title: The effect of exercise on von Willebrand factor and ADAMTS-13 in individuals with type 1 and type 2B von Willebrand disease.
abstract: BACKGROUND
  The effect of exercise on von Willebrand factor (VWF) and ADAMTS-13 levels in individuals with von Willebrand disease (VWD) has never been reported.
  
  
  OBJECTIVE
  The aim was to quantify the effect of a standardized exercise protocol on individuals with type 1 and type 2B VWD.
  
  
  METHODS
  Thirty individuals from three groups (10 controls, 11 with type 1 VWD and 9 with type 2B VWD) completed the Standard Bruce Protocol Treadmill Test. A bleeding questionnaire was administered and blood tests were performed pre- and immediately postexercise. The groups were well matched for age, gender and body mass index (BMI).
  
  
  RESULTS
  There was a correlation in all groups between the metabolic equivalents (METS) achieved and the degree of change of VWF and FVIII:C levels (P < 0.002, Pearson's correlation). There was a significant postexercise increase in VWF:Ag, VWF:RCo, FVIII:C and activated VWF levels in both the control group and in the type 2B VWD group, but not in the type 1 VWD group. Specific to the type 2B VWD group was an increase in the percentage of high molecular weight multimers (P = 0.022), a decrease in the mean platelet count compared with the other groups (P < 0.001) and an increase in the ADAMTS-13 level (P = 0.001).
  
  
  CONCLUSIONS
  There are significant differences in the effects of exercise on individuals with type 1 and type 2B VWD compared with controls. Further clinical studies are necessary to evaluate exercise as a therapeutic option in VWD.
authors.affiliation: Department of Medicine, Queen's University, Kingston, ON, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Stakiw
authors.forename: M
authors.initials: M
authors.lastname: Bowman
authors.forename: C
authors.initials: C
authors.lastname: Hegadorn
authors.forename: C
authors.initials: C
authors.lastname: Pruss
authors.forename: C
authors.initials: C
authors.lastname: Notley
authors.forename: E
authors.initials: E
authors.lastname: Groot
authors.forename: P J
authors.initials: PJ
authors.lastname: Lenting
authors.forename: D
authors.initials: D
authors.lastname: Rapson
authors.forename: D
authors.initials: D
authors.lastname: Lillicrap
authors.forename: P
authors.initials: P
authors.lastname: James
mesh_terms: D051722:ADAM Proteins / Q000097:blood*; D000071120:ADAMTS13 Protein; D016022:Case-Control Studies; D015444:Exercise / Q000502:physiology*; D005169:Factor VIII / Q000032:analysis; D006801:Humans; D010976:Platelet Count; D014842:von Willebrand Diseases / Q000097:blood* / Q000145:classification / Q000628:therapy*; D014841:von Willebrand Factor / Q000032:analysis*
chemical_list: D014841:von Willebrand Factor; D005169:Factor VIII; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human