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The Journal of Sports Medicine and Physical Fitness 1999 March;39(1):31-6

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: English

Variations in hemostatic parameters after near-maximum exercise and specific tests in athletes

Cerneca F. 1, Crocetti G. 2, Gombacci A. 3, Simeone R. 1, Tamaro G. 1, Mangiarotti M. A. 1

1 Laboratory of Analysis IRCCS “Burlo Garofalo”, Trieste, Italy; 2 Regional Centre for Sports Medicine CONI - FMSI, Trieste, Italy; 3 Cardiology Unit IRCCS “Burlo Garofalo” and Regional Centre for Sports Medicine CONI-FMSI, Trieste, Italy


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Background. The clot­ting ­state of the ­blood chang­es accord­ing to the ­type of phys­i­cal exer­cise to ­which a ­group of ­healthy sub­jects are sub­ject­ed. We stud­ied the beha­vi­our of the coag­u­la­tion ­system ­before and ­after ­near-max­i­mum, spe­cif­ic and stan­dard­ized exer­cise ­tests in ­three ­groups of ­males prac­tis­ing ­sports ­defined as demand­ing in ­terms of car­di­o­vas­cu­lar out­put.
Methods. The ­study was a com­par­a­tive inves­ti­ga­tion ­between ath­letes and the ­group of con­trols com­posed of pre­sum­ably ­healthy ­males. Setting: athletes train­ing for com­pe­ti­tions ­such as mar­a­thon, row­ing and weight­lift­ing. Participants and Interventions: we test­ed 7 row­ers ­using the row­ing ­machine, 12 mar­a­thon run­ners ­using the tread­mill, 7 weight­lift­ers ­using ­their own exer­cise equip­ment, and 7 ­healthy sub­jects (con­trols) ­using the ­cycle ergom­e­ter. Measures: during the ­tests we mon­i­tored ­heart ­rates, max­i­mal oxy­gen ­intake, anaer­o­bic thresh­old, res­pir­a­to­ry quo­tient, max­i­mum ven­ti­la­tion, and lac­tic ­acid. The fol­low­ing coag­u­la­tion ­tests ­were per­formed ­before and ­after ­near-max­i­mum exer­cise: pro­throm­bin ­time (PT), par­tial acti­vat­ed throm­bo­plas­tin ­time (PTT), fibrino­gen (FBG), anti­throm­bin III (­ATIII), pro­tein C (PC), pro­tein S (PS), pro­throm­bin frag­ment 1+2 (F1+2), tis­sue acti­va­tor of plas­mi­no­gen (t-PA) and its inhib­i­tor (PAI).
Results. The ­most sig­nif­i­cant ­results ­showed a low ­basal PC in the row­ers ­which ­decreased fur­ther ­after ­near-max­i­mum exer­cise; sig­nif­i­cant­ly high­er ­basal activ­ities of ­ATIII, PC and PS in the mar­a­thon run­ners com­pared to the row­ers; a ­high pro­por­tion of weight­lift­ers ­showed a reduc­tion in t-PA ­after exer­cise and an ­increase of PAI; the con­trols ­were the ­only ­group in ­which fibrin­o­lyt­ic activ­ity and all the cir­cu­lat­ing anti­co­ag­u­lants ­increased ­after ­near-max­i­mum exer­cise. Thus sub­jects who prac­tise aero­bic ­sports dif­fer prin­ci­pal­ly in ­terms of vari­a­tions in inhib­i­tors (low PC in row­ers and mar­a­thon run­ners, ­increased pres­ence of inhib­i­tors in con­trols). The weight­lift­ers did not ­show any sig­nif­i­cant vari­a­tions, and so the ­kind of exer­cise ­involved (train­ing to ­increase resis­tence and max­i­mum ­strength) and the recov­ery ­times ­between the exer­cis­es do not ­seem to trig­ger chang­es in coag­u­la­tion/fib­ri­nol­y­sis.
Conclusions. We can there­fore con­firm ­that ­only rel­a­tive­ly pro­longed ­effort can trig­ger a mech­a­nism ben­e­fi­cial to the car­di­o­vas­cu­lar ­system. In con­clu­sion, phys­i­cal activ­ity ben­e­fits the coag­u­la­tion ­system par­tic­u­lar­ly as ­regards fib­ri­nol­y­sis, but cer­tain sub­jects may be at ­risk of throm­bo­sis and ­these ­must be iden­ti­fied and fol­lowed. We sug­gest ­that fibrin­o­lyt­ic activ­ity be stud­ied in ath­letes who prac­tise weight­lift­ing and ­have a his­to­ry of car­di­o­vas­cu­lar dis­ease, and ­that inhib­i­tors (pro­tein C in par­tic­u­lar) be stud­ied in row­ers ­with a fam­i­ly his­to­ry of throm­boem­bo­lism.

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