title: Chronic exercise leads to antiaggregant, antioxidant and anti-inflammatory effects in heart failure patients.
abstract: BACKGROUND
  Heart failure (HF) patients are at an increased risk of thrombotic events. Here, we investigated the effects of exercise training on platelet function and factors involved in its modulation in HF.
  
  
  METHODS
  Thirty HF patients were randomized to 6 months of supervised exercise training or to a control group that remained sedentary. Exercise training consisted of 30 min of moderate-intensity treadmill exercise, followed by resistance and stretching exercises, performed three times a week. Blood was collected before and after the intervention for platelet and plasma obtainment.
  
  
  RESULTS
  Peak VO2 increased after exercise training (18.0 ± 2.2 vs. 23.8 ± 0.5 mlO2/kg/min; p < 0.05). Exercise training reduced platelet aggregation induced by both collagen and ADP (approximately -6%; p < 0.05), as well as platelet nitric oxide synthase activity (0.318 ± 0.030 vs. 0.250 ± 0.016 pmol/10(8) cells; p < 0.05). No difference in the above-mentioned variables were observed in the control group. No significant difference was observed in intraplatelet cyclic guanosine monophosphate levels among groups. There was a significant increase in the activity of the antioxidant enzymes superoxide dismutase and catalase in plasma and platelets, resulting in a decrease in both lipid and protein oxidative damage. Systemic levels of the inflammatory markers C-reactive protein, fibrinogen, and tumour necrosis factor α were also reduced in HF after training.
  
  
  CONCLUSIONS
  Our results suggest that regular exercise training is a valuable adjunct to optimal medical management of HF, reducing platelet aggregation via antioxidant and anti-inflammatory effects, and, therefore, reducing the risk of future thrombotic events.
authors.affiliation: State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Luisa Ribeiro
authors.initials: LR
authors.lastname: de Meirelles
authors.affiliation: State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Matsuura
authors.affiliation: State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Angela de Castro
authors.initials: Ade C
authors.lastname: Resende
authors.affiliation: State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Angelo Antunes
authors.initials: AA
authors.lastname: Salgado
authors.affiliation: State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Natália Rodrigues
authors.initials: NR
authors.lastname: Pereira
authors.affiliation: State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Pedro Guimaraes
authors.initials: PG
authors.lastname: Coscarelli
authors.affiliation: State University of Rio de Janeiro, Rio de Janeiro, Brazil Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Antônio C
authors.initials: AC
authors.lastname: Mendes-Ribeiro
authors.affiliation: State University of Rio de Janeiro, Rio de Janeiro, Brazil tbrunini@uerj.br.
authors.forename: Tatiana M C
authors.initials: TM
authors.lastname: Brunini
mesh_terms: D000975:Antioxidants / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets / Q000201:enzymology / Q000276:immunology; D001938:Brazil; D006152:Cyclic GMP / Q000097:blood; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D018836:Inflammation Mediators / Q000097:blood*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D052580:Muscle Stretching Exercises; D019001:Nitric Oxide Synthase / Q000097:blood; D018384:Oxidative Stress; D010101:Oxygen Consumption; D010974:Platelet Aggregation; D010979:Platelet Function Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D055070:Resistance Training; D012307:Risk Factors; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D018836:Inflammation Mediators; D008055:Lipids; D019001:Nitric Oxide Synthase; D006152:Cyclic GMP
keywords: Blood platelets; exercise therapy; nitric oxide