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A Preclinical Model of Exertional Heat Stroke in Mice
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Hemostasis during Extreme Exertion.

Cécile Hélène Kicken1,2, Adam Miszta2,3, Hilde Kelchtermans2,4

  • 1Department of Anesthesiology and Pain Therapy, Maastricht University Medical Center, Maastricht, The Netherlands.

Seminars in Thrombosis and Hemostasis
|May 5, 2018
PubMed
Summary
This summary is machine-generated.

Extreme exercise temporarily shifts hemostasis towards a hypercoagulable and hyperfibrinolytic state. Recovery may disrupt this balance, increasing thrombosis risk, especially in women.

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Area of Science:

  • Cardiovascular Physiology
  • Hemostasis and Thrombosis
  • Exercise Science

Background:

  • Exercise offers cardiovascular protection but can paradoxically trigger sudden cardiac death.
  • Extreme exertion induces a temporary rebalanced hemostatic state characterized by hypercoagulability and enhanced fibrinolysis.
  • Novel hemostasis quantification techniques offer new insights into exercise-induced hemostatic changes.

Purpose of the Study:

  • To review the effects of short- and long-duration extreme exertion on coagulation, fibrinolysis, and hemostatic recovery.
  • To explore the role of the vascular endothelium in exercise-induced hemostatic alterations.
  • To identify gaps in knowledge regarding exercise, hemostasis, and sex-based differences.

Main Methods:

  • Literature review of recent studies on extreme exertion and hemostasis.
  • Analysis of coagulation and fibrinolysis markers following intense exercise.
  • Examination of hemostatic recovery patterns and the impact of training.

Main Results:

  • Extreme exertion transiently increases hypercoagulability (via contact pathway, FVIII, vWF, platelets) and fibrinolysis (via t-PA).
  • The vascular endothelium is central to these exercise-induced hemostatic changes.
  • Hypercoagulability persists longer than hyperfibrinolysis post-exertion, potentially disrupting balance during recovery.

Conclusions:

  • The hemostatic balance may be compromised during recovery from extreme exertion, warranting further investigation into thrombosis risk.
  • Endurance training attenuates the hemostatic response to exertion and accelerates recovery.
  • Further research is crucial to address sex-based differences in exercise-related cardiovascular events and hemostatic responses.