Effects of Repeated Bouts of Exercise on the Hemostatic System

Lisa N. van der Vorm; Dana Huskens; Cécile H. Kicken; Jasper A. Remijn; Mark Roest; Bas de Laat; Adam Miszta

doi:10.1055/s-0038-1673619

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2018; 44(08): 710-722
DOI: 10.1055/s-0038-1673619

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effects of Repeated Bouts of Exercise on the Hemostatic System

Authors

Lisa N. van der Vorm

¹Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands

²Synapse Research Institute, Maastricht, The Netherlands

³Department of Clinical Chemistry and Hematology, Gelre Hospitals, Apeldoorn, The Netherlands
Dana Huskens

¹Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands

²Synapse Research Institute, Maastricht, The Netherlands
Cécile H. Kicken

²Synapse Research Institute, Maastricht, The Netherlands

⁴Department of Anaesthesiology, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
Jasper A. Remijn

¹Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands

³Department of Clinical Chemistry and Hematology, Gelre Hospitals, Apeldoorn, The Netherlands
Mark Roest

¹Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands

²Synapse Research Institute, Maastricht, The Netherlands
Bas de Laat

¹Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands

²Synapse Research Institute, Maastricht, The Netherlands

³Department of Clinical Chemistry and Hematology, Gelre Hospitals, Apeldoorn, The Netherlands
Adam Miszta

¹Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands

²Synapse Research Institute, Maastricht, The Netherlands

⁵Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Abstract

Physical activity is beneficial for health, for example, by lowering the risk of cardiovascular events. However, vigorous exercise is associated with the occurrence of thromboembolic events and sudden cardiac death, in particular in untrained individuals. Whereas acute exercise is known to cause a hypercoagulable state, repeated exposure to (strenuous) exercise by means of training may actually condition the hemostatic response to exercise. To date, the effects of exercise training on blood coagulability and the underlying mechanisms have yet to be fully discerned. In this review, the authors provide an overview of existing literature on how training programs and training status influence hemostasis in healthy individuals. Furthermore, they present data of a pilot study in which we studied the effects of repetitive submaximal intensity cycling on procoagulant and anticoagulant processes. It is known that factor VIII (FVIII) and von Willebrand factor (VWF) increase after exercise, but we found that this increase in FVIII and VWF (antigen, propeptide, and VWF in active conformation) was smaller on each of three subsequent days, suggesting either adaptation of endothelial activation or exhaustion of endothelial VWF supplies. With respect to thrombin generation, elevated FVIII significantly increased the thrombin generation peak but not the endogenous thrombin potential. In contrast, platelet activation in terms of P-selectin expression after stimulation with protease-activated receptor-1 and glycoprotein VI agonists decreased after exercise and did not recover, indicating exhaustion of the platelet response to repetitive exercise.

Keywords

physical training - repetitive exercise - hemostasis - coagulation - fibrinolysis

Full Text

References

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