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Changes in hemorheologic properties and platelet function induced by a multistage ergometric stress testing in the supine position were observed in 31 patients with ischemic heart disease (IHD), 12 middle aged (MH) and 14 young normal subjects (YH). Slight but significant increases in hematocrit and platelet count were observed at peak exercise in all groups. Erythrocyte deformabiltiy (nuclepore filtration method) at peak exercise reduced significantly from 0.83±0.14 to 0.76±0.14ml/min in IHD and 0.80±0.10 to 0.75±0.10ml/min in MH, but unchanged in YH. Corresponding to such change, whole blood viscosity at the shear rate of 230 sec-1 increased significantly from 4.23±0.48 to 4.38±0.54 cP in IHD, while that at the shear rate of 23sec-1 remained unchanged. Platelet adhesiveness (modified Salzman's method) was enhanced, and platelet aggregability to ADP and epinephrine was increased at peak exercise in IHD. Epinephrine-induced platelet aggregation was also increased in normal subjects with exercise. Aspirin inhibited platelet aggregability both at rest and during exercise in IHD. The data suggest that hemorheologic characteristics and platelet function during exercise are, at least in part, responsible for an acute coronary event in patients with IHD.
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