Related Experiment Video
Updated: Sep 8, 2026

Surgical Placement of Catheters for Long-term Cardiovascular Exercise Testing in Swine
Published on: February 9, 2016
Fibrinolytic response to acute exercise in patients with peripheral arterial disease
C J Womack1, F M Ivey, A W Gardner
1Department of Medicine, Division of Gerontology, University of Maryland at Baltimore, Baltimore VA Medical Center, GRECC, Baltimore, MD 21201, USA. cwomack@pilot.msu.edu
Purpose:
Elevations in tissue plasminogen activator (tPA) are postulated to protect against atherothrombotic events during exercise. However, fibrinolytic response to repetitive bouts of symptom-limited exercise is unknown in peripheral arterial disease (PAD) patients, a population with impaired fibrinolysis and increased risk for ischemic events. The purpose of the present study was to evaluate the fibrinolytic response to repetitive bouts of symptom-limited exercise in PAD patients.
Methods:
Nine (8 male, 1 female) patients with Fontaine State II PAD were studied. Fasting blood samples for determination of tPA and plasminogen activator inhibitor (PAI-1) were obtained into an acidified citrate solution via an indwelling venous catheter before, immediately after, 30 min after, and 60 min after submaximal treadmill walking. Patients walked intermittently at 65% of maximal intensity achieved on a previous graded exercise test until 30 min of exercise was achieved.
Results:
Exercise increased tPA activity by 180% (0.5 +/- 0.16 IU.mL(-1) baseline, 1.4 +/- 1.2 IU.mL(-1) postexercise), and decreased PAI-1 activity by 40% (20.6 +/- 5.5 AU.mL(-1) baseline, 11.8 +/- 6.2 AU.mL(-1) postexercise), without changing tPA or PAI-1 antigen. Notably, plasma tPA activity levels 1 h after exercise remained elevated by 80%, whereas PAI-1 activity remained decreased by 49%. The decrease in PAI-1 significantly (P < 0.05) correlated with oxygen uptake (VO(2)) during submaximal exercise (r = -0.77).
Conclusion:
These findings demonstrate that repetitive bouts of symptom-limited exercise produce a substantial improvement in the fibrinolytic profile of PAD patients, which persists at least 1 h after exercise cessation.
Related Concept Videos
Clot Retraction and Fibrinolysis
Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Peripheral Artery Disease I: Introduction
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease V: Postoperative Nursing Management

