Thromb Haemost 2021; 121(07): 900-912
DOI: 10.1055/s-0040-1722191
Cellular Haemostasis and Platelets

Cycling Exercise Training Enhances Platelet Mitochondrial Bioenergetics in Patients with Peripheral Arterial Disease: A Randomized Controlled Trial

Ming-Lu Lin
1  Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Tao-Yuan, Taiwan
,
Tieh-Cheng Fu*
2  Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
,
Chih-Chin Hsu
2  Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
,
Shu-Chun Huang
3  Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
,
Yu-Ting Lin
1  Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Tao-Yuan, Taiwan
,
Jong-Shyan Wang
1  Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Tao-Yuan, Taiwan
2  Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
4  Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan
› Author Affiliations
Funding This work was supported by the National Science Council of Taiwan (grant number NSC 180–2314-B-182–039-MY3) and Chang Gung Medical Research Program (grant number CMRPD1J0221).

Abstract

Exercise training influences the risk of vascular thrombosis in patients with peripheral arterial disease (PAD). Mitochondrial functionalities in platelets involve the cellular bioenergetics and thrombogenesis. This study aimed to elucidate the effect of cycling exercise training (CET) on platelet mitochondrial bioenergetics in PAD patients. Forty randomly selected patients with PAD engaged in general rehabilitation (GR) with CET (i.e., cycling exercise at ventilation threshold for 30 minute/day, 3 days/week) (GR + CET, n = 20) or to a control group that only received GR course (n = 20) for 12 weeks. Systemic aerobic capacity and platelet mitochondrial bioenergetics that included oxidative phosphorylation (OXPHOS) and electron transport system (ETS) were measured using automatic gas analysis and high-resolution respirometry, respectively. The experimental results demonstrated that GR + CET for 12 weeks significantly (1) elevated VO2peak and lowered VE-VCO2 slope, (2) raised resting ankle-brachial index and enhanced cardiac output response to exercise, (3) increased the distance in 6-minute walk test and raised the Short Form-36 physical/mental component scores, and (4) enhanced capacities of mitochondrial OXPHOS and ETS in platelets by activating FADH2 (complex II)-dependent pathway. Moreover, changes in VO2peak levels were positively associated with changes in platelet OXPHOS and ETS capacities. However, no significant changes in systemic aerobic capacity, platelet mitochondrial bioenergetics, and health-related quality of life (HRQoL) occurred following GR alone. Hence, we conclude that CET effectively increases the capacities of platelet mitochondrial bioenergetics by enhancing complex II activity in patients with PAD. Moreover, the exercise regimen also enhanced functional exercise capacity, consequently improving HRQoL in PAD patients.

Authors' Contributions

J.-S.W., T.-C.F., and C.-C.H. were involved in conception and design of research; M.-L.L., T.-C.F., S.-C.H., and Y.-T.L. performed experiments; J.-S.W., T.-C.F., and M.-L.L. analyzed data, interpreted results of experiments, prepared the figures, and drafted the paper; J.-S.W. and T.-C.F. edited and revised the paper; J.-S.W., M.-L.L., T.-C.F., C.-C.H., S.-C.H., and Y.-T.L. approved the final version of the paper.


* Equal contribution as the first author.


Supplementary Material



Publication History

Received: 05 August 2020

Accepted: 17 November 2020

Publication Date:
09 January 2021 (online)

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