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Gibbons TD, Caldwell HG, Islam H, Duffy J, MacLeod DB, Ainslie PN. Intense exercise at high altitude causes platelet loss across the brain in humans. J Physiol 2024. [PMID: 38180146 DOI: 10.1113/jp285603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/19/2023] [Indexed: 01/06/2024] Open
Abstract
Platelets are known primarily for their role in blood clotting; however, it is becoming clear that they play diverse roles beyond that of haemostasis. Exercise has been shown to activate platelets and stimulate neurogenesis, neuroplasticity and improve cognitive function, highlighting a potentially powerful link between platelet function and brain health. Despite this clear link between platelets and the brain, very little is known about the behaviour of platelets through the cerebral circulation in humans. We examined platelet concentration across the brain in exercising humans at sea level (340 m) and high altitude (6-8 days at 3800 m; a stimulus known to modify platelet function). During intense exercise at sea level, platelet concentration increased similarly by 27 ± 17% in the arterial and internal jugular venous circulations (exercise: P < 0.001, interaction: P = 0.262), indicating no uptake or release of platelets into/from the brain. At high altitude, resting platelet concentrations were similar to sea level values in both the arterial and jugular venous circulations (P = 0.590); however, intense exercise at high altitude caused a 31 ± 35% decrease in platelet concentration across the brain (P = 0.016). This divergent response across the brain was not observed in any other haematological or metabolic variables. These data highlight a unique situation where the combination of intense exercise and high altitude hypoxia cause a decrease in platelet concentration across the cerebral circulation. The physiological implications and mechanisms that might influence platelet function across the brain during exercise at high altitude remain to be established. KEY POINTS: Platelets are known primarily for their role in blood clotting; however, it is becoming clear that they play diverse roles beyond that of haemostasis. Exercise has been shown to activate platelets, which in turn stimulate neurogenesis, neuroplasticity and improve cognitive function, highlighting a powerful link between platelet function and brain health. At sea level, platelet concentration in blood going into and out of the brain was similar at rest, during maximal exercise and in recovery from exercise. During maximal exercise at high altitude, platelet concentration was 31% lower in the blood exiting the brain; the final destination of these platelets is unknown. The physiological implications and mechanisms that might influence platelet function across the cerebral circulation during exercise at high altitude remain to be established.
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Affiliation(s)
- Travis Dylan Gibbons
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia - Okanagan, Kelowna, BC, Canada
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Hannah G Caldwell
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia - Okanagan, Kelowna, BC, Canada
| | - Hashim Islam
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia - Okanagan, Kelowna, BC, Canada
| | - Jennifer Duffy
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia - Okanagan, Kelowna, BC, Canada
| | - David B MacLeod
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia - Okanagan, Kelowna, BC, Canada
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Tobias GC, Gomes JLP, Fernandes LG, Voltarelli VA, de Almeida NR, Jannig PR, de Souza RWA, Negrão CE, Oliveira EM, Chammas R, Alves CRR, Brum PC. Aerobic exercise training mitigates tumor growth and cancer-induced splenomegaly through modulation of non-platelet platelet factor 4 expression. Sci Rep 2023; 13:21970. [PMID: 38081853 PMCID: PMC10713653 DOI: 10.1038/s41598-023-47217-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/10/2023] [Indexed: 12/18/2023] Open
Abstract
Exercise training reduces the incidence of several cancers, but the mechanisms underlying these effects are not fully understood. Exercise training can affect the spleen function, which controls the hematopoiesis and immune response. Analyzing different cancer models, we identified that 4T1, LLC, and CT26 tumor-bearing mice displayed enlarged spleen (splenomegaly), and exercise training reduced spleen mass toward control levels in two of these models (LLC and CT26). Exercise training also slowed tumor growth in melanoma B16F10, colon tumor 26 (CT26), and Lewis lung carcinoma (LLC) tumor-bearing mice, with minor effects in mammary carcinoma 4T1, MDA-MB-231, and MMTV-PyMT mice. In silico analyses using transcriptome profiles derived from these models revealed that platelet factor 4 (Pf4) is one of the main upregulated genes associated with splenomegaly during cancer progression. To understand whether exercise training would modulate the expression of these genes in the tumor and spleen, we investigated particularly the CT26 model, which displayed splenomegaly and had a clear response to the exercise training effects. RT-qPCR analysis confirmed that trained CT26 tumor-bearing mice had decreased Pf4 mRNA levels in both the tumor and spleen when compared to untrained CT26 tumor-bearing mice. Furthermore, exercise training specifically decreased Pf4 mRNA levels in the CT26 tumor cells. Aspirin treatment did not change tumor growth, splenomegaly, and tumor Pf4 mRNA levels, confirming that exercise decreased non-platelet Pf4 mRNA levels. Finally, tumor Pf4 mRNA levels are deregulated in The Cancer Genome Atlas Program (TCGA) samples and predict survival in multiple cancer types. This highlights the potential therapeutic value of exercise as a complementary approach to cancer treatment and underscores the importance of understanding the exercise-induced transcriptional changes in the spleen for the development of novel cancer therapies.
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Affiliation(s)
- Gabriel C Tobias
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil.
- Children's Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children's Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY, USA.
| | - João L P Gomes
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil
| | - Larissa G Fernandes
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil
| | - Vanessa A Voltarelli
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02115, USA
| | - Ney R de Almeida
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil
| | - Paulo R Jannig
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil
- Department of Physiology and Pharmacology, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Rodrigo W Alves de Souza
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02115, USA
| | - Carlos E Negrão
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil
- Instituto do Coração (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Edilamar M Oliveira
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil
| | - Roger Chammas
- Department of Radiology and Oncology, Faculdade de Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Christiano R R Alves
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil
| | - Patricia C Brum
- School of Physical Education and Sport, Universidade de São Paulo, Avenida Professor Mello Moraes, 65-Butantã, São Paulo, SP, 05508-030, Brazil.
- Department of Physiology & Biophysics, Institute of Biomedical Sciences, Universidade de São Paulo, São Paulo, Brazil.
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Dalçóquio TF, Alves Dos Santos M, Silva Alves L, Bittar Brito Arantes F, Ferreira-Santos L, Pinto Brandão Rondon MU, Furtado RHM, Gehlen Ferrari A, Genestreti Rizzo PR, Salsoso R, Franci A, Moreira Baracioli L, de Nazare Nunes Alves MJ, Negrão CE, Nicolau JC. Effects of exercise on platelet reactivity after myocardial infarction: a randomized clinical trial. Platelets 2023; 34:2139821. [PMID: 36377063 DOI: 10.1080/09537104.2022.2139821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/20/2022] [Indexed: 11/17/2022]
Abstract
Exercise training (ET) can lower platelet reactivity in patients with cardiovascular risk factors. However, the effects of ET on platelet reactivity in higher-risk patients is unknown. The aim of this study was to evaluate the effects of ET on platelet reactivity in patients with recent myocardial infarction (MI). Ninety patients were randomly assigned 1 month post-MI to the intervention (patients submitted to a supervised ET program) or control group. All patients were on dual antiplatelet therapy (DAPT). Platelet reactivity by VerifyNow-P2Y12 (measured by P2Y12 reaction units - PRUs) test was determined at baseline and at the end of 14 ± 2 weeks of follow-up at rest (primary endpoint), and multiplate electrode aggregometry (MEA) adenosine diphosphate (ADP) and aspirin (ASPI) tests were performed immediately before and after the maximal cardiopulmonary exercise test (CPET) at the same time points (secondary endpoints). Sixty-five patients (mean age 58.9 ± 10 years; 73.8% men; 60% ST elevation MI) completed follow-up (control group, n = 31; intervention group, n = 34). At the end of the follow-up, the mean platelet reactivity was 172.8 ± 68.9 PRUs and 166.9 ± 65.1 PRUs for the control and intervention groups, respectively (p = .72). Platelet reactivity was significantly increased after the CPET compared to rest at the beginning and at the end of the 14-week follow-up (among the intervention groups) by the MEA-ADP and MEA-ASPI tests (p < .01 for all analyses). In post-MI patients on DAPT, 14 weeks of supervised ET did not reduce platelet reactivity. Moreover, platelet reactivity was increased after high-intensity exercise (ClinicalTrials.gov: NCT02958657; https://clinicaltrials.gov/ct2/show/NCT02958657).
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Affiliation(s)
- Talia Falcão Dalçóquio
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Mayara Alves Dos Santos
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Leandro Silva Alves
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Flávia Bittar Brito Arantes
- Hospital das Clinicas, Faculdade de Medicina, Universidade Federal de Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Larissa Ferreira-Santos
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Remo Holanda M Furtado
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
- Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | - Aline Gehlen Ferrari
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Paulo Roberto Genestreti Rizzo
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Rocio Salsoso
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Andre Franci
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Luciano Moreira Baracioli
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Carlos Eduardo Negrão
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - José Carlos Nicolau
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Sibley D, Chen M, West MA, Matthew AG, Santa Mina D, Randall I. Potential mechanisms of multimodal prehabilitation effects on surgical complications: a narrative review. Appl Physiol Nutr Metab 2023; 48:639-656. [PMID: 37224570 DOI: 10.1139/apnm-2022-0272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Continuous advances in prehabilitation research over the past several decades have clarified its role in improving preoperative risk factors, yet the evidence demonstrating reduced surgical complications remains uncertain. Describing the potential mechanisms underlying prehabilitation and surgical complications represents an important opportunity to establish biological plausibility, develop targeted therapies, generate hypotheses for future research, and contribute to the rationale for implementation into the standard of care. In this narrative review, we discuss and synthesize the current evidence base for the biological plausibility of multimodal prehabilitation to reduce surgical complications. The goal of this review is to improve prehabilitation interventions and measurement by outlining biologically plausible mechanisms of benefit and generating hypotheses for future research. This is accomplished by synthesizing the available evidence for the mechanistic benefit of exercise, nutrition, and psychological interventions for reducing the incidence and severity of surgical complications reported by the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). This review was conducted and reported in accordance with a quality assessment scale for narrative reviews. Findings indicate that prehabilitation has biological plausibility to reduce all complications outlined by NSQIP. Mechanisms for prehabilitation to reduce surgical complications include anti-inflammation, enhanced innate immunity, and attenuation of sympathovagal imbalance. Mechanisms vary depending on the intervention protocol and baseline characteristics of the sample. This review highlights the need for more research in this space while proposing potential mechanisms to be included in future investigations.
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Affiliation(s)
- Daniel Sibley
- Faculty of Kinesiology, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Maggie Chen
- Faculty of Kinesiology, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Malcolm A West
- Faculty of Medicine, Cancer Sciences, University of Southampton, UK
- NIHR Southampton Biomedical Research Centre, Perioperative and Critical Care, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Andrew G Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Ian Randall
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Soltani M, Sarvestan A, Hoseinzadeh F, Ahmadizad S, Kingsley JD. The effects of type of recovery in resistance exercise on responses of platelet indices and hemodynamic variables. PLoS One 2023; 18:e0290076. [PMID: 37595001 PMCID: PMC10437857 DOI: 10.1371/journal.pone.0290076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/01/2023] [Indexed: 08/20/2023] Open
Abstract
To examine the effects of two different volume-matched resistance exercise (RE) recovery protocols (passive and active) on platelet indices and hemodynamic variables. Twelve Healthy participants (mean ± SD; 25 ± 3 yrs) completed a traditional resistance exercise (TRE) protocol that included three sets of six repetitions at 80% one repetition maximum (1RM) with two minutes passive recovery between sets, exercises and an interval resistance exercise (IRE) protocol that included three sets of six repetitions at 60%1RM followed by active recovery including six repetitions of the same exercise at 20%1RM. Blood samples for multiple platelet indices were taken before the protocols, immediately-post (IP), and after 1-hour recovery. Hemodynamic variables were measured before, IP, and every five minutes during recovery. Mean platelet volume and platelet large cell ratio P_LCR decreased from baseline to recovery. Heart rate (HR) and rate pressure product (RPP) were augmented at IP following IRE compared to TRE. HR was significantly elevated for 20 minutes after both RE protocols, and RPP recovered by five minutes. Systolic blood pressure was increased at IP compared to baseline and all recovery time points for both RE protocols. Our research demonstrated that both RE protocols, produced transient increases in platelet indices (MPV, and P_LCR) and hemodynamic variables (SBP, HR, and RPP), all of which returned to baseline within an hour. Notably, the IRE protocol elicited a greater increase in HR and RPP compared to the TRE protocol.
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Affiliation(s)
- Mohammad Soltani
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Atefe Sarvestan
- Faculty of Sport Sciences and Health, Department of Biological Sciences in Sport, Shahid Beheshti University, Tehran, Iran
| | - Fatemeh Hoseinzadeh
- Faculty of Sport Sciences and Health, Department of Biological Sciences in Sport, Shahid Beheshti University, Tehran, Iran
| | - Sajad Ahmadizad
- Faculty of Sport Sciences and Health, Department of Biological Sciences in Sport, Shahid Beheshti University, Tehran, Iran
| | - J. Derek Kingsley
- Exercise Science and Exercise Physiology, Kent State University, Kent, OH, United States of America
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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.
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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.)
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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.
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Dhar I, Svingen GFT, Pedersen EKR, Ulvik A, Bjørnestad EØ, Dankel SN, Mellgren G, Nygård OK. Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatment. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2022; 15:200150. [PMID: 36573185 PMCID: PMC9789355 DOI: 10.1016/j.ijcrp.2022.200150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/22/2022] [Accepted: 09/05/2022] [Indexed: 12/30/2022]
Abstract
Background Physical activity (PA) influences sympathetic stimulation, platelet activation as well as vascular function, and has been associated with improved health outcomes in patients with coronary heart disease. β-blocker therapy reduces sympathetic activity and improves platelet and endothelial function. We investigated if β-blocker treatment modifies the association of self-reported PA with the risk of all-cause mortality. Methods A total of 2284 patients undergoing elective coronary angiography for suspected stable angina pectoris (SAP) were studied. Using Cox modeling, we examined associations between PA (categorized as 'sedentary/inactive', 'low', 'moderate', and 'high') and all-cause mortality according to β-blocker therapy. Results During a median follow-up of 10.3 years, 390 patients (17.1%) died. Higher PA was generally associated with a more favorable cardiovascular risk profile. Compared to the patients who were sedentary or inactive, the age and sex adjusted HRs (95% CI) for all-cause mortality were 0.89 (0.66-1.20), 0.73 (0.57-0.95) and 0.72 (0.55-0.95) in the low, moderate and high PA group, respectively. However, and notably, these risk estimates were 0.85 (0.60-1.20), 0.65 (0.47-0.89) and 0.58 (0.41-0.81) in β-blocker treated subjects vs. 1.00 (0.57-1.78), 0.96 (0.61-1.52) and 1.20 (0.74-1.95) in non-treated groups (P interaction = 0.018). The results were essentially similar in the multivariable adjusted models. Conclusions In patients with suspected SAP, increased PA was associated with reduced mortality risk primarily in patients treated with β-blockers.
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Affiliation(s)
- Indu Dhar
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway,Corresponding author. Department of Clinical Science, University of Bergen, Laboratory Building, 9th floor, Haukeland University Hospital, Jonas Lies vei 87, Bergen N‐5021, Norway.
| | - Gard FT. Svingen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Eva KR. Pedersen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | | | - Simon N. Dankel
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway,Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Gunnar Mellgren
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway,Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Ottar K. Nygård
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
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9
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D’Amico A, Cavarretta E, Fossati C, Borrione P, Pigozzi F, Frati G, Sciarretta S, Costa V, De Grandis F, Nigro A, Peruzzi M, Miraldi F, Saade W, Calogero A, Rosa P, Galardo G, Loffredo L, Pignatelli P, Nocella C, Carnevale R. Platelet Activation Favours NOX2-Mediated Muscle Damage in Elite Athletes: The Role of Cocoa-Derived Polyphenols. Nutrients 2022; 14:nu14081558. [PMID: 35458119 PMCID: PMC9030438 DOI: 10.3390/nu14081558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/25/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
Mechanisms of exercise-induced muscle injury with etiopathogenesis and its consequences have been described; however, the impact of different intensities of exercise on the mechanisms of muscular injury development is not well understood. The aim of this study was to exploit the relationship between platelet activation, oxidative stress and muscular injuries induced by physical exercise in elite football players compared to amateur athletes. Oxidant/antioxidant status, platelet activation and markers of muscle damage were evaluated in 23 elite football players and 23 amateur athletes. Compared to amateurs, elite football players showed lower antioxidant capacity and higher oxidative stress paralleled by increased platelet activation and muscle damage markers. Simple linear regression analysis showed that sNOX2-dp and H2O2, sCD40L and PDGF-bb were associated with a significant increase in muscle damage biomarkers. In vitro studies also showed that plasma obtained from elite athletes increased oxidative stress and muscle damage in human skeletal muscle myoblasts cell line compared to amateurs’ plasma, an effect blunted by the NOX2 inhibitor or by the cell treatment with cocoa-derived polyphenols. These results indicate that platelet activation increased muscular injuries induced by oxidative stress. Moreover, NOX2 inhibition and polyphenol extracts treatment positively modulates redox status and reduce exercise-induced muscular injury.
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Affiliation(s)
- Alessandra D’Amico
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.D.); (C.F.); (P.B.); (F.P.)
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
- Mediterranea, Cardiocentro, 80122 Napoli, Italy; (M.P.); (P.P.)
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.D.); (C.F.); (P.B.); (F.P.)
| | - Paolo Borrione
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.D.); (C.F.); (P.B.); (F.P.)
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.D.); (C.F.); (P.B.); (F.P.)
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
- IRCCS Neuromed, Località Camerelle, 86077 Pozzilli, Italy
| | - Sebastiano Sciarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
- IRCCS Neuromed, Località Camerelle, 86077 Pozzilli, Italy
| | - Vincenzo Costa
- AS Roma Football Club, Piazzale Dino Viola 1, 00128 Rome, Italy;
| | - Fabrizio De Grandis
- Villa Stuart Sport Clinic, FIFA Medical Center of Excellence, 00135 Rome, Italy; (F.D.G.); (A.N.)
| | - Antonia Nigro
- Villa Stuart Sport Clinic, FIFA Medical Center of Excellence, 00135 Rome, Italy; (F.D.G.); (A.N.)
| | - Mariangela Peruzzi
- Mediterranea, Cardiocentro, 80122 Napoli, Italy; (M.P.); (P.P.)
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Fabio Miraldi
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Wael Saade
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Antonella Calogero
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
| | - Paolo Rosa
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
| | | | - Lorenzo Loffredo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Pasquale Pignatelli
- Mediterranea, Cardiocentro, 80122 Napoli, Italy; (M.P.); (P.P.)
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
| | - Cristina Nocella
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.M.); (W.S.); (L.L.)
- Correspondence: (C.N.); (R.C.)
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (E.C.); (G.F.); (S.S.); (A.C.); (P.R.)
- Mediterranea, Cardiocentro, 80122 Napoli, Italy; (M.P.); (P.P.)
- Correspondence: (C.N.); (R.C.)
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10
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Global thrombosis test for assessing thrombotic status and efficacy of antithrombotic diet and other conditions. Future Sci OA 2022; 8:FSO788. [PMID: 35251699 PMCID: PMC8890116 DOI: 10.2144/fsoa-2021-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022] Open
Abstract
Because of the high mortality from myocardial infarction and stroke, there is a great demand for finding novel methods of diagnosis, prevention and treatment of these diseases. Most of the current tests measure important determinants of thrombosis such as platelet function, coagulation and fibrinolysis in isolation; therefore, a global test measuring the actual thrombotic status would be more useful in clinical conditions. We obtained considerable experience by using the global thrombosis test, which determines the actual thrombotic status by taking into account the measured platelet reactivity, coagulation and fibrinolytic activities. In animal experiments, we found significant correlation between the ex vivo global thrombosis test measurements and the in vivo thrombotic status. The published evidence for the benefit of an antithrombotic diet with regular physical exercise is also described. There is a great concern in the general population how to detect the risk of thrombotic events and prevent the high mortality from stroke, myocardial infarction, sudden death and cancer-associated thrombosis. Our experience on antithrombotic fruits and vegetables intake and regular exercise assessed by the global thrombosis test suggested a potentially unique way of preventing these life-threatening diseases. In addition, global thrombosis testing may offer some benefit in detecting risk of thrombotic of forthcoming thrombotic events in cancer and COVID-19 virus-infected patients.
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11
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Stawski R, Walczak K, Perdas E, Prymont-Przymińska A, Zwolińska A, Kosielski P, Budlewski T, Padula G, Jerczynska H, Nowak D. Increased Circulating H3 Histone in Response to Repeated Bouts of Exercise Does Not Associate with Parallel Alterations of Cell-Free DNA. BIOLOGY 2021; 10:181. [PMID: 33801313 PMCID: PMC7999358 DOI: 10.3390/biology10030181] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/18/2021] [Accepted: 02/24/2021] [Indexed: 12/18/2022]
Abstract
Numerous studies have shown that cf nDNA significantly rises in stress caused by exercise. However, during nuclear decondensation, released DNA is followed by histones. Histones are also a common disease marker. After PAD4 mediated hypercitrullination extracellular H3Cit exhibits high toxicity contributing to tissue damage which, in cases of systemic inflammation, may lead to multiorgan failure and finally to death. We tested whether circulating histones rise in response to strenuous exercise. Eleven average-trained men performed three treadmill exercise tests to exhaustion at speed corresponding to 70% VO2max separated by 72 h of resting. Blood was collected before and just after each bout of exercise and plasma proteins were measured using enzyme-linked immunosorbent assay, whereas platelet activity was estimated with Light Transmission Aggregometry. Both, circulating histones and PAD4 raised in response to exercise. Plasma citrullinated histones increased from 3.1 ng/mL to 5.96 ng/mL (p = 0.0059), from 3.65 ng/mL to 6.37 ng/mL (p = 0.02), and from 3.86 ng/mL to 4.75 ng/mL (p = 0.033) after the first, second, and third treadmill run, respectively. However despite the parallel increase, no significant correlation between citrullinated histone and aggregation or cell-free nDNA was found. Furthermore, positive correlations of cf nDNA with aggregation and PAD4, lactate with aggregation, and lactate with citrullinated histone have been observed.
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Affiliation(s)
- Robert Stawski
- Department of Clinical Physiology, Medical University of Lodz, 92-215 Lodz, Poland; (E.P.); (A.P.-P.)
| | - Konrad Walczak
- Department of Internal Medicine and Nephrodiabetology, Medical University of Lodz, 92-215 Lodz, Poland;
| | - Ewelina Perdas
- Department of Clinical Physiology, Medical University of Lodz, 92-215 Lodz, Poland; (E.P.); (A.P.-P.)
| | - Anna Prymont-Przymińska
- Department of Clinical Physiology, Medical University of Lodz, 92-215 Lodz, Poland; (E.P.); (A.P.-P.)
| | - Anna Zwolińska
- Cell-to-Cell Communication Department, Medical University of Lodz, 92-215 Lodz, Poland;
| | - Piotr Kosielski
- Academic Laboratory of Movement and Human Physical Performance, Medical University of Lodz, 92-215 Lodz, Poland; (P.K.); (G.P.)
| | - Tomasz Budlewski
- Department of Rheumatology, Medical University of Lodz, University Hospital Name of the Military Medical Academy-Central Hospital Veterans of Lodz, ul. Pieniny 30, 92-115 Lodz, Poland;
| | - Gianluca Padula
- Academic Laboratory of Movement and Human Physical Performance, Medical University of Lodz, 92-215 Lodz, Poland; (P.K.); (G.P.)
| | - Hanna Jerczynska
- Central Scientific Laboratory, Medical University, Mazowiecka 6/8, 92-215 Lodz, Poland;
| | - Dariusz Nowak
- Department of Clinical Physiology, Medical University of Lodz, 92-215 Lodz, Poland; (E.P.); (A.P.-P.)
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12
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Parkkila K, Valtonen RIP, Hiltunen L, Hintsala HE, Jaakkola JJK, Ikäheimo TM. The effects of submaximal exercise and cold exposure on blood coagulation parameters in coronary artery disease patients. BMC Cardiovasc Disord 2021; 21:93. [PMID: 33593303 PMCID: PMC7885551 DOI: 10.1186/s12872-021-01907-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/21/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Both exercise and cold exposure increase blood coagulation potential but their combined effects are not known. The purpose of the present study was to assess blood coagulation factors in response to submaximal exercise in the cold environment among patients with stable coronary artery disease (CAD). METHODS Sixteen men (61.1 ± 7.1 years) with stable CAD participated in three 30-min experimental conditions (seated rest in - 15 °C and exercise in both + 22 °C and - 15 °C) in random order. The employed exercise consisted of brisk walking (66-69% of maximal heart rate). Factor VII (FVII), fibrinogen, D-dimer and von Willebrand factor (vWF) were analyzed from blood samples obtained before, immediately and one hour after each experiment. RESULTS On average, FVII activity (95% confidence interval, CI) was 123 (108-143) %, 123 (106-140) %, 121 (103-139) % (baseline, recovery 1, recovery 2), fibrinogen concentration (95% CI) 3.81 (3.49-4.12) g/l, 3.71 (3.34-4.08) g/l, 3.65 (3.26-4.05) g/l, D-dimer concentration (95% CI) 0.42 (0.28-0.56) µg/ml, 0.42 (0.29-.55) µg/ml and 0.39 (0.29-0.49) µg/ml, and vWF activity (95% CI) 184 (135-232) %, 170 (128-212) % and 173 (129-217) % after exercise in the cold. Average FVII activity varied from 122 to 123%, fibrinogen concentration from 3.71 to 3.75 g/l, D-dimer concentration from 0.35 to 0.51 µg/ml and von Willebrand factor activity from 168 to 175% immediately after each three experimental condition. CONCLUSIONS Our findings suggest that submaximal lower body exercise carried out in a cold environment does not significantly affect blood coagulation parameters among patients with stable CAD.
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Affiliation(s)
- Karri Parkkila
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Rasmus I P Valtonen
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Leena Hiltunen
- Department of Hemostasis, Finnish Red Cross Blood Service, Helsinki, Finland.,Hemostasis and Platelet Laboratory, Fimlab Laboratoriot Oy Ltd, Vantaa, Finland
| | - Heidi E Hintsala
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Centria University of Applied Sciences, Kokkola, Finland
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland.,Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Tiina M Ikäheimo
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. .,Medical Research Center, University of Oulu, Oulu University Hospital, Oulu, Finland.
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13
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Abstract
Distinct clinical characteristics have been demonstrated in patients with plaque erosion as compared with those with plaque rupture. We reasoned that greater physical activity might influence the onset of plaque erosion. In total, 97 consecutive patients with non ST-segment elevation acute coronary syndrome (ACS) who underwent optical coherence tomography (OCT) imaging of the culprit lesion were enrolled. OCT-determined culprit plaque characteristics were plaque erosion (18.6%), calcified plaque (26.8%), plaque rupture (32.0%) and other (22.7%). The physical activity evaluated by estimated metabolic equivalents (METs) at ACS onset was significantly greater in the plaque erosion group than in the plaque rupture group (3.3 ± 1.7 vs. 2.1 ± 1.0, p = 0.011). The rate of ACS onset outdoors was the highest (61.1%) in the plaque erosion group. The combination of greater physical activity (> 3 METs), outdoor onset and higher body mass index (> 25.1 kg/m2) had a significant odds ratio for the incidence of plaque erosion (odds ratio 15.0, 95% confidence interval 3.81 to 59.0, p < 0.001). Plaque erosion was associated with greater physical activity at the onset. This finding may help to further clarify the pathogenesis of ACS Impact of physical exertion on the incidence of plaque erosion. NSTE-ACS, non ST-segment elevation acute coronary syndrome.
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14
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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.
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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
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15
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Sangha GS, Goergen CJ, Prior SJ, Ranadive SM, Clyne AM. Preclinical techniques to investigate exercise training in vascular pathophysiology. Am J Physiol Heart Circ Physiol 2021; 320:H1566-H1600. [PMID: 33385323 PMCID: PMC8260379 DOI: 10.1152/ajpheart.00719.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Atherosclerosis is a dynamic process starting with endothelial dysfunction and inflammation and eventually leading to life-threatening arterial plaques. Exercise generally improves endothelial function in a dose-dependent manner by altering hemodynamics, specifically by increased arterial pressure, pulsatility, and shear stress. However, athletes who regularly participate in high-intensity training can develop arterial plaques, suggesting alternative mechanisms through which excessive exercise promotes vascular disease. Understanding the mechanisms that drive atherosclerosis in sedentary versus exercise states may lead to novel rehabilitative methods aimed at improving exercise compliance and physical activity. Preclinical tools, including in vitro cell assays, in vivo animal models, and in silico computational methods, broaden our capabilities to study the mechanisms through which exercise impacts atherogenesis, from molecular maladaptation to vascular remodeling. Here, we describe how preclinical research tools have and can be used to study exercise effects on atherosclerosis. We then propose how advanced bioengineering techniques can be used to address gaps in our current understanding of vascular pathophysiology, including integrating in vitro, in vivo, and in silico studies across multiple tissue systems and size scales. Improving our understanding of the antiatherogenic exercise effects will enable engaging, targeted, and individualized exercise recommendations to promote cardiovascular health rather than treating cardiovascular disease that results from a sedentary lifestyle.
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Affiliation(s)
- Gurneet S Sangha
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
| | - Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana.,Purdue University Center for Cancer Research, Purdue University, West Lafayette, Indiana
| | - Steven J Prior
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland.,Baltimore Veterans Affairs Geriatric Research, Education, and Clinical Center, Baltimore, Maryland
| | - Sushant M Ranadive
- Department of Kinesiology, University of Maryland School of Public Health, College Park, Maryland
| | - Alisa M Clyne
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland
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16
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Management of venous thromboembolism in athletes. Blood Rev 2020; 47:100780. [PMID: 33229140 DOI: 10.1016/j.blre.2020.100780] [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: 07/18/2020] [Revised: 09/05/2020] [Accepted: 10/15/2020] [Indexed: 11/22/2022]
Abstract
Venous thromboembolism (VTE) is a common condition with high associated morbidity and mortality. Athletes have unique VTE risk factors compared with the general population, and may have a higher than anticipated risk of thrombosis. Anticoagulant treatment poses additional challenges in athletes, as these individuals usually wish to return to sporting activities without delay. In addition, those athletes who engage in contact sports may have bleeding complications with extended anticoagulation. In this paper, we discuss VTE risk factors in athletes, the impact of exertion on haemostasis, measures which could be adopted to mitigate VTE risks in these highly active individuals and options to deal with bleeding risks from anticoagulation during injury-prone sporting activities.
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17
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Ahmadizad S, Rahmani H, Khosravi N, Falakdin Z, Connes P, Daraei A. Acute responses of platelet count and ADP-induced platelet aggregation to different high intensity interval exercise modes. Clin Hemorheol Microcirc 2020; 75:467-474. [PMID: 32390610 DOI: 10.3233/ch-200848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Platelet activation is associated with abdominal obesity and exercise training is an important modulator of body weight. OBJECTIVE We investigated the effects of two high intensity interval exercise (HIIE) protocols of different intensity and duration on platelet indices and platelet aggregation in overweight men. METHODS Ten overweight men performed 6 intervals of 30s exercise at 110% of peak power output (PPO) interspersed by 3 : 30 min active recovery (1/7 protocol) at 40% of PPO and 6 intervals of 2 min exercise at 85% of PPO interspersed by 2 min active recovery (1/1 protocol) at 30% of PPO in two separate sessions. Platelet indices and platelet aggregation were measured before and immediately after both HIIEs. RESULTS Platelet indices increased significantly following HIIE (P < 0.05), though, significant differences between the two protocols were only detected for platelet count, which was markedly increased following 1/1 protocol. Platelet aggregation increased significantly (P < 0.05) in response to the two HIIE protocols, with no significant difference being observed between the two protocols (P > 0.05). CONCLUSIONS It is concluded that HIIE leads to transient increases in markers of thrombus formation and that work to rest ratio is an important factor when investigating the changes in thrombocytosis following HIIE.
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Affiliation(s)
- Sajad Ahmadizad
- Department of Biological Sciences in Sport, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Hiwa Rahmani
- Department of Biological Sciences in Sport, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Nikoo Khosravi
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Alzahra University, Tehran, Iran
| | - Zahra Falakdin
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Alzahra University, Tehran, Iran
| | - Philippe Connes
- University of Lyon, University Claude Bernard Lyon 1, Interuniversity Laboratory of Human Movement Biology EA7424, "Vascular Biology and Red Blood Cell" Team, Lyon, France.,Labex GR-Ex, Paris, France
| | - Ali Daraei
- Department of Biological Sciences in Sport, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
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18
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Hou J, Duan Y, Liu X, Li R, Tu R, Pan M, Dong X, Mao Z, Huo W, Chen G, Guo Y, Li S, Wang C. Associations of long-term exposure to air pollutants, physical activity and platelet traits of cardiovascular risk in a rural Chinese population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 738:140182. [PMID: 32594998 DOI: 10.1016/j.scitotenv.2020.140182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Long-term exposure to air pollutants relate to increase risk of cardiovascular diseases that may be partially attributable to platelet dysfunction. Physical activity (PA) may attenuate inflammation to modulate platelet function. Thus, this study aimed to evaluate associations of air pollutants and PA with platelet traits of cardiovascular risk. METHODS A total of 31,282 participants were obtained from the Henan Rural Cohort (n = 39,259). The concentrations of particulate matter (PM) (PM with an aerodynamic diameter ≤1.0 μm (PM1), ≤2.5 μm (PM2.5), or ≤10 μm (PM10)) and nitrogen dioxide (NO2) were evaluated by using a spatiotemporal model incorporated into satellites data. Independent and combined effects of air pollutants and PA on platelet traits were analyzed by linear mixed models. RESULTS Positive associations of PM1, PM2.5, PM10 and NO2 with platelet indices (mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR), the MPV to platelet counts (PLT) ratio (MPVP)) were observed, whereas negative associations of PM10 and NO2 with PLT or plateletcrit (PCT) were observed; negative interaction effects of PM2.5 PM10 and NO2 and PA on MPV, PDW or P-LCR were found; negative interaction effects of PM1, PM2.5 and PM10 and PA on PCT were observed. CONCLUSIONS Long-term exposure to air pollutants were related to increase platelet size and these associations were attenuated by increased PA, implying that PA is a costless and affordable method to decrease adverse effects on platelet traits in relation to air pollutants.
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Affiliation(s)
- Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yanying Duan
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Runqi Tu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Mingming Pan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, China
| | - Yuming Guo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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19
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Heuberger JAAC, Posthuma JJ, Ziagkos D, Rotmans JI, Daniels JMA, Gal P, Stuurman FE, Spronk HMH, Ten Cate H, Burggraaf J, Moerland M, Cohen AF. Additive effect of erythropoietin use on exercise-induced endothelial activation and hypercoagulability in athletes. Eur J Appl Physiol 2020; 120:1893-1904. [PMID: 32537688 PMCID: PMC7340646 DOI: 10.1007/s00421-020-04419-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 06/05/2020] [Indexed: 11/25/2022]
Abstract
Purpose Recombinant human erythropoietin (rHuEPO) is known to increase thrombotic risk in patients and might have similar effects in athletes abusing the drug. rHuEPO is prohibited by anti-doping legislation, but this risk has not been investigated thoroughly. This analysis was designed to evaluate whether rHuEPO impacts hemostatic profile and endothelial and platelet activation markers in trained subjects, and whether the combination with exercise affects exercise induced alterations. Methods This double-blind, randomized, placebo-controlled trial enrolled healthy, trained male cyclists aged 18–50 years. Participants were randomly allocated (1:1) to receive subcutaneous injections of rHuEPO (epoetin-β; mean dose 6000 IU per week) or placebo (0.9% NaCl) for 8 weeks. Subjects performed five maximal exercise tests and a road race, coagulation and endothelial/platelet markers were measured at rest and directly after each exercise effort. Results rHuEPO increased P-selectin (+ 7.8% (1.5–14.5), p = 0.02) and E-selectin (+ 8.6% (2.0–15.7), p = 0.01) levels at rest. Maximal exercise tests significantly influenced all measured coagulation and endothelial/platelet markers, and in the rHuEPO group maximal exercise tests led to 15.3% ((7.0–24.3%), p = 0.0004) higher E-selectin and 32.1% ((4.6–66.8%), p = 0.0207) higher Platelet factor 4 (PF4) levels compared to the placebo group. Conclusion In conclusion, rHuEPO treatment resulted in elevated E- and P-selectin levels in trained cyclists, indicating enhanced endothelial activation and/or platelet reactivity. Exercise itself induces hypercoagulability, and the combination of rHuEPO and exercise increased E-selectin and PF4 levels more than either intervention alone. Based on this, exercise potentially increases thrombotic risk, a risk that might be enhanced in combination with rHuEPO use. Electronic supplementary material The online version of this article (10.1007/s00421-020-04419-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Jelle J Posthuma
- Departments of Internal Medicine and Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Dimitrios Ziagkos
- Centre for Human Drug Research, Zernikedreef 8, 2333 CL, Leiden, The Netherlands
| | - Joris I Rotmans
- Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | - Johannes M A Daniels
- Department of Pulmonary Diseases, VU University Medical Centre, Amsterdam, The Netherlands
| | - Pim Gal
- Centre for Human Drug Research, Zernikedreef 8, 2333 CL, Leiden, The Netherlands
| | - Frederik E Stuurman
- Centre for Human Drug Research, Zernikedreef 8, 2333 CL, Leiden, The Netherlands
| | - Henri M H Spronk
- Departments of Internal Medicine and Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Hugo Ten Cate
- Departments of Internal Medicine and Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Jacobus Burggraaf
- Centre for Human Drug Research, Zernikedreef 8, 2333 CL, Leiden, The Netherlands
- Leiden Academic Centre for Drug Research, Leiden, The Netherlands
| | - Matthijs Moerland
- Centre for Human Drug Research, Zernikedreef 8, 2333 CL, Leiden, The Netherlands
| | - Adam F Cohen
- Centre for Human Drug Research, Zernikedreef 8, 2333 CL, Leiden, The Netherlands
- Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
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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.
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Kachur S, Lavie CJ, Morera R, Ozemek C, Milani RV. Exercise training and cardiac rehabilitation in cardiovascular disease. Expert Rev Cardiovasc Ther 2019; 17:585-596. [DOI: 10.1080/14779072.2019.1651198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Sergey Kachur
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
| | - Carl J. Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
| | - Rebecca Morera
- Department of Graduate Medical Education, Ocala Regional Medical Center, Ocala, FL, USA
| | - Cemal Ozemek
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Richard V. Milani
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, LA, USA
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22
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Çakır H, Kaymaz C, Tanboga İH, Çakır H, Tokgöz HC, Hakgör A, Akbal ÖY, Er F, Topal D, Mutluer FO, Demir M, Tenekecioglu E. Increased exercise-related platelet activation assessed by impedance aggregometry in diabetic patients despite aspirin therapy. J Thromb Thrombolysis 2019; 47:396-402. [PMID: 30790162 DOI: 10.1007/s11239-019-01825-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Aspirin is widely used for the prevention of thromboembolic diseases, but inhibition of platelet aggregation (PA) is not uniform. Additionally, aspirin has been shown to be ineffective in blunting PA in response to exercise in patients with coronary artery disease (CAD). Limited data exists about platelet function following acute exercise in diabetics taking aspirin. In our study, we aimed to investigate PA before and after exercise stress test in type-2 diabetic patients taking aspirin. Forty-three patients with type-2 diabetes mellitus (DM) and 36 subjects (age- and sex-matched) as control group were included prospectively. All participants were under aspirin (100 mg/day) therapy for at least 1 week. The measures of PA were assessed by impedance aggregometry using arachidonic acid as an agonist (ASPI test). Blood samplings were undertaken before and immediately after treadmill exercise test. At rest, diabetic and control groups had comparable pre-exercise PA (22.97 ± 14.57 versus 22.11 ± 12.71 AU min, p = NS, respectively). After treadmill exercise, both groups showed significantly higher absolute increase (9.02 ± 13.08 and 3.66 ± 5.87 AU min, p < 0.01, p < 0.01, respectively) and percent (%) increase (45.67 ± 49.34 and 24.04 ± 46.59 AU min, p < 0.01, p = 0.01, respectively) in PA. Both absolute increase (p < 0.05) and % increase (p < 0.05) in PA were significantly higher in DM group compared to the control group. Multiple regression analysis revealed that high-sensitive C-reactive protein (p = 0.014) was independent predictor of absolute increase PA. Our study showed that aspirin has limited effect in inhibiting exercise-induced PA, even in the absence of documented CAD. The increase in PA following exercise was significantly greater in patients with DM compared with controls.
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Affiliation(s)
- Hakan Çakır
- Department of Cardiology, Bursa Yuksek İhtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey.
| | - Cihangir Kaymaz
- Department of Cardiology, Kartal Koşuyolu Cardiovascular Research and Training Hospital, Health Sciences University, Istanbul, Turkey
| | | | - Hilal Çakır
- Department of Internal Medicine, Kelkit State Hospital, Gümüşhane, Turkey
| | - Hacer Ceren Tokgöz
- Department of Cardiology, Kartal Koşuyolu Cardiovascular Research and Training Hospital, Health Sciences University, Istanbul, Turkey
| | - Aykun Hakgör
- Department of Cardiology, Kartal Koşuyolu Cardiovascular Research and Training Hospital, Health Sciences University, Istanbul, Turkey
| | - Özgür Yaşar Akbal
- Department of Cardiology, Kartal Koşuyolu Cardiovascular Research and Training Hospital, Health Sciences University, Istanbul, Turkey
| | - Fahri Er
- Department of Cardiology, Bursa Yuksek İhtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey
| | - Dursun Topal
- Department of Cardiology, Bursa Yuksek İhtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey
| | - Ferit Onur Mutluer
- Department of Cardiology, Medicine School, Koc University, Istanbul, Turkey
| | - Mehmet Demir
- Department of Cardiology, Bursa Yuksek İhtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey
| | - Erhan Tenekecioglu
- Department of Cardiology, Bursa Yuksek İhtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey
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23
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Przyborowski K, Proniewski B, Czarny J, Smeda M, Sitek B, Zakrzewska A, Zoladz JA, Chlopicki S. Vascular Nitric Oxide-Superoxide Balance and Thrombus Formation after Acute Exercise. Med Sci Sports Exerc 2019; 50:1405-1412. [PMID: 29470281 DOI: 10.1249/mss.0000000000001589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION An acute bout of strenuous exercise in humans results in transient impairment of nitric oxide (NO)-dependent function, but it remains unknown whether this phenomenon is associated with increased risk of thrombotic events after exercise. This study aimed to evaluate effects of a single bout of exhaustive running in mice on the balance of vascular NO/reactive oxygen species production, and on thrombogenicity. METHODS At different time points (0, 2, and 4 h) after exercise and in sedentary C57BL/6 mice, the production of NO and superoxide (O2) in aorta was measured by electron paramagnetic resonance spin trapping and by dihydroethidium/high-performance liquid chromatography-based method, respectively, whereas collagen-induced thrombus formation was analyzed in a microchip-based flow-chamber system (total thrombus-formation analysis system). We also measured pre- and postexercise plasma concentration of nitrite/nitrate and 6-keto-PGF1α. RESULTS An acute bout of exhaustive running in mice resulted in decreased production of NO and increased production of O2 in aorta, with maximum changes 2 h after completion of exercise when compared with sedentary mice. However, platelet thrombus formation was not changed by exercise as evidenced by unaltered time to start of thrombus formation, capillary occlusion time, and total thrombogenicity (area under the flow pressure curve) as measured in a flow-chamber system. Strenuous exercise increased the plasma concentration of nitrite but did not affect nitrate and 6-keto-PGF1α concentrations. CONCLUSION An acute bout of strenuous exercise in mice reduced NO and in parallel increased O2 production in aorta. This response was most pronounced 2 h after exercise. Surprisingly, the reduced NO and increased O2 production in mice after exercise did not result in increased platelet-dependent thrombogenicity. These results show that transient reduction in NO bioavailability does not modify thromboresistance in healthy mice after exercise.
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Affiliation(s)
- Kamil Przyborowski
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, POLAND
| | - Bartosz Proniewski
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, POLAND
| | - Joanna Czarny
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, POLAND
| | - Marta Smeda
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, POLAND
| | - Barbara Sitek
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, POLAND
| | - Agnieszka Zakrzewska
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, POLAND
| | - Jerzy A Zoladz
- Department of Muscle Physiology, Chair of Physiology and Biochemistry, Faculty of Rehabilitation, University School of Physical Education, Krakow, POLAND
| | - Stefan Chlopicki
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, POLAND.,Chair of Pharmacology, Jagiellonian University Medical College, Krakow, POLAND
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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.
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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
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Tryfonos A, Green DJ, Dawson EA. Effects of Catheterization on Artery Function and Health: When Should Patients Start Exercising Following Their Coronary Intervention? Sports Med 2019; 49:397-416. [PMID: 30719682 DOI: 10.1007/s40279-019-01055-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Coronary artery disease (CAD) is a leading cause of death worldwide, and percutaneous transluminal coronary angiography (PTCA) and/or percutaneous coronary intervention (PCI; angioplasty) are commonly used to diagnose and/or treat the obstructed coronaries. Exercise-based rehabilitation is recommended for all CAD patients; however, most guidelines do not specify when exercise training should commence following PTCA and/or PCI. Catheterization can result in arterial dysfunction and acute injury, and given the fact that exercise, particularly at higher intensities, is associated with elevated inflammatory and oxidative stress, endothelial dysfunction and a pro-thrombotic milieu, performing exercise post-PTCA/PCI may transiently elevate the risk of cardiac events. This review aims to summarize extant literature relating to the impacts of coronary interventions on arterial function, including the time-course of recovery and the potential deleterious and/or beneficial impacts of acute versus long-term exercise. The current literature suggests that arterial dysfunction induced by catheterization recovers 4-12 weeks following catheterization. This review proposes that a period of relative arterial vulnerability may exist and exercise during this period may contribute to elevated event susceptibility. We therefore suggest that CAD patients start an exercise training programme between 2 and 4 weeks post-PCI, recognizing that the literature suggest there is a 'grey area' for functional recovery between 2 and 12 weeks post-catheterization. The timing of exercise onset should take into consideration the individual characteristics of patients (age, severity of disease, comorbidities) and the intensity, frequency and duration of the exercise prescription.
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Affiliation(s)
- Andrea Tryfonos
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, 6009, Australia
| | - Ellen A Dawson
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, L3 3AF, UK.
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26
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Miron VV, Baldissarelli J, Pranke G, Mânica A, da Silva Rosa Bonadiman B, Manfredi LH, Morsch VM, Schetinger MRC, Machado Cardoso A. High-intensity intermittent exercise increases adenosine hydrolysis in platelets and lymphocytes and promotes platelet aggregation in futsal athletes. Platelets 2018; 30:878-885. [DOI: 10.1080/09537104.2018.1529299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Vanessa Valéria Miron
- Biochemistry and Molecular Biology department, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Jucimara Baldissarelli
- Biochemistry and Molecular Biology department, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Gabriel Pranke
- Department of Collective Sports, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Aline Mânica
- Biochemistry and Molecular Biology department, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Leandro Henrique Manfredi
- Academic Coordination, Medicine, Campus Chapecó, Federal University of Fronteira Sul, Chapecó, SC, Brazil
| | - Vera Maria Morsch
- Biochemistry and Molecular Biology department, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Andréia Machado Cardoso
- Academic Coordination, Medicine, Campus Chapecó, Federal University of Fronteira Sul, Chapecó, SC, Brazil
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27
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Lundberg Slingsby MH, Gliemann L, Thrane M, Rytter N, Egelund J, Chan MV, Armstrong PC, Warner TD, Hellsten Y. Platelet responses to pharmacological and physiological interventions in middle-aged men with different habitual physical activity levels. Acta Physiol (Oxf) 2018; 223:e13028. [PMID: 29297976 DOI: 10.1111/apha.13028] [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: 10/19/2017] [Revised: 12/08/2017] [Accepted: 12/25/2017] [Indexed: 11/29/2022]
Abstract
The current guidelines following an acute coronary syndrome recommend dual-antiplatelet therapy (DAPT) (aspirin plus a P2Y12 antagonist) alongside lifestyle modifications, including more regular physical activity. It is currently unknown whether regular exercise affects the pharmacology of DAPT. AIM To explore how exercise-induced improvements in vascular and platelet function affect the efficacy of DAPT, in a cross-sectional study of men with different physical activity levels (training status). METHODS A total of 42 healthy, normal-weight, middle-aged men were divided into 3 groups: untrained, moderately trained and well-trained. Their platelet reactivity (agonist-induced % aggregation) was investigated in platelet-rich plasma at rest and after inhibition with aspirin and ticagrelor and/or prostacyclin and nitric oxide added to the blood in vitro, and after physiological tests of vascular function; passive movement of the leg, flow-mediated dilation and one-leg knee-extensor exercise. Vascular function of the femoral artery (changes in arterial blood flow) was assessed by ultrasound Doppler. RESULTS Platelets from the well-trained subjects had lower basal reactivity, a higher sensitivity to the anti-aggregatory effects of prostacyclin and were more potently inhibited by DAPT compared to the untrained subjects. The moderately trained and well-trained subjects had a superior vascular function compared to untrained subjects, and their platelets were more inhibited by the passive movement, flow-mediated dilation and one-leg knee-extensor exercise. DISCUSSION A habitually active lifestyle leads to an increased platelet sensitivity to pharmacological and physiological platelet inhibitors. We suggest that physical activity habits (training status) should be considered when personalizing and optimizing antithrombotic treatment strategies.
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Affiliation(s)
| | - L. Gliemann
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Copenhagen Denmark
| | - M. Thrane
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Copenhagen Denmark
| | - N. Rytter
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Copenhagen Denmark
| | - J. Egelund
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Copenhagen Denmark
| | - M. V. Chan
- Centre for Immunobiology; Blizard Institute; Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
| | - P. C. Armstrong
- Centre for Immunobiology; Blizard Institute; Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
| | - T. D. Warner
- Centre for Immunobiology; Blizard Institute; Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
| | - Y. Hellsten
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Copenhagen Denmark
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28
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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]
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Siqueira R, Fernandes W. Resposta hematológica de cavalos de enduro, que correram diferentes distâncias, no período pós-prova. ARQ BRAS MED VET ZOO 2017. [DOI: 10.1590/1678-4162-9296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo deste trabalho foi estudar as alterações hematológicas após provas de enduro de diferentes distâncias até 14 dias após a prova, período de recuperação metabólica e musculoesquelética, as quais ocorrem em cavalos treinados e que concluíram as competições em boas condições de saúde. Foram avaliados 32 cavalos Árabes, com 400 (±32kg), treinados para provas de enduro, que competiram em quatro provas nas categorias velocidade livre de 80km (n=13), 120km (n=14) e 160km (n=5). Amostras de sangue foram coletadas antes da largada (M0), imediatamente após a saída da última inspeção veterinária (M1) e três horas após (M2). Já nos respectivos haras, foram coletadas amostras aos três (M3), sete (M4) e 14 (M5) dias após a prova. Houve aumento dos valores de eritrócitos, hemoglobina e hematócrito após o término da prova em todos os cavalos, e esse aumento se manteve até três horas após a prova nos cavalos de 120 e 80km. Houve aumento do número de plaquetas em todos os cavalos, que permaneceu elevado até três horas após a prova e normalizou-se a partir do terceiro dia. Houve efeito (P<0,05) da prova sobre as variáveis eritrócitos, hemoglobina e hematócrito, do número de plaquetas, aumento na contagem de neutrófilos e diminuição da contagem de linfócitos após o término da prova e três horas depois, retornando ao normal a partir do terceiro dia. Um dado inédito deste estudo foi o aumento de eosinófilos sanguíneos após três dias da competição, que se manteve até o sétimo dia. Esse fato pode sinalizar a participação dessas células no processo de reparação. A avaliação dos componentes sanguíneos se mostrou uma importante ferramenta para a avaliação da recuperação dos animais. Como só foram avaliados cavalos que completaram a prova, as alterações encontradas após dias do esforço sinalizam a relevância de se estudarem melhor as etapas e os componentes da recuperação metabólica e muscular, a fim de não se cometerem excessos, retornando esses animais no tempo correto.
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Ikarugi H, Yamamoto J. The exercise paradox may be solved by measuring the overall thrombotic state using native blood. Drug Discov Ther 2017; 11:15-19. [PMID: 28202881 DOI: 10.5582/ddt.2016.01077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
While exercise is widely believed to prevent atherothrombotic diseases, it occasionally causes sudden death. This exercise paradox may be due to the inadequate testing of the thrombotic and thrombolytic status. A recently developed shear-induced thrombosis/endogenous fibrinolysis test performed with non-anticoagulated blood samples allows the assessment of the thrombotic state of an individual both at rest and after exercise. This sensitive and physiologically relevant test may help to solve the aforementioned exercise paradox.
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31
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Przyborowski K, Kassassir H, Wojewoda M, Kmiecik K, Sitek B, Siewiera K, Zakrzewska A, Rudolf AM, Kostogrys R, Watala C, Zoladz JA, Chlopicki S. Effects of a single bout of strenuous exercise on platelet activation in female ApoE/LDLR -/- mice. Platelets 2017; 28:657-667. [PMID: 28067100 DOI: 10.1080/09537104.2016.1254764] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Strenuous physical exercise leads to platelet activation that is normally counterbalanced by the production of endothelium-derived anti-platelet mediators, including prostacyclin (PGI2) and nitric oxide (NO). However, in the case of endothelial dysfunction, e.g. in atherosclerosis, there exists an increased risk for intravascular thrombosis during exercise that might be due to an impairment in endothelial anti-platelet mechanisms. In the present work, we evaluated platelet activation at rest and following a single bout of strenuous treadmill exercise in female ApoE/LDLR-/- mice with early (3-month-old) and advanced (7-month-old) atherosclerosis compared to female age-matched WT mice. In sedentary and post-exercise groups of animals, we analyzed TXB2 generation and the expression of platelet activation markers in the whole blood ex vivo assay. We also measured pre- and post-exercise plasma concentration of 6-keto-PGF1α, nitrite/nitrate, lipid profile, and blood cell count. Sedentary 3- and 7-month-old ApoE/LDLR-/- mice displayed significantly higher activation of platelets compared to age-matched wild-type (WT) mice, as evidenced by increased TXB2 production, expression of P-selectin, and activation of GPIIb/IIIa receptors, as well as increased fibrinogen and von Willebrand factor (vWf) binding. Interestingly, in ApoE/LDLR-/- but not in WT mice, strenuous exercise partially inhibited TXB2 production, the expression of activated GPIIb/IIIa receptors, and fibrinogen binding, with no effect on the P-selectin expression and vWf binding. Post-exercise down-regulation of the activated GPIIb/IIIa receptor expression and fibrinogen binding was not significantly different between 3- and 7-month-old ApoE/LDLR-/- mice; however, only 7-month-old ApoE/LDLR-/- mice showed lower TXB2 production after exercise. In female 4-6-month-old ApoE/LDLR-/- but not in WT mice, an elevated pre- and post-exercise plasma concentration of 6-keto-PGF1α was observed. In turn, the pre- and post-exercise plasma concentrations of nitrite (NO2-) and nitrate (NO3-) were decreased in ApoE/LDLR-/- as compared to that in age-matched WT mice. In conclusion, we demonstrated overactivation of platelets in ApoE/LDLR-/- as compared to WT mice. However, platelet activation in ApoE/LDLR-/- mice was not further increased by strenuous exercise, but was instead attenuated, a phenomenon not observed in WT mice. This phenomenon could be linked to compensatory up-regulation of PGI2-dependent anti-platelet mechanisms in ApoE/LDLR-/- mice.
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Affiliation(s)
- K Przyborowski
- a Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University , Krakow , Poland
| | - H Kassassir
- b Department of Haemostasis and Haemostatic Disorders , Chair of Biomedical Sciences, Medical University of Lodz , Lodz , Poland
| | - M Wojewoda
- a Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University , Krakow , Poland
| | - K Kmiecik
- a Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University , Krakow , Poland
| | - B Sitek
- a Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University , Krakow , Poland
| | - K Siewiera
- b Department of Haemostasis and Haemostatic Disorders , Chair of Biomedical Sciences, Medical University of Lodz , Lodz , Poland
| | - A Zakrzewska
- a Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University , Krakow , Poland
| | - A M Rudolf
- a Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University , Krakow , Poland
| | - R Kostogrys
- c Department of Human Nutrition, Faculty of Food Technology , Agricultural University of Krakow , Krakow , Poland
| | - C Watala
- b Department of Haemostasis and Haemostatic Disorders , Chair of Biomedical Sciences, Medical University of Lodz , Lodz , Poland
| | - J A Zoladz
- d Department of Muscle Physiology, Chair of Physiology and Biochemistry, Faculty of Rehabilitation , University School of Physical Education , Krakow , Poland
| | - S Chlopicki
- a Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University , Krakow , Poland.,e Chair of Pharmacology , Jagiellonian University Medical College , Krakow , Poland
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Andriichuk A, Tkachenko H. Effect of gender and exercise on haematological and biochemical parameters in Holsteiner horses. J Anim Physiol Anim Nutr (Berl) 2017; 101:e404-e413. [DOI: 10.1111/jpn.12620] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 09/12/2016] [Indexed: 01/14/2023]
Affiliation(s)
- A. Andriichuk
- Department of Horse Breeding; Institute of Animal Science; National Academy of Agrarian Sciences of Ukraine; Kharkiv Ukraine
| | - H. Tkachenko
- Institute of Biology and Environmental Protection; Pomeranian University; Slupsk Poland
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HEBER STEFAN, ASSINGER ALICE, POKAN ROCHUS, VOLF IVO. Correlation between Cardiorespiratory Fitness and Platelet Function in Healthy Women. Med Sci Sports Exerc 2016; 48:1101-10. [DOI: 10.1249/mss.0000000000000882] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Imran TF, Patel Y, Ellison RC, Carr JJ, Arnett DK, Pankow JS, Heiss G, Hunt SC, Gaziano JM, Djoussé L. Walking and Calcified Atherosclerotic Plaque in the Coronary Arteries: The National Heart, Lung, and Blood Institute Family Heart Study. Arterioscler Thromb Vasc Biol 2016; 36:1272-7. [PMID: 27102966 DOI: 10.1161/atvbaha.116.307284] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 03/31/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Studies have reported mixed findings on the association between physical activity and subclinical atherosclerosis. We sought to examine whether walking is associated with prevalent coronary artery calcification (CAC) and aortic calcification. APPROACH AND RESULTS In a cross-sectional design, we studied 2971 participants of the National Heart, Lung, and Blood Institute Family Heart Study without a history of myocardial infarction, coronary artery bypass grafting, or percutaneous transluminal angioplasty. A standardized questionnaire was used to ascertain the number of blocks walked daily to compute walking metabolic equivalent hours. CAC was measured by cardiac computed tomography. We defined prevalent CAC and aortic calcification using an Agatston score of at least 100 and used generalized estimating equations to calculate adjusted prevalence ratios. Mean age was 55 years, and 60% of participants were women. Compared with the ≤3.75-Met-h/wk group, prevalence ratios for CAC after adjusting for age, sex, race, smoking, alcohol use, total physical activity (excluding walking), and familial clustering were 0.53 (95% confidence interval, 0.35-0.79) for >3.75 to 7.5 Met-h/wk, 0.72 (95% confidence interval, 0.52-0.99) for >7.5 to 15 Met-h/wk, and 0.54 (95% confidence interval, 0.36-0.81) for >15 to 22.5 Met-h/wk, (P trend=0.01). The walking-CAC relationship remained significant for those with body mass index ≥25 (P trend=0.02) and persisted with CAC cutoffs of 300, 200, 150, and 50 but not 0. When examined as a continuous variable, a J-shaped association between walking and CAC was found. The walking-aortic calcification association was not significant. CONCLUSIONS Our findings suggest that walking is associated with lower prevalent CAC (but not aortic calcification) in adults without known heart disease.
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Affiliation(s)
- Tasnim F Imran
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.).
| | - Yash Patel
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - R Curtis Ellison
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - J Jeffrey Carr
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - Donna K Arnett
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - James S Pankow
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - Gerardo Heiss
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - Steven C Hunt
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - J Michael Gaziano
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
| | - Luc Djoussé
- From the Department of Medicine, Brigham and Women's Hospital and Boston Veterans Affairs Healthcare System, Harvard Medical School, Boston, MA (T.F.I., Y.P., J.M.G., L.D.); Preventive Medicine and Epidemiology, Boston University School of Medicine, MA (R.C.E.); Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN (J.J.C.); Department of Epidemiology, University of Alabama at Birmingham (D.K.A.); Division of Epidemiology and Community Health, University of Minnesota, Minneapolis (J.S.P.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Cardiovascular Genetics, Department of Medicine, University of Utah, Salt Lake City (S.C.H.)
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Huskens D, Roest M, Remijn JA, Konings J, Kremers RMW, Bloemen S, Schurgers E, Selmeczi A, Kelchtermans H, van Meel R, Meex SJ, Kleinegris MC, de Groot PG, Urbanus RT, Ninivaggi M, de Laat B. Strenuous exercise induces a hyperreactive rebalanced haemostatic state that is more pronounced in men. Thromb Haemost 2016; 115:1109-19. [PMID: 26864794 DOI: 10.1160/th15-10-0821] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/07/2016] [Indexed: 11/05/2022]
Abstract
Physical exercise is recommended for a healthy lifestyle. Strenuous exercise, however, may trigger the haemostatic system, increasing the risk of vascular thrombotic events and the incidence of primary cardiac arrest. Our goal was to study the effects of strenuous exercise on risk factors of cardiovascular disease. Blood was collected from 92 healthy volunteers who participated in the amateur version of the pro-tour Amstel Gold cycling race, before and directly after the race. Thrombin generation showed a shortening of the lag time and time to peak and an increase of the velocity index. Interestingly, the endogenous thrombin potential measured in plasma decreased due to reduced prothrombin conversion. Platelet reactivity increased and this effect was stronger in men than in women. Lower fibrinogen and higher D-dimer levels after exercise indicated higher fibrin formation. On the other hand, fibrinolysis was also elevated as indicated by a shortening of the clot lysis time. Exercise activated the endothelium (von Willebrand factor (VWF) and active VWF levels were elevated) and the immune system (concentrations IL-6, IL-8, MCP-1, RANTES and PDGF increased). Additionally, an increased cardiac troponin T level was measured post-exercise. Strenuous exercise induces a temporary hyperreactive state in the body with enhanced pro- and anticoagulant responses. As strenuous exercise has a more pronounced effect on platelet function in male subjects, this gives a possible explanation for the higher incidence of sudden cardiac death during exercise compared to women. This trial is registered at www.clinicaltrials.gov as NCT02048462.
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Affiliation(s)
- Dana Huskens
- Dana Huskens, Oxfordlaan 70, Maastricht 6229EV, The Netherlands, Tel.: +31 43 388 58 96, Fax: +31 43 388 45 70, E-mail:
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Goodman JM, Burr JF, Banks L, Thomas SG. The Acute Risks of Exercise in Apparently Healthy Adults and Relevance for Prevention of Cardiovascular Events. Can J Cardiol 2016; 32:523-32. [PMID: 27017149 DOI: 10.1016/j.cjca.2016.01.019] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Increased physical activity (PA) is associated with improved quality of life and reductions in cardiovascular (CV) morbidity and all-cause mortality in the general population in a dose-response manner. However, PA acutely increases the risk of adverse CV event or sudden cardiac death (SCD) above levels expected at rest. We review the likelihood of adverse CV events related to exercise in apparently healthy adults and strategies for prevention, and contextualize our understanding of the long-term risk reduction conferred from PA. METHODS A systematic review of the literature was performed using electronic databases; additional hand-picked relevant articles from reference lists and additional sources were included after the search. RESULTS The incidence of adverse CV events in adults is extremely low during and immediately after PA of varying types and intensities and is significantly lower in those with long-standing PA experience. The risk of SCD and nonfatal events during and immediately after PA remains extremely low (well below 0.01 per 10,000 participant hours); increasing age and PA intensity are associated with greater risk. In most cases of exercise-related SCD, occult CV disease is present and SCD is typically the first clinical event. CONCLUSIONS Exercise acutely increases the risk of adverse CV events, with greater risk associated with vigorous intensity. The risks of an adverse CV event during and immediately after exercise are outweighed by the health benefits of vigorous exercise performed regularly. A key challenge remains the identification of occult structural heart disease and inheritable conditions that increase the chances of lethal arrhythmias during exercise.
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Affiliation(s)
- Jack M Goodman
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada; UHN/Mt Sinai Division of Cardiology, Heart and Stroke/Richard Lewar Centres of Excellence in Cardiovascular Research, Toronto, Ontario, Canada.
| | - Jamie F Burr
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Laura Banks
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Scott G Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Effects of Physical (In)activity on Platelet Function. BIOMED RESEARCH INTERNATIONAL 2015; 2015:165078. [PMID: 26557653 PMCID: PMC4628769 DOI: 10.1155/2015/165078] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 04/19/2015] [Indexed: 12/18/2022]
Abstract
As platelet activation is closely related to the liberation of growth factors and inflammatory mediators, platelets play a central role in the development of CVD. Virtually all cardiovascular risk factors favor platelet hyperreactivity and, accordingly, also physical (in)activity affects platelet function. Within this paper, we will summarize and discuss the current knowledge on the impact of acute and habitual exercise on platelet function. Although there are apparent discrepancies regarding the reported effects of acute, strenuous exercise on platelet activation, a deeper analysis of the available literature reveals that the applied exercise intensity and the subjects' cardiorespiratory fitness represent critical determinants for the observed effects. Consideration of these factors leads to the summary that (i) acute, strenuous exercise can lead to platelet activation, (ii) regular physical activity and/or physical fitness diminish or prevent platelet activation in response to acute exercise, and (iii) habitual physical activity and/or physical fitness also favorably modulate platelet function at physical rest. Notably, these effects of exercise on platelet function show obvious similarities to the well-recognized relation between exercise and the risk for cardiovascular events where vigorous exercise transiently increases the risk for myocardial infarction and a physically active lifestyle dramatically reduces cardiovascular mortality.
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38
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Olver TD, Ferguson BS, Laughlin MH. Molecular Mechanisms for Exercise Training-Induced Changes in Vascular Structure and Function: Skeletal Muscle, Cardiac Muscle, and the Brain. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2015; 135:227-57. [PMID: 26477917 DOI: 10.1016/bs.pmbts.2015.07.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Compared with resting conditions, during incremental exercise, cardiac output in humans is elevated from ~5 to 25 L min(-1). In conjunction with this increase, the proportion of cardiac output directed toward skeletal muscle increases from ~20% to 85%, while blood flow to cardiac muscle increases 500% and blood flow to specific brain structures increases nearly 200%. Based on existing evidence, researchers believe that blood flow in these tissues is matched to the increases in metabolic rate during exercise. This phenomenon, the matching of blood flow to metabolic requirement, is often referred to as functional hyperemia. This chapter summarizes mechanical and metabolic factors that regulate functional hyperemia as well as other exercise-induced signals, which are also potent stimuli for chronic adaptations in vascular biology. Repeated exposure to exercise-induced increases in shear stress and the induction of angiogenic factors alter vascular cell gene expression and mediate changes in vascular volume and blood flow control. The magnitude and regulation of this coordinated response appear to be tissue specific and coupled to other factors such as hypertrophy and hyperplasia. The cumulative effects of these adaptations contribute to increased exercise capacity, reduced relative challenge of a given submaximal exercise bout and ameliorated vascular outcomes in patient populations with pathological conditions. In the subsequent discussion, this chapter explores exercise as a regulator of vascular biology and summarizes the molecular mechanisms responsible for exercise training-induced changes in vascular structure and function in skeletal and cardiac muscle as well as the brain.
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Affiliation(s)
- T Dylan Olver
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, USA
| | - Brian S Ferguson
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, USA
| | - M Harold Laughlin
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, USA; Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, Missouri, USA; Dalton Cardiovascular Research Center, University of Missouri, Columbia, Missouri, USA.
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39
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Posthuma JJ, van der Meijden PE, ten Cate H, Spronk HM. Short- and Long-term exercise induced alterations in haemostasis: a review of the literature. Blood Rev 2015; 29:171-8. [DOI: 10.1016/j.blre.2014.10.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 10/23/2014] [Indexed: 01/24/2023]
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40
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Safavi-Naeini P, Rasekh A, Razavi M, Saeed M, Massumi A. Sudden Cardiac Death in Coronary Artery Disease. Coron Artery Dis 2015. [DOI: 10.1007/978-1-4471-2828-1_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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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.
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Affiliation(s)
- Yu-Wen Chen
- Haemostasis, Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Science, City Hospital , Birmingham , United Kingdom
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Creatine kinase inhibits ADP-induced platelet aggregation. Sci Rep 2014; 4:6551. [PMID: 25298190 PMCID: PMC4190537 DOI: 10.1038/srep06551] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 08/11/2014] [Indexed: 02/08/2023] Open
Abstract
Bleeding risk with antiplatelet therapy is an increasing clinical challenge. However, the inter-individual variation in this risk is poorly understood. We assessed whether the level of plasma creatine kinase, the enzyme that utilizes ADP and phosphocreatine to rapidly regenerate ATP, may modulate bleeding risk through a dose-dependent inhibition of ADP-induced platelet activation. Exogenous creatine kinase (500 to 4000 IU/L, phosphocreatine 5 mM) added to human plasma induced a dose-dependent reduction to complete inhibition of ADP-induced platelet aggregation. Accordingly, endogenous plasma creatine kinase, studied in 9 healthy men (mean age 27.9 y, SE 3.3; creatine kinase 115 to 859 IU/L, median 358), was associated with reduced ADP-induced platelet aggregation (Spearman's rank correlation coefficient, -0.6; p < 0.05). After exercise, at an endogenous creatine kinase level of 4664, ADP-induced platelet aggregation was undetectable, normalizing after rest, with a concomitant reduction of creatine kinase to normal values. Thus, creatine kinase reduces ADP-induced platelet activation. This may promote bleeding, in particular when patients use platelet P2Y12 ADP receptor inhibitors.
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Effects of two types of partial sleep deprivation on hematological responses during intermittent exercise: A pilot study. Sci Sports 2014. [DOI: 10.1016/j.scispo.2014.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Shear enhances thrombopoiesis and formation of microparticles that induce megakaryocytic differentiation of stem cells. Blood 2014; 124:2094-103. [PMID: 24948658 DOI: 10.1182/blood-2014-01-547927] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
In vivo visualization of thrombopoiesis suggests an important role for shear flow in platelet biogenesis. In vitro, shear stress was shown to accelerate proplatelet formation from mature megakaryocytes (Mks). Yet, the role of biomechanical forces on Mk biology and platelet biogenesis remains largely unexplored. In this study, we investigated the impact of shear stress on Mk maturation and formation of platelet-like particles (PLPs), pro/preplatelets (PPTs), and Mk microparticles (MkMPs), and furthermore, we explored a physiological role for MkMPs. We found that shear accelerated DNA synthesis of immature Mks in an exposure time- and shear stress level-dependent manner. Both phosphatidylserine exposure and caspase-3 activation were enhanced by shear stress. Exposure to physiological shear dramatically increased generation of PLPs/PPTs and MkMPs by up to 10.8 and 47-fold, respectively. Caspase-3 inhibition reduced shear-induced PLP/PPT and MkMP formation. PLPs generated under shear flow displayed improved functionality as assessed by CD62P exposure and fibrinogen binding. Significantly, coculture of MkMPs with hematopoietic stem and progenitor cells promoted hematopoietic stem and progenitor cell differentiation to mature Mks synthesizing α- and dense-granules, and forming PPTs without exogenous thrombopoietin, thus identifying a novel and unexplored potential physiological role for MkMPs.
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Burke N, Flood K, Muellers S, Murray A, Dempsey M, Geary M, Kenny D, Malone F. An overview of platelet function in normal and complicated pregnancies. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17474108.2013.811934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
We aimed to review the literature to explore the magnitude of sudden cardiac death (SCD) in young athletes. Although SCD in athletes is not a common event, it represents a tragedy of the apparently fit young population. SCD varies according to countries, age groups, and sex. In addition, it varies in the underlying causes and the screening tool. Therefore, we are in need for further research efforts. Guidelines, public and physician awareness, and education regarding the warning signs are integral part in the strategy to reduce SCD tragedy. However, all these requirements raise concern for cost-effectiveness in some countries for proper implementation.
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47
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Lamprecht M, Moussalli H, Ledinski G, Leschnik B, Schlagenhauf A, Koestenberger M, Polt G, Cvirn G. Effects of a single bout of walking exercise on blood coagulation parameters in obese women. J Appl Physiol (1985) 2013; 115:57-63. [DOI: 10.1152/japplphysiol.00187.2013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Obesity is associated with increased prevalence of thromboembolic events. We aimed to investigate whether obese women might benefit from vigorous aerobic exercise. Forty-two overweight and obese women performed a 30-min walking exercise test (treadmill ergometer) at an intensity of 70% of individual peak oxygen uptake. Blood samples were collected before and immediately after exercise. Thrombelastometry and platelet function measurements were performed on whole blood. Standard coagulation times, thrombin generation curves, markers of thrombin generation, fibrinolytic parameters, plasma levels of pro- and anticoagulatory factors, and microparticle procoagulant activity were determined in platelet-poor plasma samples. Thrombelastometry revealed a significant prolongation of clot formation time ( P = 0.037) and a significant deceleration of fibrin build up (alpha angle, P = 0.034) after exercise. Calibrated automated thrombography revealed a significant exercise-induced decrease in endogenous thrombin potential ( P = 0.039). Moreover, thrombin formation stopped earlier postexercise, reflected in shortened StartTail ( P = 0.046). Significantly elevated tissue-plasminogen activator levels ( P = 0.001) indicate an exercise-induced activation of the fibrinolytic system. White blood cell count increased significantly from pre- to postexercise ( P = 0.045), indicating a mild exercise-induced leukocytosis. The results of this study demonstrate that vigorous aerobic exercise might be a suitable tool to protect obese women from thrombotic events. We show that a single bout of vigorous aerobic exercise is clearly associated with an activation of the fibrinolytic system and a decreased readiness of the postexercise samples to form a clot and to generate thrombin, the pivotal enzyme of hemostasis.
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Affiliation(s)
- Manfred Lamprecht
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
- Green Beat-Institute of Nutrient Research and Sport Nutrition, Graz, Austria; and
| | - Herve Moussalli
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Gerhard Ledinski
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Bettina Leschnik
- Department of Pediatrics, Medical University of Graz, Graz, Austria
| | | | | | - Guenter Polt
- Green Beat-Institute of Nutrient Research and Sport Nutrition, Graz, Austria; and
| | - Gerhard Cvirn
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
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Whittaker JP, Linden MD, Coffey VG. Effect of aerobic interval training and caffeine on blood platelet function. Med Sci Sports Exerc 2013; 45:342-50. [PMID: 22935739 DOI: 10.1249/mss.0b013e31827039db] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Hyperactive platelets contribute to the thrombotic response in humans, and exercise transiently increases platelet function. Caffeine is routinely used by athletes as an ergogenic aid, but the combined effect of exercise and caffeine on platelet function has not been investigated. METHODS Twelve healthy males were randomly assigned to one of four groups and undertook four experimental trials of a high-intensity aerobic interval training (AIT) bout or rest with ingestion of caffeine (3 mg·kg(-1)) or placebo. AIT was 8 × 5 min at approximately 75% peak power output (approximately 80% V˙O2peak) and 1-min recovery (approximately 40% peak power output, approximately 50% V˙O2peak) intervals. Blood/urine was collected before, 60, and 90 min after capsule ingestion and analyzed for platelet aggregation/activation. RESULTS AIT increased platelet reactivity to adenosine diphosphate (placebo 30.3%, caffeine 13.4%, P < 0.05) and collagen (placebo 10.8%, caffeine 5.1%, P < 0.05) compared with rest. Exercise placebo increased adenosine diphosphate-induced aggregation 90 min postingestion compared with baseline (40.5%, P < 0.05), but the increase when exercise was combined with caffeine was small (6.6%). During the resting caffeine protocol, collagen-induced aggregation was reduced (-4.3%, P < 0.05). AIT increased expression of platelet activation marker PAC-1 with exercise placebo (P < 0.05) but not when combined with caffeine. CONCLUSION A single bout of AIT increases platelet function, but caffeine ingestion (3 mg·kg(-1)) does not exacerbate platelet function at rest or in response to AIT. Our results provide new information showing caffeine at a dose that can elicit ergogenic effects on performance has no detrimental effect on platelet function and may have the potential to attenuate increases in platelet activation and aggregation when undertaking strenuous exercise.
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Affiliation(s)
- Joshua P Whittaker
- Health Innovations Research Institute, School of Medical Sciences, RMIT University, Melbourne, Australia
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SYU GUANDA, CHEN HSIUNING, JEN CHAUYINGJ. Acute Severe Exercise Facilitates Neutrophil Extracellular Trap Formation in Sedentary but Not Active Subjects. Med Sci Sports Exerc 2013; 45:238-44. [DOI: 10.1249/mss.0b013e31826df4a1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Koudouovoh-Tripp P, Sperner-Unterweger B. Influence of mental stress on platelet bioactivity. World J Psychiatry 2012; 2:134-47. [PMID: 24175179 PMCID: PMC3782187 DOI: 10.5498/wjp.v2.i6.134] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 10/10/2012] [Accepted: 10/23/2012] [Indexed: 02/05/2023] Open
Abstract
It is well established that various mental stress conditions contribute, or at least influence, underlying pathophysiological mechanisms in somatic, as well as in psychiatric disorders; blood platelets are supposed to represent a possible link in this respect. The anculeated platelets are the smallest corpuscular elements circulating in the human blood. They display different serotonergic markers which seem to reflect the central nervous serotonin metabolism. They are known as main effectors in haematological processes but recent research highlights their role in the innate and adaptive immune system. Platelets are containing a multitude of pro-inflammatory and immune-modulatory bioactive compounds in their granules and are expressing immune-competent surface markers. Research gives hint that platelets activation and reactivity is increased by mental stress. This leads to enhanced cross talk with the immune system via paracrine secretion, receptor interaction and formation of platelet leucocyte-aggregates. Recently it has been demonstrated that the immune system can have a remarkable impact in the development of psychiatric disorders. Therefore platelets represent an interesting research area in psychiatry and their role as a possible biomarker has been investigated. We review the influence of mental stress on what is termed platelet bioactivity in this article, which subsumes the mainly immune-modulatory activity of platelets in healthy volunteers, elderly persons with chronic care-giving strain, patients with cardiovascular diseases who are prone to psychosocial stress, as well as in patients with posttraumatic stress disorder. Research data suggest that stress enhances platelet activity, reactivity and immune-modulatory capacities.
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Affiliation(s)
- Pia Koudouovoh-Tripp
- Pia Koudouovoh-Tripp, Clinic for Biological Psychiatry, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
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