Exhaustive Exercise with High Eccentric Components Induces Prothrombotic and Hypofibrinolytic Responses in Boys

Abstract

It is known that coagulation and fibrinolysis are activated after exercise, and that the response is related to exercise intensity. The contribution, however, of eccentric exercise has not yet been investigated. Twenty boys (age 13 years) were randomly assigned to two experimental groups, which had to perform a monopedal stepping exercise until exhaustion. One group had to step up and down (U/D) in the same rhythm of one second each, while the other group (U/DD) had to step up during one second and to step down during two seconds, thereby experiencing a higher eccentric load. Blood samples were collected before and at 0, 1, and 24 hrs after exercise, and F VIII, t-PA, PAI-1, and D-dimer were determined as markers for coagulation or fibrinolysis, respectively. While the tendency for hypercoagulability was counterbalanced by fibrinolysis in the U/D group, the U/DD group showed a prothrombotic and hypofibrinolytic hemostatic response. It is assumed that eccentric exercise, beyond the well-known muscle fiber damage, also leads to some damage of the endothelial cells, affecting their capacity to liberate sufficient amounts of fibrinolytic agents.

Key words

Exercise - muscle contractions - endothelium - coagulation - fibrinolysis

References

• 1 Adams G R, Duvoisin M R, Dudley G A. Magnetic resonance imaging and electromyography as indexes of muscle function.  J Appl Physiol. 1992;  73 1578-1583
• 2 Andrew M, Carter C, O'Brodovich H, Heigenhauser G. Increases in factor VIII complex and fibrinolytic activity are dependent on exercise intensity.  J Appl Physiol. 1986;  60 1917-1922
• 3 Armstrong R B, Taylor C R. Glycogen loss in rat muscles during locomotion on different inclines.  J Exp Biol. 1993;  176 135-144
• 4 Asmussen E. Positive and negative muscular work.  Acta Physiol Scand. 1953;  28 364-382
• 5 Bigland-Ritchie B, Woods J J. Integrated electromyogram and oxygen uptake during positive and negative work.  J Physiol. 1976;  260 267-277
• 6 Bonde-Petersen F, Knuttgen H G, Henriksson J. Muscle metabolism during exercise with concentric and eccentric contractions.  J Appl Physiol. 1972;  33 792-795
• 7 Bouma B N, Mosnier L O. Thrombin activatable fibrinolysis inhibitor (TAFI) at the interface between coagulation and fibrinolysis.  Pathophysiol Haemost Thromb. 2004;  33 375-381
• 8 Bourey R E, Santoro S A. Interactions of exercise, coagulation, platelets, and fibrinolysis - a brief review.  Med Sci Sports Exerc. 1988;  20 439-446
• 9 Colman R W. Role of the light chain of high molecular weight kininogen in adhesion, cell-associated proteolysis and angiogenesis.  Biol Chem. 2001;  382 65-70
• 10 Davis G L, Abildgaard C F, Bernauer E M, Britton M. Fibrinolytic and hemostatic changes during and after maximal exercise in males.  J Appl Physiol. 1976;  40 287-292
• 11 Duarte J A, Appell H J, Carvalho F, Bastos M L, Soares J M. Endothelium-derived oxidative stress may contribute to exercise-induced muscle damage.  Int J Sports Med. 1993;  14 440-443
• 12 Duarte J A, Magalhaes J F, Monteiro L, Almeida-Dias A, Soares J M, Appell H J. Exercise-induced signs of muscle overuse in children.  Int J Sports Med. 1999;  20 103-108
• 13 El-Sayed M S, Lin X, Rattu A J. Blood coagulation and fibrinolysis at rest and in response to maximal exercise before and after a physical conditioning programme.  Blood Coagul Fibrinol. 1995;  6 747-752
• 14 Esmon C T. The impact of the inflammatory response on coagulation.  Thromb Res. 2004;  114 321-327
• 15 Ferguson E W, Bernier L L, Banta G R, Yu-Yahiro J, Schoomaker E B. Effects of exercise and conditioning on clotting and fibrinolytic activity in men.  J Appl Physiol. 1987;  62 1416-1421
• 16 Gibala M J, MacDougall J D, Tarnopolsky M A, Stauber W T, Elorriaga A. Changes in human skeletal muscle ultrastructure and force production after acute resistance exercise.  J Appl Physiol. 1995;  78 702-708
• 17 Hansen J B, Wilsgard L, Olsen J O, Osterud B. Formation and persistence of procoagulant and fibrinolytic activities in circulation after strenuous physical exercise.  Thromb Haemost. 1990;  64 385-389
• 18 Hortobágyi T, Houmard J, Fraser D, Dudek R, Lambert J, Tracy J. Normal forces and myofibrillar disruption after repeated eccentric exercise.  J Appl Physiol. 1998;  84 492-498
• 19 MacIntyre D L, Reid W D, Lyster D M, Szasz I J, Mc-Kenzie D C. Presence of WBC, decreased strength, and delayed soreness in muscle after eccentric exercise.  J Appl Physiol. 1996;  80 1006-1013
• 20 Malm C, Lenkei R, Sjödin B. Effects of eccentric exercise on the immune system in men.  J Appl Physiol. 1999;  86 461-468
• 21 Matz R L, Andriantsitohaina R. Age-related endothelial dysfunction: potential implications for pharmacotherapy.  Drugs Aging. 2003;  20 527-550
• 22 Molz A B, Heyduck B, Lill H, Spanuth E, Rocker L. The effect of different exercise intensities on the fibrinolytic system.  Eur J Appl Physiol. 1993;  67 298-304
• 23 Nielson H B, Secher N H, Kappel M, Hanel B, Pedersen B. Lymphocyte, NK, and LAK cell responses to maximal exercise.  Int J Sports Med. 1996;  17 60-65
• 24 Prisco D, Paniccia R, Bandinelli B, Fedi S, Cellai A P, Liotta A A, Gatteschi L, Giusti B, Colella A, Abbate R, Gensini G F. Evaluation of clotting and fibrinolytic activation after protracted physical exercise.  Thromb Res. 1998;  89 73-78
• 25 Rankinen T, Vaisanen S, Penttila I, Rauramaa R. Acute dynamic exercise increases fibrinolytic activity.  Thromb Haemost. 1995;  73 281-286
• 26 Sackner M A, Gummels E M, Adams J A. Say NO to fibromyalgia and chronic fatigue syndrome: an alternative and complementary therapy to aerobic exercise.  Med Hypoth. 2004;  63 118-123
• 27 Speidl W S, Zeiner A, Nikfardjam M, Geppert A, Jordanova N, Niessner A, Zorn G, Maurer G, Schreiber W, Wojta J, Huber K. An increase of C-reactive protein is associated with enhanced activation of endogenous fibrinolysis at baseline but an impaired endothelial fibrinolytic response after venous occlusion.  J Am Coll Cardiol. 2005;  45 30-34
• 28 Spitler D L, Alexander W C, Hoffler G W, Doerr D F, Buchanan P. Haptoglobin and serum enzyme responses to maximal exercise in relation to physical fitness.  Med Sci Sports Exerc. 1984;  16 366-370
• 29 Vallance P. Nitric oxide synthesised from L-arginine mediates endothelium dependent dilatation in human veins in vivo.  Cardiovasc Res. 2000;  45 143-147
• 30 van den Burg P J, Hospers J E, Mosterd W L, Bouma B N, Huisveld I A. Aging, physical conditioning, and exercise-induced changes in hemostatic factors and reaction products.  J Appl Physiol. 2000;  88 1558-1564