Abstract-Vigorous exercise transiently increases the risk of primary cardiac arrest. Strenuous, acute exercise can also increase the release of plasma epinephrine. Previous investigations have indicated that epinephrine can potentiate platelet activation by activating platelet ␣ 2 -adrenoceptors. This study investigated how strenuous, acute exercise affects ␣ 2 -adrenergic agonistpotentiated platelet activation by closely examining 15 sedentary men who exercised strenuously on a bicycle ergometer. Before and immediately after exercise, platelet adhesiveness on fibrinogen-coated surfaces, [Ca 2ϩ ] i in platelets, the number and affinity of ␣ 2 -adrenergic sites on the platelet surface, and plasma catecholamine levels were determined. The results of this study can be summarized as follows: (1) The affinity of ␣ 2 -adrenergic receptors on platelets decreases while the maximal binding number significantly increases after strenuous exercise, thereby correlating with the rise in plasma catecholamine levels. Other investigators have postulated that vigorous, short-term exercise may enhance the risk of major vascular thrombotic events and transiently increase the incidence of primary cardiac arrest. 4 -6 According to our previous studies of healthy men and of male patients with stable angina, strenuous, acute exercise can enhance platelet function (ie, platelet adhesiveness on a fibrinogen-coated surface and ADP-induced aggregation). 7,8 However, the underlying mechanisms of strenuous, acute exercise-induced changes on platelet function remain unclear.Although strenuous, acute exercise can enhance epinephrine release, 9,10 the ability of epinephrine to induce human platelets has been the subject of extensive debate. 11-22a Related investigations have confirmed that epinephrine potentiates human platelet activation; however, epinephrine is not, by itself, an activating agent. 15,17-20,22a Moreover, apyrase blocks epinephrine-induced platelet activation. 19,20,22a The aforementioned studies indicated that the platelet-stimulating effect of epinephrine occurs only in the presence of extracellular ADP or another agonist. By acting through ␣ 2 -adrenergic receptors, epinephrine can enhance the opening of glycoprotein IIb/IIIa binding sites for fibrinogen in the presence of ADP; fibrinogen binding to the active form of the fibrinogen receptor produces platelet aggregation as well. 15,17,18,21 Therefore, we hypothesized that strenuous, acute exercise might alter the performance of platelet ␣ 2 -adrenergic receptors by increasing the endogenous release of epinephrine, thereby modifying the ability of ADP-activated fibrinogen receptors and fibrinogen to bind to platelet fibrinogen receptors.In light of the above discussion, this study elucidates how strenuous, acute exercise affects ␣ 2 -adrenergic agonist-potentiated platelet activation. To specifically assess platelet adhesiveness under various experimental conditions, this study used a tapered, parallel-plate chamber (ie, linear shear stress flow chamber) that provi...