Thrombin Potential and Thrombin Generation After Exhaustive Exercise

Abstract

Exhaustive exercise leads to an activation of blood coagulation, but the implications of this activation are still unclear. The aim of this study was to investigate if a hypercoagulant stage exists after exhaustive treadmill- or cycle exercise; intrinsic and extrinsic endogenous thrombin potential (ETP) were measured by using the method of Hemker et al. Thirteen healthy male subjects underwent an exhaustive treadmill (TR) or cycle (CY) ergometer test and a control-day in random order. Blood samples were taken, repeatedly, after a 30 min rest, immediately before and after, and 1 h after exercise for measuring intrinsic and extrinsic total thrombin potential (TTPin, TTPex) (including free and alpha 2 -macroglobulin-bound thrombin) and endogenous thrombin potential (ETPin, ETPex), aPTT, PT, F1 + 2 and TAT. In comparison to the pre-value taken immediately before the exercise, the intrinsic TTP was significantly (p < 0.05) increased directly after exercise (TR-TTPin, + 11.6 %; CY-TTPin, + 11.5 %). In contrast, ETPin remained unchanged after both exercises. Additionally for TTPex and ETPex, no changes after exercise were detectable. aPTT was significantly (p < 0.05) shorter after exercise (TR-aPTT, - 16.2 %; CY-aPTT - 17.5 %), F1 + 2-concentrations were higher (p < 0.05) (TR-F1 + 2, + 21.2 %; CY-F1 + 2, + 9.8 %), but TAT remained unchanged. Differences between TR or CY could not be determined. These results show the expected shortening of aPTT and the increase of F1 + 2 indicating an activation of the coagulation system during exercise. However, the unchanged intrinsic and extrinsic ETP lead to the conclusion that in healthy young male subjects the potential for thrombin generation is insignificant, is directly counterbalanced by alpha 2-macroglobulin and is independent of the type of exhaustive exercise done.

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

“…These results agree with other investigations which displayed TAT and F1 ? 2 increase after exercise, but they could not show significant differences between two exercise intensities (Acil et al 2007;Andrew et al 1986;Cadroy et al 2002;Drygas 1988;Hilberg et al 2002Hilberg et al , 2003bWeiss et al 1998a). In addition, Weiss et al (1998a), who examined trained subjects (rel.…”

“…An imbalance of this complex system proceeds towards an enhanced risk of cardiovascular diseases. It is well known that physical exercise induces an activation of coagulation and fibrinolysis, but this reaction depends on the exercise type, duration and intensity (Andrew et al 1986;Dufaux et al 1984;El-Sayed et al 2004;Hilberg et al 2002Hilberg et al , 2003bWeiss et al 1998a, c). In most studies, exercise duration is not comparable between the different test protocols (Acil et al 2007;Andrew et al 1986;Drygas 1988;Weiss et al 1998a).…”

Effects of KAATSU training on haemostasis in healthy subjects

“…Exercises have been shown to affect activation of both the coagulation and fibrinolytic cascades (Davis et al, 1976;Andrew et al, 1986;Boman et al, 1994;Weiss et al, 1998;El-Sayed et al, 2000;Ribeiro et al, 2006). Regular exercise preferentially activates fibrinolysis, which is generally associated with favorable alterations in risk from cardiovascular morbidity, while strenuous exercise may increase blood coagulation, and promote thrombus formation (Hilberg et al, 2002), resulting in exertion-related ischemic events (Giri et al, 1999). Thus, it is likely that effects of exercise on the haemostatis are Effects of KAATSU training on haemostasis in healthy subjects dependent upon exercises intensity and duration (Rosing et al, 1970;Weiss et al, 1998;Molz et al, 1993;Rankinen et al, 1995).…”

Pure eccentric exercise does not activate blood coagulation

“…In our own previous study, no difference could be observed between two types of exercise, e.g. after a maximal step test on a treadmill versus on a cycle ergometer (Hilberg et al 2002). Nevertheless, the observation of varying activation of blood coagulation after different types of exercise leads to the question of whether the eccentric component of treadmill exercise plays a role in thrombin generation after exercise.…”

“…Total and endogenous, intrinsic and extrinsic thrombin generation (TTPin, ETPin, TTPex, ETPex) were measured according to the method of Hemker et al 1993 exactly as described in a previous study (Hilberg et al 2002). TTP represents the total amount of thrombin generated in plasma including both free and a 2 -macroglobulin-bound thrombin (a 2 M-IIa) and ETP represents the endogenous (free) thrombin potential (ETP).…”