title: Acute impact of conventional and eccentric cycling on platelet and vascular function in patients with chronic heart failure.
abstract: Evidence-based guidelines recommend exercise therapy for patients with chronic heart failure (CHF). Such patients have increased atherothrombotic risk. Exercise can transiently increase platelet activation and reactivity and decrease vascular function in healthy participants, although data in CHF are scant. Eccentric (ECC) cycling is a novel exercise modality that may be particularly suited to patients with CHF, but the acute impacts of ECC cycling on platelet and vascular function are currently unknown. Our null hypothesis was that ECC and concentric (CON) cycling, performed at matched external workloads, would not induce changes in platelet or vascular function in patients with CHF. Eleven patients with heart failure with reduced ejection fraction (HFrEF) took part in discrete bouts of ECC and CON cycling. Before and immediately after exercise, vascular function was assessed by measuring diameter and flow-mediated dilation (FMD) of the brachial artery. Platelet function was measured by the flow cytometric determination of glycoprotein IIb/IIIa activation and granule exocytosis in the presence and absence of platelet agonists. ECC cycling increased baseline artery diameter (pre: 4.0 ± 0.8 mm vs. post: 4.2 ± 0.7 mm;P= 0.04) and decreased FMD%. When changes in baseline artery diameter were accounted for, the decrease in FMD post-ECC cycling was no longer significant. No changes were apparent after CON. Neither ECC nor CON cycling resulted in changes to any platelet-function measures (allP> 0.05). These results suggest that both ECC and CON cycling, at a moderate intensity and short duration, can be performed by patients with HFrEF without detrimental impacts on vascular or platelet function.NEW & NOTEWORTHYThis is the first evidence to indicate that eccentric (ECC) cycling can be performed relatively safely by patients with chronic heart failure (CHF), as it did not result in impaired vascular or platelet function compared with conventional cycling. This is important, as acute exercise can transiently increase atherothrombotic risk, and ECC cycling is a novel exercise modality that may be particularly suited to patients with CHF.
authors.affiliation: School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia.
authors.forename: Andrew
authors.identifier: http://orcid.org/0000-0001-7312-8265
authors.initials: A
authors.lastname: Haynes
authors.affiliation: School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Linden
authors.affiliation: School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia.
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Chasland
authors.affiliation: Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia.
authors.forename: Kazunori
authors.identifier: http://orcid.org/0000-0001-7373-4994
authors.initials: K
authors.lastname: Nosaka
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia.|Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Maiorana
authors.affiliation: Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom; and.
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Dawson
authors.affiliation: Advanced Heart Failure and Cardiac Transplantation Unit, Fiona Stanley Hospital, Perth, Western Australia.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Dembo
authors.affiliation: School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia.|Allied Health Department, Fiona Stanley Hospital, Perth, Western Australia.
authors.forename: Louise H
authors.initials: LH
authors.lastname: Naylor
authors.affiliation: School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia; danny.green@uwa.edu.au.|Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom; and.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Green
mesh_terms: D001642:Bicycling / Q000502:physiology; D001792:Blood Platelets / Q000378:metabolism / Q000502:physiology*; D002908:Chronic Disease; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy; D005260:Female; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D005082:Physical Exertion / Q000502:physiology; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000378:metabolism
chemical_list: D019039:Platelet Glycoprotein GPIIb-IIIa Complex
keywords: chronic heart failure; eccentric exercise; platelets; vascular function