Heart Failure Center, Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan.
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan.
Thromb Res. 2020 Mar;187:159-165. doi: 10.1016/j.thromres.2020.01.013. Epub 2020 Jan 15.
Consumptive coagulopathy is associated with increased mortality in patients with heart failure (HF). Physical activity influences the risk of major vascular thrombotic events. This study investigates how high-intensity interval training (HIIT) affects the capacity of endogenous thrombin generation (TG) by modulating circulatory procoagulant microparticles (MPs) in HF patients.
Thirty-eight HF patients with reduced ejection fraction (HFrEF) and 38 age- and gender-matched normal counterparts (NC) were recruited into this study. The HFrEF group performed HIIT (3-min intervals at 40% and 80%VO) on a bicycle ergometer for 30 min/day, 3 days/week for 12 weeks, whereas the NC group did not receive any form of intervention. Plasma TG kinetics, procoagulant MPs, coagulation-related factors, and oxidative stress/proinflammatory status were analyzed.
The HFrEF group exhibited (i) less endogenous thrombin potential (ETP) and TG rate, (ii) lower concentration/activity of tissue factor (TF) and counts of TF-rich MPs derived from blood cells, and (iii) higher vascular endothelial shedding and plasma myeloperoxidase and interleukin-6 concentrations, compared to the NC group did. However, HIIT elevated TG rate and TF concentration/activity in plasma, as well as, TF-rich MP counts derived from blood cells in patients with HFrEF. Moreover, the exercise regimen also decreased vascular endothelial shedding and plasma myeloperoxidase and interleukin-6 concentrations in HFrEF patients.
HFrEF reduces the capacity of endogenous TG in plasma, which is associated with decreased (or consumed) circulatory procoagulant MP levels. However, HIIT alleviates HFrEF-declined endogenous TG capacity and vascular endothelial damage through recuperating TF-related coagulation activity and suppressing oxidative stress/proinflammatory status.
消耗性凝血病与心力衰竭（HF）患者的死亡率增加有关。身体活动影响主要血管血栓栓塞事件的风险。本研究调查了高强度间歇训练（HIIT）如何通过调节 HF 患者循环促凝微粒（MPs）来影响内源性凝血酶生成（TG）的能力。
这项研究纳入了 38 名射血分数降低的 HF 患者（HFrEF）和 38 名年龄和性别匹配的正常对照组（NC）。HFrEF 组在自行车测功计上进行 HIIT（40%和 80%VO 的 3 分钟间隔），每天 30 分钟，每周 3 天，共 12 周，而 NC 组未接受任何形式的干预。分析了血浆 TG 动力学、促凝 MPs、凝血相关因子和氧化应激/促炎状态。
与 NC 组相比，HFrEF 组表现出（i）较低的内源性凝血酶潜能（ETP）和 TG 率，（ii）较低的组织因子（TF）浓度/活性和源自血细胞的 TF 丰富 MPs 计数，以及（iii）较高的血管内皮脱落和血浆髓过氧化物酶和白细胞介素-6 浓度。然而，HIIT 提高了 HFrEF 患者的 TG 率和 TF 浓度/活性以及源自血细胞的 TF 丰富 MPs 计数。此外，运动方案还降低了 HFrEF 患者的血管内皮脱落和血浆髓过氧化物酶和白细胞介素-6 浓度。
HFrEF 降低了血浆中内源性 TG 的能力，这与循环促凝 MP 水平的降低（或消耗）有关。然而，HIIT 通过恢复 TF 相关的凝血活性和抑制氧化应激/促炎状态来减轻 HFrEF 降低的内源性 TG 能力和血管内皮损伤。
