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DOI: 10.1055/s-0038-1650375
Enhanced Platelet Aggregability under High Shear Stress after Treadmill Exercise in Patients with Effort Angina
Publication History
Received 25 July 1995
Accepted after resubmission 22 January 1996
Publication Date:
10 July 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035024/199605/lookinside/thumbnails/10-1055-s-0038-1650375-1.jpg)
Summary
Platelet activation induced by shear forces occurring in a stenosed coronary artery is one of the mechanisms of coronary thrombosis. We evaluated the shear-induced platelet aggregation (SIPA) dynamics in patients with effort angina during treadmill exercise. SIPA was measured by a rotational cone-plate aggregometer. SIPA was markedly increased by exercise from 71.2 ± 8.9% to 81.9 ± 7.6% (p <0.01) in the patient group. Although epinephrine concentrations were elevated, its rate of increase was not correlated with that of SIPA. Yohimbine partially inhibited the exercise-induced increase in SIPA. In contrast, a significant correlation between the changing rate of plasma von Willebrand factor (vWF) larger multimers and that of SIPA (r = 0.74, p <0.05) was observed. Exercise-augmented SIPA is probably dependent on an increase in vWF larger multimers rather than platelet alpha2-receptor activation. Prevention of the interaction between vWF and its platelet receptors may play some role in decreasing the risk of coronary thrombosis during exercise.
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References
- 1 O’Brien JR. Shear-induced platelet aggregation. Lancet 1990; 335: 711-713
- 2 Nichols TC, Bellinger DA, Reddick RL, Read MS, Koch GG, Brinkhous KM, Griggs TR. Role of von Willebrand factor in arterial thrombosis. Studies in normal and von Willebrand disease pigs. Circulation 1991; 83 (Suppl IV): IV 56-64
- 3 Ikeda Y, Handa M, Kawano K, Kamata T, Murata M, Araki Y, Anbo H, Ka-wai Y, Watanabe K, Itagaki I, Sasaki K, Ruggeri ZM. The role of von Willebrand factor and fibrinogen in platelet aggregation under varying shear stress. J Clin Invest 1991; 87: 1234-1240
- 4 Peterson DM, Stathopoulos NA, Giorgio TD, Heliums JH, Moake JL. Shear-induced platelet aggregation requires von Willebrand factor and platelet membrane glycoproteins Ib and IIb-IIIa. Blood 1987; 69: 625-628
- 5 O’Brien JR, Salmon GP. Shear stress activation of platelet glycoprotein IIb/IIIa plus von Willebrand factor causes aggregation: Filter blockage and the long bleeding time in von Willebrand’s disease. Blood 1987; 70: 1354-1361
- 6 Moake JL, Turner NA, Stathopoulos NA, Nalasco L, Heliums JD. Shear-induced platelet aggregation can be mediated by vWF released from platelets, as well as by exogenous large or unusually large vWF multimers, requires adenosine diphosphate, and is resistant to aspirin. Blood 1988; 71: 1366-1374
- 7 Hardwick RA, Heliums JD, Peterson DM, Moake JL, Olson JD. The effect of PGI2 and theophylline on the response of platelets subjected to shear stress. Blood 1981; 58: 678-681
- 8 Lipowsky HH, Usami S, Chien S. In vivo measurements of “apparent viscosity” and microvessel hematocrit in the mesentery of the cat. Microvasc Res 1980; 19: 297-319
- 9 Back LD, Radbill JR, Crawford DW. Analysis of pulsatile, viscous blood flow through diseased coronary arteries of man. J Biochem 1977; 10: 339-353
- 10 Folts JD, Gallagher K, Rowe GG. Blood flow reductions in stenosed canine coronary arteries: Vasospasm or platelet aggregation?. Circulation 1982; 65: 248-255
- 11 Bellinger DA, Nichols TC, Read MS, Reddick RL, Lamb MA, Brinkhous KM, Evatt BL, Griggs TR. Prevention of occlusive coronary artery thrombosis by a murine monoclonal antibody to porcine von Willebrand factor. Proc Natl Acad Sci USA 1987; 84: 8100-8104
- 12 Strony J, Phillips M, Brands D, Moake J, Adelman B. Aurintricarboxylic acid in a canine model of coronary artery thrombosis. Circulation 1990; 81: 1106-1114
- 13 Gold HK, Yasuda T, Jang IK, Guerrero JL, Fallon JT, Leinbach RC, Collen D. Animal models for arterial thrombolysis and prevention of reocclusion. Erythrocyte-rich versus platelet-rich thrombus. Circulation 1991; 83 (Suppl IV): IV 26-40
- 14 Moake JL, Turner NA, Stathopoulos NA, Nolasco LN, Heliums JD. Involvement of large plasma von Willebrand factor (vWF) multimers and unusually large vWF forms derived from endothelial cells in shear stress-induced platelet aggregation. J Clin Invest 1986; 78: 1456-1461
- 15 Casonato A, Marco LD, Mazzucato M, Angelis VD, Roia DD, Fabris F, Ruggeri ZM, Girolami A. A new congenital platelet abnormality characterized by spontaneous platelet aggregation, enhanced von Willebrand factor platelet interaction, and the presence of all von Willebrand factor multimers in plasma. Blood 1989; 74: 2028-2033
- 16 Goto S, Ikeda Y, Murata M, Handa M, Takahashi E, Yoshioka A, Fujimura Y, Fukuyama M, Handa S, Ogawa S. Epinephrine augments von Willebrand factor-dependent shear-induced platelet aggregation. Circulation 1992; 86: 1859-1863
- 17 Willich SN, Linderer T, Wegscheider K, Leizorovicz A, Alamercery I, Schroder R. the ISAM Study Group Increased morning incidence of myocardial infarction in the ISAM study: Absence with prior beta-adrenergic blockade. Circulation 1989; 80: 853-858
- 18 Toiler GH, Brezinski D, Schafer AI, Czeisler CA, Rutherford JD, Willich SN, Gleason RE, Williams GH, Muller JE. Concurrent morning increase in platelet aggregability and the risk of myocardial infarction and sudden cardiac death. N Engl J Med 1987; 316: 1514-1518
- 19 Kawano K, Ikeda Y, Handa M, Kamata T, Anbo H, Araki Y, Kawai Y, Watanabe K, Itagaki I, Kawakami K, Fukuyama M, Sakai K. Enhancing effect by heparin on shear-induced platelet aggregation. Semin Thromb Hemost 1990; 16: 160-165
- 20 Fukuyama M, Sakai K, Itagaki I, Kawano K, Murata M, Kawai Y, Watanabe K, Handa M, Ikeda Y. Continuous measurement of shear-induced platelet aggregation. Thromb Res 1989; 54: 253-260
- 21 Amiral J, Adalbert B, Adam M. Application of enzyme immunoassays to coagulation testing. Clin Chem 1984; 30: 1512-1516
- 22 Ruggeri ZM, Zimmerman TS. The complex multimeric composition of factor VIII/von Willebrand factor. Blood 1981; 57: 1140-1143
- 23 Tomita Y, Harrison J, Abildgaard CF. von Willebrand factor multimer analysis using a sensitive peroxidase staining method. Thromb Haemost 1989; 62: 781-783
- 24 Taylor RB, Reid R, Kendle KE, Geddes C, Curie PF. Assay procedures for the determination of biogenic amines and their metabolites in rat hypothalamus using ion-pairing reversed-phase high-performance liquid chromatography. J Chromatogr 1983; 277: 101-114
- 25 Lubbecke F, Zschatzsch S, Mitrovic V, Husseini H, Schlepper M, Lasch HG, Schutterle G, Wizemann V. Catecholamines and thrombocyte alpha2-adrenoceptors in patients with acute myocardial infarction. Eur Heart J 1991; 12: 88-91
- 26 Bloom AL. von Willebrand factor: Clinical features of inherited and acquired disorders. Mayo Clin Proc 1991; 66: 743-751
- 27 Herren T, Bartsch P, Haeberli A, Straub PW. Increased thrombin-antithrombin III complexes after 1 h of physical exercise. J Appl Physiol 1992; 73: 2499-2504
- 28 Hansen JB, Wilsgard L, Olsen JO, Osterud B. Formation and persistence of procoagulant and fibrinolytic activities in circulation after strenuous physical exercise. Thromb Haemost 1990; 64: 385-389
- 29 Weiss HJ, Hawiger J, Ruggeri ZM, Turitto VT, Thiagarajan P, Hoffmann T. Fibrinogen-independent platelet adhesion and thrombus formation on subendothelium mediated by glycoprotein IIb-IIIa complex at high shear rate. J Clin Invest 1989; 83: 288-297
- 30 La Croix KA, Davis GL, Schneider DA, Lavoie P, Kintzing E, Waterfield DA. The effects of acute exercise and increased atmospheric pressure on the hemostatic mechanism and plasma catecholamine levels. Thromb Res 1990; 57: 717-728
- 31 Chandler WL, eith RC, Fellingham GW, Levy WC, Schwartz RS, Cer-queira M, Kahn SE, Larson VG, Cain KC, Beard JC, Abrass IB, Stratton JR. Fibrinolytic response during exercise and epinephrine infusion in the same subjects. J Am Coll Cardiol 1992; 19: 1412-1420
- 32 Eidt JF, Ashton J, Golino P, McNatt J, Buja LM, Willerson JT. Treadmill exercise promotes cyclic alterations in coronary blood flow in dogs with coronary artery stenosis and endotherial injury. J Clin Invest 1989; 84: 517-527
- 33 Kestin AS, Ellis PA, Barnard MR, Errichetti A, Rosner BA, Michelson AD. Effect of strenuous exercise on platelet activation state and reactivity. Circulation 1993; 88: 1502-1511
- 34 Vicente V, Alberca I, Mannucci PM. Reduced effect of exercise and DDAVP on factor VUI-von Willebrand factor and plasminogen activator after sequential application of both the stimuli. Thromb Haemost 1984 51: 129-130
- 35 Musumeci V, Cardillo C, Baroni S, Zuppi C, Zappacosta B, Tutinelli F, Folli G. Effects of calcium channel blockers on the endothelial release of von Willebrand factor after exercise in healthy subjects. J Lab Clin Med 1989; 113: 525-531