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

Chris H.H. Chan, Margaret R. Passmore, Oystein Tronstad, Helen Seale, Mahe Bouquet, Nicole White, Jun Teruya, Airlie Hogan, David Platts, Wandy Chan, Alexander M. Dashwood, David C. McGiffin, Andrew J. Maiorana, Christopher S. Hayward, Michael J. Simmonds, Geoff D. Tansley, Jacky Y. Suen, John F. Fraser, Bart Meyns, Libera FresielloSteven Jacobs

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Pages (from-to)11-20
Number of pages10
JournalASAIO journal (American Society for Artificial Internal Organs : 1992)
Volume71
Issue number1
DOIs
Publication statusPublished - 1 Jan 2025

Keywords

  • 2025 OA procedure

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