The Impact of Acute Exercise on Hemostasis and Angiogenesis Mediators in Patients With Continuous-Flow Left Ventricular Assist Devices: A Prospective Observational Pilot Study

Author:

Chan Chris H. H.1234,Passmore Margaret R.13,Tronstad Oystein15,Seale Helen5,Bouquet Mahe13,White Nicole16,Teruya Jun7,Hogan Airlie8,Platts David8,Chan Wandy89,Dashwood Alexander M.89,McGiffin David C.11011,Maiorana Andrew J.1213,Hayward Christopher S.1415,Simmonds Michael J.16,Tansley Geoff D.12,Suen Jacky Y.13,Fraser John F.13,Meyns Bart17,Fresiello Libera1718,Jacobs Steven17

Affiliation:

1. the Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia

2. School of Engineering and Built Environment, Griffith University, Gold Coast, Australia

3. Faculty of Medicine, University of Queensland, Brisbane, Australia

4. Innovative Device & Engineering Applications Laboratory, Texas Heart Institute, Houston, Texas

5. Physiotherapy Department, The Prince Charles Hospital, Brisbane, Australia

6. School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia

7. Departments of Pathology & Immunology, Pediatrics, and Medicine, Baylor College of Medicine, Houston, Texas

8. Department of Cardiology, The Prince Charles Hospital, Brisbane, Australia

9. Cardio-Vascular Molecular and Therapeutics Translational Research Group, University of Queensland, Brisbane, Australia

10. Department of Cardiothoracic Surgery and Transplantation, The Alfred Hospital, Melbourne, Australia

11. Department of Cardiothoracic Surgery, Monash University, Melbourne, Australia

12. Allied Health Department, Fiona Stanley Hospital, Perth, Australia

13. Curtin School of Allied Health, Curtin University, Perth, Australia

14. Heart Failure and Transplant Unit, St. Vincent’s Hospital, Sydney, Australia

15. Victor Chang Cardiac Research Institute, Sydney, Australia

16. Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia

17. Department of Cardiovascular Sciences, Cardiac Surgery, Katholieke Universiteit Leuven, Leuven, Belgium; and

18. Group of Cardiovascular and Respiratory Physiology, University of Twente, Enschede, The Netherlands.

Abstract

Impaired primary hemostasis and dysregulated angiogenesis, known as a two-hit hypothesis, are associated with gastrointestinal (GI) bleeding in patients with continuous-flow left ventricular assist devices (CF-LVADs). Exercise is known to influence hemostasis and angiogenesis in healthy individuals; however, little is known about the effect in patients with CF-LVADs. The objective of this prospective observational study was to determine whether acute exercise modulates two-hit hypothesis mediators associated with GI bleeding in patients with a CF-LVAD. Twenty-two patients with CF-LVADs performed acute exercise either on a cycle ergometer for approximately 10 minutes or on a treadmill for 30 minutes. Blood samples were taken pre- and post-exercise to analyze hemostatic and angiogenic biomarkers. Acute exercise resulted in an increased platelet count (p < 0.00001) and platelet function (induced by adenosine diphosphate, p = 0.0087; TRAP-6, p = 0.0005; ristocetin, p = 0.0009). Additionally, high-molecular-weight vWF multimers (p < 0.00001), vWF collagen-binding activity (p = 0.0012), factor VIII (p = 0.034), angiopoietin-1 (p = 0.0026), and vascular endothelial growth factor (p = 0.0041) all increased after acute exercise. This pilot work demonstrates that acute exercise modulated two-hit hypothesis mediators associated with GI bleeding in patients with CF-LVADs.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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