biotecnologie Applicate, Laboratorio di Fisiologia Comparata dell'Esercizio Fisico, Facoltà di Medicina Veterinaria, Università degli Studi di Messina, Polo Universitario Annunziata, 98168 Messina, Italy.
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21
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The C-type lectin receptor CLEC4M binds, internalizes, and clears von Willebrand factor and contributes to the variation in plasma von Willebrand factor levels. Blood 2013; 121:5228-37. [PMID: 23529928 DOI: 10.1182/blood-2012-10-457507] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Genetic variation in or near the C-type lectin domain family 4 member M (CLEC4M) has been associated with plasma levels of von Willebrand factor (VWF) in healthy individuals. CLEC4M is a lectin receptor with a polymorphic extracellular neck region possessing a variable number of tandem repeats (VNTR). A total of 491 participants (318 patients with type 1 von Willebrand disease [VWD] and 173 unaffected family members) were genotyped for the CLEC4M VNTR polymorphism. Family-based association analysis on kindreds with type 1 VWD demonstrated an excess transmission of VNTR 6 to unaffected individuals (P = .0096) and an association of this allele with increased VWF:RCo (P = .029). CLEC4M-Fc bound to VWF. Immunofluorescence and enzyme-linked immunosorbent assay demonstrated that HEK 293 cells transfected with CLEC4M bound and internalized VWF. Cells expressing 4 or 9 copies of the CLEC4M neck region VNTR showed reduced interaction with VWF relative to CLEC4M with 7 VNTR (CLEC4M 4%-60% reduction, P < .001; CLEC4M 9%-45% reduction, P = .006). Mice expressing CLEC4M after hydrodynamic liver transfer have a 46% decrease in plasma levels of VWF (P = .0094). CLEC4M binds to and internalizes VWF, and polymorphisms in the CLEC4M gene contribute to variable plasma levels of VWF.
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22
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Groen WG, den Uijl IEM, van der Net J, Grobbee DE, de Groot PG, Fischer K. Protected by nature? Effects of strenuous physical exercise on FVIII activity in moderate and mild haemophilia A patients: a pilot study. Haemophilia 2013; 19:519-23. [DOI: 10.1111/hae.12111] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2012] [Indexed: 10/27/2022]
Affiliation(s)
- W. G. Groen
- Child Development and Exercise Center; UMC Utrecht; Utrecht; The Netherlands
| | | | - J. van der Net
- Child Development and Exercise Center; UMC Utrecht; Utrecht; The Netherlands
| | - D. E. Grobbee
- Julius Center for Health Sciences and Primary Care; UMC Utrecht; Utrecht; The Netherlands
| | - Ph. G. de Groot
- Department of Clinical Chemistry and Haematology; UMC Utrecht; Utrecht; The Netherlands
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Vanhees L, Geladas N, Hansen D, Kouidi E, Niebauer J, Reiner Ž, Cornelissen V, Adamopoulos S, Prescott E, Börjesson M. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II). Eur J Prev Cardiol 2011; 19:1005-33. [DOI: 10.1177/1741826711430926] [Citation(s) in RCA: 178] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - N Geladas
- University of Athens, Athens, Greece
| | - D Hansen
- University Hasselt, Diepenbeek, Belgium
| | - E Kouidi
- Aristotle University, Thessaloniki, Greece
| | - J Niebauer
- Paracelsus Medical University, Salzburg, Austria
| | - Ž Reiner
- University Hospital Center Zagreb, Zagreb, Croatia
| | | | | | - E Prescott
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - M Börjesson
- Sahlgrenska University Hospital/Ostra, Goteborg, Sweden
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24
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Baker DJ, Grimes EA, Hopwood AJ. D-dimer assays for the identification of menstrual blood. Forensic Sci Int 2011; 212:210-4. [PMID: 21741187 DOI: 10.1016/j.forsciint.2011.06.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 04/28/2011] [Accepted: 06/07/2011] [Indexed: 12/20/2022]
Abstract
A method to reliably distinguish menstrual blood from blood in the normal circulation (peripheral blood) would be of considerable use in the forensic analysis and interpretation of evidence in sexual offence investigations. Previous attempts to address this issue have explored microscopy, lactate dehydrogenase isozyme identification, mRNA and miRNA profiling, and identification of the products of fibrinolysis. Here, four assays for D-dimer, a terminal degradation product of fibrinolysis, are evaluated for their specificity and sensitivity in detection of menstrual blood. In addition the effect of exercise, and sample storage upon D-dimer detection was investigated. Comparison of different assays revealed significant differences in results given. Nevertheless, no positive results for D-dimer were obtained using peripheral blood, mixtures of peripheral blood with semen, or peripheral blood taken from donors after moderate exercise. D-dimer was found to be detectable in 100% of menstrual blood samples after 1 week at room temperature and also in samples stored long-term (>3 years) at -20 °C. D-dimer may be an effective, simple to use tool for the presumptive identification of menstrual blood identification.
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Affiliation(s)
- David J Baker
- Forensic Science Service Ltd, Trident Court 2960 Solihull Parkway, Birmingham Business Park, Birmingham B37 7YN, United Kingdom
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25
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Borch KH, Hansen-Krone I, Braekkan SK, Mathiesen EB, Njolstad I, Wilsgaard T, Hansen JB. Physical activity and risk of venous thromboembolism. The Tromso study. Haematologica 2010; 95:2088-94. [PMID: 20801904 DOI: 10.3324/haematol.2009.020305] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Previous studies have shown differences in the impact of regular physical exercise on the risk of venous thromboembolism. The inconsistent findings may have depended on differences in study design and specific population cohorts (men only, women only and elderly). We conducted a prospective, population-based cohort to investigate the impact of regular physical exercise on the risk of venous thromboembolism. DESIGN AND METHODS Risk factors, including self-reported moderate intensity physical exercise during leisure time, were recorded for 26,490 people aged 25-97 years old, who participated in a population health survey, the Tromsø study, in 1994-95. Incident venous thromboembolic events were registered during the follow-up until September 1, 2007. RESULTS There were 460 validated incident venous thromboembolic events (1.61 per 1000 person-years) during a median of 12.5 years of follow-up. Age, body mass index, the proportion of daily smokers, total cholesterol, and serum triglycerides decreased (P<0.001), whereas high density cholesterol increased (P<0.001) across categories of more physical exercise. Regular physical exercise of moderate to high intensity during leisure time did not significantly affect the risk of venous thromboembolism in the general population. However, compared to inactivity, high amounts of physical exercise (≥ 3 hours/week) tended to increase the risk of provoked venous thromboembolism (multivariable hazard ratio, 1.30; 95% confidence interval, 0.84-2.0), and total venous thromboembolism in the elderly (multivariable hazard ratio, 1.33; 95% confidence interval, 0.80-2.21) and in the obese (multivariable hazard ratio, 1.49; 95% confidence interval, 0.63-3.50). Contrariwise, compared to inactivity, moderate physical activity (1.0-2.9 hours/week) was associated with a border-line significant decreased risk of venous thromboembolism among subjects under 60 years old (multivariable hazard ratio, 0.72; 95% confidence interval, 0.48-1.08) and subjects with a body mass index of less than 25 kg/m(2) (multivariable hazard ratio, 0.59; 95% confidence interval, 0.35-1.01). CONCLUSIONS Our study showed that regular, moderate intensity physical exercise did not have a significant impact on the risk of venous thromboembolism in a general population. Future studies are required to assess the impact of regular physical exercise on venous thromboembolism risk in different population subgroups.
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Affiliation(s)
- Knut H Borch
- Hematological Research Group (HERG), Department of Medicine, Institute of Clinical Medicine, University of Tromsø, N-9037 Tromsø, Norway.
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Exercise in Patients with Intermittent Claudication Elicits Signs of Inflammation and Angiogenesis. Eur J Vasc Endovasc Surg 2009; 38:689-96. [DOI: 10.1016/j.ejvs.2009.08.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2009] [Accepted: 08/06/2009] [Indexed: 11/19/2022]
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28
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Gonzales JU, Thistlethwaite JR, Thompson BC, Scheuermann BW. Exercise-induced shear stress is associated with changes in plasma von Willebrand factor in older humans. Eur J Appl Physiol 2009; 106:779-84. [PMID: 19437032 DOI: 10.1007/s00421-009-1074-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2009] [Indexed: 11/26/2022]
Abstract
Shear stress is the frictional force of blood against the endothelium, a stimulus for endothelial activation and the release of von Willebrand factor (vWF). This study tested the hypothesis that the increase in shear stress associated with exercise correlates with plasma vWF. Young (n = 14, 25.7 +/- 5.4 years) and older (n = 13, 65.6 +/- 10.7 years) individuals participated in 30 min of dynamic handgrip exercise at a moderate intensity. Brachial artery diameter and blood flow were measured using ultrasound Doppler and blood samples were collected before, immediately after, and following 30 min of recovery from exercise with plasma levels of vWF. Plasma levels of vWF increased (P < 0.05) by 6 +/- 2% in young individuals and 4 +/- 1% in older individuals immediately after exercise. The change in plasma vWF was linearly correlated with the increase in shear stress during exercise in older individuals (post-exercise: r = 0.78, 30 min recovery: r = 0.77, P < 0.01), but no association was found in the young individuals. These changes in plasma levels of vWF in humans suggest that aging influences endothelial activation and hemostasis.
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Affiliation(s)
- Joaquin U Gonzales
- Cardiopulmonary and Metabolism Research Laboratory, Department of Kinesiology, The University of Toledo, Toledo, OH 43606, USA
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29
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Exercise-induced hemostatic activation in patients with dilated cardiomyopathy in sinus rhythm. Blood Coagul Fibrinolysis 2008; 19:146-52. [DOI: 10.1097/mbc.0b013e3282f54510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Effects of an Off-Site Walking Program on Fibrinogen and Exercise Energy Expenditure in Women. Asian Nurs Res (Korean Soc Nurs Sci) 2008; 2:35-45. [DOI: 10.1016/s1976-1317(08)60027-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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31
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Ribeiro JL, Salton GD, Bandinelli E, Oliveira AR, Roisenberg I. The effect of ABO blood group on von Willebrand response to exercise. Clin Appl Thromb Hemost 2007; 14:454-8. [PMID: 18160595 DOI: 10.1177/1076029607305530] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Individuals of O blood group have significantly lower plasma levels of either Factor VIII (FVIII) or the von Willebrand factor (vWF). Conversely, there is accumulating evidence that elevated FVIII-vWF levels may represent an important risk factor for ischemic heart and venous thromboembolic disease. In this study, individuals exercised for 20 minutes at 10% below the first ventilatory threshold (aerobic threshold), which corresponds to 48% of maximum oxygen uptake. People with non-O blood group show higher resting and postexercise vWF levels compared with those of O blood group, as evidenced by a lower maximal heart rate. The groups were compared using the ANOVA one-way test, and a P < 0.05 was considered statistically significant. These results could change the way in which exercise training is designed for both healthy and sick individuals because O group individuals could have a more thrombogenic response to exercise.
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Affiliation(s)
- Jerri L Ribeiro
- Exercise Research Laboratory, Physical Education School, Federal University of Rio Grande do Sul, Brazil.
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Sugawara J, Hayashi K, Kurachi S, Tanaka T, Yokoi T, Kurachi K. Age-related effects of regular physical activity on hemostatic factors in men. J Thromb Thrombolysis 2007; 26:203-10. [PMID: 17828598 DOI: 10.1007/s11239-007-0092-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Accepted: 08/24/2007] [Indexed: 11/30/2022]
Abstract
BACKGROUND Age-related changes in blood coagulation and fibrinolytic factors are associated with an increase in risk of thrombotic events. The purpose of this study was to assess the effects of age, regular aerobic exercise and detraining on blood coagulation and fibrinolytic factors in men. METHODS Initially, 41 sedentary and 42 physically active men (20-64 years) were analyzed for plasma levels of coagulation and fibrinolytic factors. Twelve sedentary men were then subjected to 16-week aerobic exercise training and subsequent 2-week detraining. Their blood samples taken at rest were assayed for activity levels of prothrombin, coagulation factor (F) V, VII, VIII, IX, X, XI and XIII, antithrombin III, protein C and plasminogen, and for antigen levels of fibrinogen, prothrombin fragment 1 + 2 (F1 + 2), FIX, protein C, tissue-type plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI-1) and tPA/PAI-1 complex. RESULTS Plasma levels of most coagulation factors, particularly for fibrinogen and FIX antigens as well as FXIII activity significantly increased with aging in sedentary men, while that tendency disappeared in physically active men. By the exercise training, plasma antigen and/or activity levels of most blood coagulation factors except for prothrombin and FIX decreased. These training-effects, however, disappeared after detraining, and in some cases even rebounded to higher levels than those of pre-training. Plasma antigen levels of tPA, PAI-1 and tPA/PAI-1 complex decreased with the training and remained low even after detraining. CONCLUSION Regular aerobic exercises give complex effects on expression of hemostatic factors, overall favoring the hemostatic balance to less thrombotic, partly cancelling out the age effects.
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Affiliation(s)
- Jun Sugawara
- Institute for Human Science and Biomedical Engineering, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba Central 6, Tsukuba, Ibaraki 305-8566, Japan.
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Nagelkirk PR, Franklin BA, Coughlin AM, Hassouna HI, Fink GD, Pivarnik JM, Womack CJ. Discordant Hemodynamic and Fibrinolytic Adaptations Following a 6-Week Cardiac Rehabilitation Program. ACTA ACUST UNITED AC 2007; 10:196-203. [DOI: 10.1111/j.1520-037x.2007.06425.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lockard MM, Gopinathannair R, Paton CM, Phares DA, Hagberg JM. Exercise training-induced changes in coagulation factors in older adults. Med Sci Sports Exerc 2007; 39:587-92. [PMID: 17414794 DOI: 10.1249/mss.0b013e31802eff4b] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
UNLABELLED The coagulation cascade plays a critical role in the development of cardiovascular disease (CVD). Elevated plasma prothrombin fragment 1 + 2 (F1 + 2) and factor VIII antigen (FVIII:Ag) levels have been associated with a hypercoagulable state, enhancing the risk for vascular thrombotic events. Aerobic training is known to reduce CVD risk, and an improved coagulation profile may contribute to this reduction. PURPOSE To analyze the effect of 6 months of standardized aerobic exercise training on resting F1 + 2 and FVIII:Ag levels in men and postmenopausal women aged 50-75 while accounting for several possibly confounding factors. MATERIALS AND METHODS Sedentary men (N=16) and women (N=31) underwent supervised aerobic training 3 d x wk(-1) for 6 months while maintaining the American Heart Association step 1 diet. Baseline and final testing included measurement of F1 + 2, FVIII:Ag, plasma lipoprotein-lipid levels, body composition, and VO2max. RESULTS When adjusted for baseline values and changes in diastolic blood pressure with training, F1 + 2 was found to decrease significantly with exercise training from 1.493 +/- 0.058 to 1.422 +/- 0.059 nM (P=0.014). FVIII:Ag levels were found to increase significantly with training when adjusted for baseline values, from 152.5 +/- 6.7% of standard at baseline to 156.0 +/- 6.1% of standard at final testing (P=0.005). Training-induced changes in coagulation markers were independent of changes in blood lipids, aerobic capacity, and body composition. CONCLUSIONS : These results indicate that endurance training has a significant impact on the coagulation cascade, reducing coagulation activity in the common pathway and thrombin formation at rest while increasing the activation potential of the intrinsic pathway.
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Affiliation(s)
- Michael M Lockard
- Department of Kinesiology, University of Maryland, College Park, MD 20742-2611, USA
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Balen S, Ruzić A, Mirat J, Persić V. Exercise induced von Willebrand Factor release -- new model for routine endothelial testing. Med Hypotheses 2007; 69:1320-2. [PMID: 17507174 DOI: 10.1016/j.mehy.2007.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 03/23/2007] [Indexed: 10/23/2022]
Abstract
Endothelial dysfunction (ED) is actively involved in the mechanism of occurrence, development and progression of all the degrees of atherosclerosis. The established impact of ED on the progress and outcome of cardiovascular diseases, together with convincing indications of a possible successful therapeutic modification, necessitate the changeover of ED assessment from experimental to a routine practice. As there is no appropriate method for a clinical practice, scientists anticipate significant research efforts in the further development. Among numerous methods already available, von Willebrand Factor (vWF) stands out significantly. In accordance with the accepted leading diagnostic role of vWF baseline levels in the group of peripheral endothelial markers, and earlier scientific observations on the absence of its expected reactivation during physical exercise, we hypothesised this promising theory. We believe that a constant stronger release of vWF in endothelial cell injury leads to the exhaustion of its stores in Weibel-Palade bodies with the consequent absence of the expected rise of concentration during the exercise. Therefore, we hypothesised that ED could be exhaustible vWF endothelopathy and the exercise induced release of vWF a new, simple, safe and reliable test for the detection of ED and monitoring of the expected therapeutic effect. In order to have a final clinical usability of the proposed diagnostic model, it is necessary to test its reliability in different pathological and risk states, and establish susceptibility in therapeutic procedures. The correlation with invasive functional angiographic tests and the flow mediated dilatation test of peripheral arteries also needs to be validated. We expect the proposed test of vWF inducibility to find its place in clinical practice, i.e. in prevention, prediction and therapy of cardiovascular diseases.
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Affiliation(s)
- Sanja Balen
- Department of Transfusiology, Clinical Hospital Centre Rijeka, Kresimirova 42, Rijeka, Croatia
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Ribeiro J, Almeida-Dias A, Ascensão A, Magalhães J, Oliveira AR, Carlson J, Mota J, Appell HJ, Duarte J. Hemostatic response to acute physical exercise in healthy adolescents. J Sci Med Sport 2006; 10:164-9. [PMID: 16844409 DOI: 10.1016/j.jsams.2006.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Accepted: 06/01/2006] [Indexed: 12/21/2022]
Abstract
The chronic and immediate post-exercise responses in the hemostatic and fibrinolytic systems have been shown to be variable and reflect differing adaptations with ageing and responses to exercise protocols. This study investigated the effects of acute and exhaustive exercise on the amplitude and duration of hemostatic and fibrinolytic responses in young adolescent males. The sample comprised 10 sedentary boys (13.2+/-0.5 years, 55.8+/-11.3kg, 165.7+/-7.4cm), who had not exercised or received any medication for at least 2 weeks before the experiments. The subjects performed exhaustive stepping exercise, consisting of 1s up and down cycles to fatigue. When the subjects were unable to maintain the required stepping rhythm, they were given a 30s recovery period. Following each 30s recovery participants recommenced the stepping cadence until fatigue prevented them continuing. Venous blood samples were drawn before and immediately, 1 and 24h after exercise to assess the following coagulation and fibrinolytic parameters: Platelet counts, activated partial thromboplastin time (aPTT), prothrombin time (PT), coagulation factor VIII (FVIII:C), von Willebrand factor (vWF), fibrinogen concentration, thrombin-antithrombin complex (TAT), D-dimer, plasminogen activator inhibitor (PAI-1), and tissue-type plasminogen activator (t-PA). Immediately following exercise, platelet counts, aPTT, FVIII, vWF and t-PA were significantly elevated in contrast to PAI-1, which decreased significantly until 1h after exercise. FVIII and platelet counts were elevated at 1 and 24h after exercise, respectively. Only the parameters FVIII and PAI-1 did not return to baseline values during the first hour after physical exercise. When compared to adults the results revealed different rates and ranges of coagulation and fibrinolysis parameters being activated by exhaustive exercise in this group of adolescents.
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Affiliation(s)
- J Ribeiro
- EsEF/UFRGS Physical Education School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Perez RL, Kimani AP, King TE, Aguayo SM, Roman J. Bronchoalveolar lavage fluid D dimer levels are higher and more prevalent in black patients with pulmonary sarcoidosis. Respiration 2006; 74:297-303. [PMID: 16534178 DOI: 10.1159/000091994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2005] [Accepted: 11/28/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Abnormalities of lung coagulation and fibrinolysis in sarcoidosis are thought to play a role in the pathogenesis of this disease. OBJECTIVE We previously showed that bronchoalveolar lavage fluid (BALF) D dimer directly correlated with various measures of severity in sarcoidosis. Here, we analyze our observation that BALF D dimer was more frequently found at higher levels in African-American patients with pulmonary sarcoidosis. METHODS BALF D dimer was measured in 55 subjects with pulmonary sarcoidosis and 31 healthy volunteers by enzyme immunoassay. The healthy group established a normal range of BALF D dimer with 71 ng/ml as the highest measured level. This was the cut point for comparisons among the patients with sarcoidosis. RESULTS High BALF D dimer levels (>71 ng/ml) were found in younger patients with sarcoidosis and were associated with a significantly lower percent predicted forced expiratory volume in 1 s and greater numbers of BAL lymphocytes. Black patients with sarcoidosis had higher BALF D dimer levels (median 131, range 0-2,040 ng/ml) than white patients (median 18, range 0-605 ng/ml; p = 0.011). Higher than normal BALF D dimer levels were found in 61% of the black subjects with sarcoidosis, but in only 20% of the white individuals (chi(2) = 5.539, p = 0.019). BALF D dimer was the only disease measure that discriminated black from white individuals with sarcoidosis. CONCLUSION BALF D dimer is an indicator of lung fibrin formation and degradation in sarcoidosis. The relationship of high D dimer levels with greater BAL lymphocytosis and worse lung function may be a marker of active sarcoidosis, especially in African-Americans who tend to suffer a more serious form of the disease.
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Affiliation(s)
- Rafael L Perez
- Pulmonary Division, Department of Medicine, Emory University, Atlanta Veterans Affairs Medical Center, Atlanta, Ga 30033, USA.
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Paton CM, Brandauer J, Weiss EP, Brown MD, Ivey FM, Roth SM, Hagberg JM. Hemostatic response to postprandial lipemia before and after exercise training. J Appl Physiol (1985) 2006; 101:316-21. [PMID: 16497841 DOI: 10.1152/japplphysiol.01363.2005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Chronic hypertriglyceridemia is thought to be atherogenic and is associated with an elevated thrombotic potential, both of which may be improved with aerobic exercise training. Eight subjects were tested for aerobic capacity, body composition, and postprandial lipemia (PPL), followed by 6 mo of exercise training and final testing. Blood samples were obtained for measurement of free fatty acid (FFA), triglycerides (TG), insulin (Ins), and glucose (Glu). Hemostatic variables including factor VII activity (FVIIa), tissue factor pathway inhibitor-factor Xa complex (TFPI/Xa), and plasminogen activator inhibitor-1 (PAI-1) antigen/activity as well as leukocyte tumor necrosis factor-alpha (TNF-alpha) gene expression were determined among four subjects. We found that the exercise training was of sufficient intensity to increase aerobic capacity (P < 0.0001) and improve body composition (P = 0.04). There were no differences between tests among PPL responses of FFA, TG, Ins, or Glu; however, the mean TG response and fat oxidation rate improved. PAI-1 antigen/activity, FVIIa, TFPI/Xa, and TNF-alpha gene expression were all improved after exercise training after adjusting for confounders. We conclude that aerobic exercise training reduces the potential for coagulation, improves fibrinolytic potential, and reduces leukocyte TNF-alpha gene expression after the ingestion of a high-fat meal.
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Affiliation(s)
- Chad M Paton
- Department of Kinesiology, University of Maryland, College Park, USA.
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Kaibara M, Iwata H, Ujiie H, Himeno R, Kaibara M. Rheological analyses of coagulation of blood from different individuals with special reference to procoagulant activity of erythrocytes. Blood Coagul Fibrinolysis 2005; 16:355-63. [PMID: 15970720 DOI: 10.1097/01.mbc.0000172832.65615.57] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In our previous papers, we reported that factor IX (FIX), when activated by erythrocyte membranes, causes coagulation. We have identified and characterized the FIX-activating enzyme located in normal human erythrocyte membranes. In this paper, to examine physiological and pathological significances of procoagulant activity of erythrocytes, coagulation of blood obtained from different individuals was analyzed by means of a rheological technique. In more than 65% of subjects including normals and patients, the initiation of coagulation seemed to be governed by erythrocytes. Coagulation of whole blood and platelet-free plasma supplemented with erythrocytes had a tendency to occur rapidly in the elderly. It was suggested that the concentration of FIX-activating enzyme on erythrocyte membranes for aged donors was somewhat higher than that for young ages. Propagation reactions on erythrocyte membranes (i.e. factor X activation leading to thrombin generation after FIX activation) was slower than that on platelet membranes. Moreover, the propagation reaction on erythrocyte membranes was greatly dependent on individuals, whereas that on platelet membranes was not so much. Our study demonstrates that the activation of FIX by erythrocytes and subsequent propagation reaction on platelet membranes may be important for initiating and controlling blood coagulation reactions.
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Affiliation(s)
- Makoto Kaibara
- Computational Biomechanics Unit, RIKEN Wako Institute, Saitama, Japan.
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Sabelis LWE, Senden PJ, Fijnheer R, de Groot PG, Huisveld IA, Mosterd WL, Zonderland ML. Endothelial markers in chronic heart failure: training normalizes exercise-induced vWF release. Eur J Clin Invest 2004; 34:583-9. [PMID: 15379756 DOI: 10.1111/j.1365-2362.2004.01388.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic heart failure (CHF) is characterized by endothelial dysfunction. Vascular endothelium is important for control of haemostasis and vasoregulation. The aim of the present study was to investigate plasma levels of several endothelial markers and the exercise-induced changes on these plasma levels in CHF patients. Subsequently, the effect of a 6-month training programme on these markers is described. MATERIALS AND METHODS Twenty-nine male CHF patients (NYHA II/III, age 60 +/- 8 year, body mass index 26.7 +/- 2.3 kg m(-2), left ventricular ejection fraction 26.3-7.2%; mean +/- SD) participated. Patients were randomly assigned to a training or control group. Training (26 weeks; combined strength and endurance exercises) was four sessions/week: two sessions supervised and two sessions at home. Before and after intervention, anthropometry, endothelial markers (haemostasis and vasoregulation), maximal workload and peak oxygen uptake were assessed. RESULTS Physical training positively affected maximal workload. Plasma levels of endothelial markers were not affected by physical training and not related to exercise tolerance. After training, stimulated (maximal exercise) plasma von Willebrand Factor (vWF) release was present, whereas at baseline this release was absent. CONCLUSION Physical training led to normalization of the stimulated plasma vWF release. Plasma levels of other endothelial markers were not affected by physical training either at rest or under stimulated (maximal exercise) conditions.
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Affiliation(s)
- L W E Sabelis
- University Medical Centre Utrecht, Utrecht, the Netherlands
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Ohkuwa T, Itoh H, Yamamoto T, Yamazaki Y. Comparison of t-PA and u-PA levels in maximal treadmill and deep-water running. Prev Med 2004; 39:177-81. [PMID: 15208000 DOI: 10.1016/j.ypmed.2004.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The differences of urokinase-type plasminogen activator (u-PA) and tissue-type plasminogen activator (t-PA) between maximal treadmill and deep-water running have not been reported. The purpose of this investigation was to compare u-PA and t-PA levels during maximal treadmill and deep-water running. METHODS Six male subjects carried out two maximal exercises, one on a treadmill and the other running in deep water using a vest. The u-PA, t-PA, total plasminogen activator inhibitor (PAI-1), epinephrine, and norepinephrine in plasma and lactate and ammonia in blood concentrations were measured after maximal exercise. RESULTS The blood lactate and ammonia concentrations were significantly higher in treadmill running than in deep-water running during recovery following exercise (P < 0.05). At 1 min after exercise, the plasma epinephrine, norepinephrine levels, and the u-PA and t-PA levels were higher in treadmill running compared with that in deep-water running (P < 0.05). No significant difference between the two runs was found in PAI-1 level. CONCLUSION The maximal treadmill running induced a greater increase in u-PA and t-PA levels than maximal deep-water running.
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Affiliation(s)
- Tetsuo Ohkuwa
- Department of General Studies, Nagoya Institute of Technology, Showa-ku, Nagoya 466-8555, Japan.
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Womack CJ, Nagelkirk PR, Coughlin AM. Exercise-induced changes in coagulation and fibrinolysis in healthy populations and patients with cardiovascular disease. Sports Med 2004; 33:795-807. [PMID: 12959620 DOI: 10.2165/00007256-200333110-00002] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This review highlights the clinical significance of coagulation and fibrinolytic responses, and adaptations in healthy individuals and patients with cardiovascular disease (CVD). Much of the review focuses on indicators of the potential for coagulation and fibrinolysis. The terms 'coagulation potential' and 'fibrinolytic potential' are used frequently, as much of the literature in the area of exercise haemostasis evaluates factors that reflect an increased potential for coagulation, while coagulation per se, may or may not be occurring. Similarly, fibrinolysis is definitively the lysis of inappropriate or excessive blood clot, which may or may not be occurring when the enzymes that stimulate fibrinolysis are activated. Nevertheless, markers of coagulation and fibrinolytic potential are associated with CVD, ischaemic events, and cardiovascular mortality. Additionally, fibrinolytic potential is associated with other established CVD risk factors. Ischaemic events triggered by physical exertion are more likely to occur due to an occlusive thrombus, suggesting the exercise-induced responses related to haemostasis are of clinical significance. The magnitude of increase in coagulation potential, platelet aggregation and fibrinolysis appears to be primarily determined by exercise intensity. Patients with CVD may also have a larger increase in coagulation potential during acute exercise than healthy individuals. Additionally, the magnitude of the fibrinolytic response is largely related to the resting fibrinolytic profile of the individual. In particular, high resting plasminogen activator inhibitor-1 may diminish the magnitude of tissue plasminogen activator response during acute exercise. Therefore, acute responses to exercise may increase the risk of ischaemic event. However, chronic aerobic exercise training may decrease coagulation potential and increase fibrinolytic potential in both healthy individuals and CVD patients. Due to the aforementioned importance of resting fibrinolysis on the fibrinolytic response to exercise, chronic aerobic exercise training may cause favourable adaptations that could contribute to decreased risk for ischaemic event, both at rest and during physical exertion.
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Affiliation(s)
- Christopher J Womack
- Human Energy Research Laboratory, Department of Kinesiology, Michigan State University, East Lansing, Michigan 48824, USA.
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Barbeau P, Litaker MS, Woods KF, Lemmon CR, Humphries MC, Owens S, Gutin B. Hemostatic and inflammatory markers in obese youths: effects of exercise and adiposity. J Pediatr 2002; 141:415-20. [PMID: 12219065 DOI: 10.1067/mpd.2002.127497] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To determine the relation of hemostatic markers to cardiovascular fitness and adiposity and the effect of physical training (PT) on these markers. STUDY DESIGN Seventy-four obese teenagers were randomly assigned to 8 months of lifestyle education (LSE), LSE plus moderate-intensity PT, or LSE plus high-intensity PT. Measures included fibrinogen, plasminogen activator inhibitor-1 (PAI-1), D-dimer, C-reactive protein (CRP), fitness, percent body fat (%BF), and visceral adiposity (VAT). RESULTS At baseline, fibrinogen and CRP were significantly correlated with %BF and VAT (0.27 </= r </= 0.51), and fitness (r = -0.39, r = -0.43, respectively); PAI-1 with %BF (r = 0.30) and VAT (r = 0.48); D-dimer with fitness (r = -0.24). Although PT produced significant changes in fitness and adiposity, there were no significant group differences in the hemostatic markers. Change in PAI-1 was significantly correlated with its baseline value (r = -0.47) and change in %BF (r = 0.38). Changes in D-dimer and CRP were significantly correlated with their respective baseline values (r = -0.68,r = -0.48, respectively). CONCLUSIONS Unfavorable levels of fitness and adiposity were associated with higher levels of hemostatic markers, putting individuals with this profile at greater risk for future cardiovascular disease. No evidence was provided that 8 months of PT had a direct influence on these markers in obese youths.
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Affiliation(s)
- Paule Barbeau
- Georgia Prevention Institute, Department of Pediatrics, Augusta 30912, USA
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Abstract
Long-term moderate or strenuous physical activity is associated with a considerable reduction in cardiovascular morbidity and mortality in primary and secondary prevention. Various mechanisms, including changes in lipids, lifestyle habits, and other positive physiologic effects, have been suggested to mediate these beneficial effects. In addition, the hemostatic and fibrinolytic systems appear to play an important role. Fibrinogen has been convincingly shown to be an independent cardiovascular risk factor. Other hemostatic and fibrinolytic parameters that are predictive of coronary events include factor VII, platelet hyperreactivity, plasminogen-activator inhibitor 1 (PAI-1), and tissue-plasminogen activator. The effects of exercise on fibrinogen have been intensively studied. Several randomized controlled trials, various other intervention studies and a large number of population-based cross-sectional studies all found an inverse relationship between measures of sport activity or leisure activity and plasma fibrinogen. The magnitude of the effect reported might be associated with a sizeable reduction in major coronary events. Relatively few data are available on the effects of endurance exercise on markers of the fibrinolytic system, with inconsistent results. Acute exercise leads to a transient activation of the coagulation system, which is accompanied by an increase in the fibrinolytic capacity in healthy subjects. Patients with ischemic heart disease, who cannot increase their fibrinolytic potential, however, may be at considerable risk for acute ischemic events if they are exposed to unaccustomed strenuous physical exertion.
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Affiliation(s)
- A Imhof
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Centre, Ulm, Germany
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