Combined effect of acute altitude exposure and vigorous exercise on platelet activation

Abstract

Exposure to high altitudes and exercise alters body's physiology and may cause acute cardiovascular events. Platelet activation is one of the key players in these events. Therefore, we investigated the effect of vigorous exercise at higher altitude (2650 m) on platelet aggregation and serum markers of platelet activation. 14 healthy subjects performed a step incremental ergometer test until exhaustion at the Environmental Research Station (UFS, 2650 m) at Zugspitze. Platelet aggregation and serum levels of endothelin-1, soluble p-selectin, platelet factor 4 and Chromogranin A were measured. Platelet activation was significantly enhanced after exercise at high altitude compared to measures immediately prior exercise. We detected significantly enhanced serum levels of endothelin-1 and soluble p-selectin whereas chromogranin A and platelet factor 4 remained unchanged. This effect might be due to increased endothelin-1 levels causing pulmonary vasoconstriction, rheological changes and direct platelet activation. This might be of clinical relevance, especially in patients with pre-existing diseases.

Fig. 1

Impedance aggregometric measurement of platelet activation stimulated with adenosine diphos-phate (ADP, A) and arachidonic acid (AA, B) is depicted. Results are given as Area Under Aggregation Curve (AUC). Results show levels of soluble p-selectin (C), PF4 (D), Chromogranin A (E) and Endothelin-1 (F) before and after exercise testing.