Mitral regurgitation is associated with similar loss of von Willebrand factor large multimers but lower frequency of anemia compared with aortic stenosis.

Autor: Takiguchi H; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Miura M; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Shirai SI; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Soga Y; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Hanyu M; Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan., Sakaguchi G; Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan., Soga Y; Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan., Arai Y; Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan., Watanabe S; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan., Kimura T; Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan., Takahama H; Cardiovascular Department, National Cerebral and Cardiovascular Center, Suita, Japan.; Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan., Yasuda S; Cardiovascular Department, National Cerebral and Cardiovascular Center, Suita, Japan.; Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan., Nakayoshi T; Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan., Fukumoto Y; Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan., Yaoita N; Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan., Shimokawa H; Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan., Sakatsume K; Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.; Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University Graduate School of Medicine, Sendai, Japan., Saiki Y; Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan., Kaikita K; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan., Tsujita K; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan., Tamura T; Department of Cardiology, Tenri Hospital, Tenri, Japan., Doman T; Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University Graduate School of Medicine, Sendai, Japan., Yamashita M; Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University Graduate School of Medicine, Sendai, Japan., Suzuki M; Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University Graduate School of Medicine, Sendai, Japan., Eura Y; Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center, Suita, Japan., Kokame K; Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center, Suita, Japan., Hayakawa M; Department of Blood Transfusion Medicine, Nara Medical University, Kashihara, Japan., Matsumoto M; Department of Blood Transfusion Medicine, Nara Medical University, Kashihara, Japan., Okubo N; Department of Clinical Laboratory Medicine, Tohoku University Hospital, Sendai, Japan., Sugawara S; Department of Clinical Laboratory Medicine, Tohoku University Hospital, Sendai, Japan., Fujimaki SI; Department of Clinical Laboratory Medicine, Tohoku University Hospital, Sendai, Japan., Kawate Y; Medical Affairs 2, Medical & Scientific Affairs, Sysmex Corporation, Kobe, Japan., Ando K; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan., Horiuchi H; Department of Molecular and Cellular Biology, Institute of Development, Aging and Cancer, Tohoku University Graduate School of Medicine, Sendai, Japan.
Jazyk: angličtina
Zdroj: Research and practice in thrombosis and haemostasis [Res Pract Thromb Haemost] 2024 May 03; Vol. 8 (4), pp. 102431. Date of Electronic Publication: 2024 May 03 (Print Publication: 2024).
DOI: 10.1016/j.rpth.2024.102431
Abstrakt: Background: Various cardiovascular diseases cause acquired von Willebrand syndrome (AVWS), which is characterized by a decrease in high-molecular-weight (large) von Willebrand factor (VWF) multimers. Mitral regurgitation (MR) has been reported as a cause of AVWS. However, much remains unclear about AVWS associated with MR.
Objectives: To evaluate VWF multimers in MR patients and examine their impact on clinical characteristics.
Methods: Moderate or severe MR patients ( n  = 84) were enrolled. VWF parameters such as the VWF large multimer index (VWF-LMI), a quantitative value that represents the amount of VWF large multimers, and clinical data were prospectively analyzed.
Results: At baseline, the mean hemoglobin level was 12.9 ± 1.9 g/dL and 58 patients (69.0%) showed loss of VWF large multimers defined as VWF-LMI < 80%. VWF-LMI in patients with degenerative MR was lower than in those with functional MR. VWF-LMI appeared to be restored the day after mitral valve intervention, and the improvement was maintained 1 month after the intervention. Seven patients (8.3%) had a history of bleeding, 6 (7.1%) of whom had gastrointestinal bleeding. Gastrointestinal endoscopy was performed in 23 patients (27.4%) to investigate overt gastrointestinal bleeding, anemia, etc. Angiodysplasia was detected in 2 of the 23 patients (8.7%).
Conclusion: Moderate or severe MR is frequently associated with loss of VWF large multimers, and degenerative MR may cause more severe loss compared with functional MR. Mitral valve intervention corrects the loss of VWF large multimers. Gastrointestinal bleeding may be relatively less frequent and hemoglobin level remains stable in MR patients.
(© 2024 The Authors.)
Databáze: MEDLINE
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