Different coagulability and fibrinolytic activity during exercise depending on exercise intensities

Handa, Koichi; Terao, Yasunori; Mori, Tsukasa; Tanaka, Hiroaki; Kiyonaga, Akira; Matsunaga, Akira; Sasaki, Jun; Shindo, Munehiro; Arakawa, Kikuo

doi:10.1016/0049-3848(92)90317-4

Cited by 23 publications

(15 citation statements)

References 11 publications

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“…A rise in tPA Ag and Act and increased PAP was reported (Handa et al 1992;Weiss et al 1998a), and these results are comparable with our data. The urokinase plasminogen activator (uPA) (ElSayed 1996) was not examined very often.…”

Section: Fibrinolytic Activitysupporting

confidence: 95%

Blood coagulation and fibrinolysis in healthy, untrained subjects: effects of different exercise intensities controlled by individual anaerobic threshold

Menzel

Hilberg

2010

Eur J Appl Physiol

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The influence of different exercise intensities on haemostasis in healthy, untrained subjects has not been intensively studied. We investigated untrained subjects for alterations in coagulation and fibrinolysis induced by two exercise intensities, precisely controlled by individual anaerobic threshold (IAT). Twenty-five healthy, untrained non-smokers (age 25 ± 3 years; relative VO(2) peak 43.1 ± 5.2 ml/kg/min) underwent exercise tests at 80% (moderate) and 100% (strenuous) of IAT for 60 min. Blood samples were taken after 30 min rest and immediately after exercise. The present results reveal that an exercise intensity at 100% IAT induces a more pronounced coagulation activity than exercises at 80% IAT. 100% IAT led to a significant higher increase in FVIII (80% IAT 85 ± 33 to 114 ± 30% vs. 100% IAT 81 ± 20 to 132 ± 29%) and TAT (80% IAT 2.5 ± 1.4 to 2.9 ± 1.0 μg/l vs. 100% IAT 2.6 ± 1.0 to 5.4 ± 4.2 μg/l). Furthermore, both exercises affected fibrinolysis, but it was significantly higher at 100% IAT (tPA activity; 80% IAT 0.44 ± 0.17 to 4.65 ± 2.67 U/ml vs. 100% IAT 0.43 ± 0.19 to 6.47 ± 3.97 U/ml). The data show that fibrinolytic activity is significantly elevated already after moderate exercise (80% IAT). After strenuous exercise (100% IAT), coagulation is more sharply enhanced together with a higher increase of fibrinolysis in comparison with 80% IAT. However, haemostasis seems to be in balance after moderate as well as after strenuous exercise intensity in healthy, untrained participants. Based on these data, exercise-induced changes of both haemostatic systems should also be tested in patients with cardiovascular diseases in order to be in a position to give recommendations for endurance training modalities in rehabilitation training.

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Section: Fibrinolytic Activitysupporting

confidence: 95%

Blood coagulation and fibrinolysis in healthy, untrained subjects: effects of different exercise intensities controlled by individual anaerobic threshold

Menzel

Hilberg

2010

Eur J Appl Physiol

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“…A variety of exercise protocols have been shown to increase t-PA significantly. For example, a multistage maximal treadmill exercise,[29, 49,50] and moderate and maximal cycle ergometer exercise, [15,19,30] evoked a significant elevation of t-PA activity and antigen. This increase was also demonstrated after a marathon run,[20] and after a triathlon race,l12] Similar to endurance exercise, resistance exercise induced substantial increase in plasminogen activator activity,l24,51] Molz et aJ.l19] examined the effects of varying exercise intensities and demonstrated that the increase in t-PA activity and antigen were exercise intensity-dependent.…”

Section: Blood Fibrinolysismentioning

confidence: 99%

Effects of Exercise on Blood Coagulation, Fibrinolysis and Platelet Aggregation

Elsayed

1996

Sports Medicine

144

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Disturbances of the haemostatic balance may result in thrombosis or bleeding tendency. There have been abundant reports on the effects of exercise on blood haemostasis, but the results reported have been conflicting and difficult to interpret. This review outlines and critically evaluates the relevant literature on the effects of short term exercise and physical training on the 3 systems of blood haemostasis i.e. blood coagulation, fibrinolysis and platelet aggregation. Short term exercise is usually associated with a significant shortening of activated partial thromboplastin time (APTT) and a marked increase in factor VIII (FVIII). The rise in FVIII is directly related to exercise intensity and the individuals' training status. Exercise also induces a significant increase in blood fibrinolysis which is dependent on exercise intensity, duration and training condition. The rise in blood fibrinolysis is mainly due to an increase in tissue-type plasminogen activator (t-PA) and a decrease in its main inhibitor plasminogen activator inhibitor (PAI-1) which are released from the endothelial cells of the vessel wall. Platelet count increases in exercise and this is probably due to a fresh release of platelets from the spleen, bone marrow and lungs. Studies on the effects of exercise on platelet aggregation and markers of platelet activation have produced conflicting results, and the exact effects of exercise remain as yet undetermined. It is suggested that short term exercise activates blood coagulation and enhances blood fibrinolysis and the delicate balance between clot formation and clot dissolution is maintained in normal populations. No valid conclusion could be reached regarding the actual effects of physical training on blood coagulation, fibrinolysis and platelet aggregation. This is undoubtedly due to variations in training programmes employed, populations studied, and the analytical methods used.

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“…Again analysis revealed interindividual differences: a broader MCF after exercise was observed in 26 Mean clot amplitudes at 20 minutes (MA20) obtained immediately after the marathon were significantly larger when compared to those before the physical exercise (MA20: 45. 8 …”

Section: Maximal Clot Firmnessmentioning

confidence: 97%

Exercise-Induced Hemostatic Alterations Are Detectable by Rotation Thrombelastography (ROTEM): A Marathon Study

Sucker

Zotz

Senft

et al. 2009

Clin Appl Thromb Hemost

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Rotation thrombelastography (ROTEM) provides a whole blood assay that allows the assessment of plasmic- and platelet-related hemostasis in a single-step procedure. In our current study, we focused on the capability of the method to detect hemostatic alterations induced by physical exercise, enrolling 33 healthy participants of the Dusseldorf Marathon 2006. Venous blood drawn immediately before and after finishing the marathon was analyzed by a rotational thrombelastograph (Pentapharm, Munich, Germany). On initiation of blood coagulation by recalcification, standard ROTEM parameters were determined. Comparison of the results obtained before and after the physical exercise was performed using the Student t test for paired samples. As a result, the mean clotting time (CT) determined from blood samples obtained immediately after the marathon was significantly shorter (662.9 + or - 67.8 seconds vs 505.6 + or - 97.3 seconds, P = .002) and the mean maximal clot firmness was significantly broader (48.4 +/- 6.6 mm vs 51.5 +/- 4.5 mm, P = .0004) when compared to results obtained before the physical exercise. Differences between mean clot formation times (CFTs; 280.6 + 96 seconds vs 270.4 + or - 73.8 seconds) and mean alpha angles (45.9 degrees + or - 8 degrees vs 47.8 degrees + or - 5.8 degrees ) before and after the marathon were not statistically significant. Remarkably, some participants showed opposed results, particularly prolongation of CT and narrowing of maximum clot firmness (MCF). Our study demonstrates that ROTEM is sensitive to exercise-induced hemostatic alterations. The method appears to be capable of detecting even distinct changes in hemostasis in a single-step procedure. Further analyses are needed to clarify which hemostasis parameters influence ROTEM results and which ROTEM results are independent predictors of exercise-induced alterations of plasmic and platelet function. This might help to explain interindividual differences in exercise-induced alterations of hemostasis.

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Different coagulability and fibrinolytic activity during exercise depending on exercise intensities

Cited by 23 publications

References 11 publications

Blood coagulation and fibrinolysis in healthy, untrained subjects: effects of different exercise intensities controlled by individual anaerobic threshold

Blood coagulation and fibrinolysis in healthy, untrained subjects: effects of different exercise intensities controlled by individual anaerobic threshold

Effects of Exercise on Blood Coagulation, Fibrinolysis and Platelet Aggregation

Exercise-Induced Hemostatic Alterations Are Detectable by Rotation Thrombelastography (ROTEM): A Marathon Study

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