Olsen Line Nørregaard, Fischer Mads, Evans Phillip Adrian, Gliemann Lasse, Hellsten Ylva
Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
Haemostasis Biomedical Research Unit, Welsh Centre for Emergency Medicine Research, Morriston Hospital, SBU Health Board, Swansea, United Kingdom.
Front Physiol. 2021 Feb 23;12:636027. doi: 10.3389/fphys.2021.636027. eCollection 2021.
Arterial thrombosis is the primary cause of death worldwide, with the most important risk factors being smoking, unhealthy diet, and physical inactivity. However, although there are clear indications in the literature of beneficial effects of physical activity in lowering the risk of cardiovascular events, exercise can be considered a double-edged sword in that physical exertion can induce an immediate pro-thrombotic environment. Epidemiological studies show an increased risk of cardiovascular events after acute exercise, a risk, which appear to be particularly apparent in individuals with lifestyle-related disease. Factors that cause the increased susceptibility to arterial thrombosis with exercise are both chemical and mechanical in nature and include circulating catecholamines and vascular shear stress. Exercise intensity plays a marked role on such parameters, and evidence in the literature accordingly points at a greater susceptibility to thrombus formation at high compared to light and moderate intensity exercise. Of importance is, however, that the susceptibility to arterial thrombosis appears to be lower in exercise-conditioned individuals compared to sedentary individuals. There is currently limited data on the role of acute and chronic exercise on the susceptibility to arterial thrombosis, and many studies include incomplete assessments of thrombogenic clotting profile. Thus, further studies on the role of exercise, involving valid biomarkers, are clearly warranted.
动脉血栓形成是全球范围内主要的死亡原因，最重要的危险因素是吸烟、不健康饮食和缺乏身体活动。然而，尽管文献中有明确迹象表明身体活动对降低心血管事件风险有益，但运动可被视为一把双刃剑，因为体力消耗会诱发即时的促血栓形成环境。流行病学研究表明，急性运动后心血管事件风险增加，这种风险在患有与生活方式相关疾病的个体中似乎尤为明显。运动导致动脉血栓形成易感性增加的因素既有化学性质的，也有机械性质的，包括循环儿茶酚胺和血管剪切应力。运动强度在这些参数上起着显著作用，因此文献证据表明，与轻度和中度强度运动相比，高强度运动时血栓形成的易感性更高。然而，重要的是，与久坐不动的个体相比，经过运动训练的个体对动脉血栓形成的易感性似乎更低。目前关于急性和慢性运动对动脉血栓形成易感性作用的数据有限，许多研究对血栓形成凝血谱的评估并不完整。因此，显然有必要开展更多涉及有效生物标志物的运动作用研究。
