Immediate effect of balloon valvuloplasty on hemostatic changes in mitral stenosis
| Autor: | Eman Mashhour, Dosoky Abou-Ammo, Mohamed Abou-Freikha, Mai Salama, Abdou Elhendy, Adel M. Zaki, Magdy El Masry, Mohamed Sweelum |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Cardiac Catheterization medicine.medical_specialty Adolescent Antithrombin III Platelet Factor 4 Catheterization Electrocardiography Mitral valve stenosis Internal medicine Mitral valve medicine Humans Mitral Valve Stenosis Sinus rhythm Platelet activation Atrium (heart) Thrombus Hemostatic function Hemostasis business.industry Fibrinolysis Middle Aged beta-Thromboglobulin medicine.disease Blood Coagulation Factors medicine.anatomical_structure Beta-thromboglobulin Case-Control Studies Cardiology Female Cardiology and Cardiovascular Medicine business Peptide Hydrolases |
| Zdroj: | The American Journal of Cardiology. 85:370-375 |
| ISSN: | 0002-9149 |
| Popis: | This study was conducted to assess right and left atrial hemostatic function in patients with mitral stenosis (MS) and to investigate the immediate effect of balloon mitral valvuloplasty (BMV) on hemostatic function. BMV was performed in 28 patients with MS (age 29 +/- 8 years) who had sinus rhythm and no left atrial (LA) thrombus. Right and left atrial biochemical markers of platelet activity (platelet factor 4 [PF4] and B thromboglobulin [BTG]), coagulation (thrombin-antithrombin III complex [TAT]), and fibrinolytic activity (D-dimer) were measured before and 30 minutes after BMV. Right atrial levels of these markers were also measured in 20 control subjects. Compared with control subjects, patients with MS had higher right atrial levels of PF4 (30 +/- 15 vs 5 +/- 2 IU/ml), BTG (231 +/- 53 vs 30 +/- 8 IU/ml), TAT (7 +/- 4 vs 2 +/- 0.3 microg/L), and D-dimer (380 +/- 145 vs 160 +/- 35 ng/ml, p0.0001 in all). TAT levels were higher in the left atrium than in the right atrium of patients before BMV (8 +/- 4 vs 7 +/- 4 microg/L, p0.0001). BMV was successful (final mitral valve areaor = 1.5 cm2 andor = 50% increase of the initial valve area) in all patients. There was a significant reduction of LA levels of PF4 (35 +/- 8 to 26 +/- 9 IU/ml, p0.0001), BTG (225 +/- 41 to 196 +/- 28 IU/ml, p0.001), and TAT (10 +/- 5 to 7 +/- 1 microg/L, p0.05) in the 16 patients with LA pressure10 mm Hg after BMV, whereas these markers were not reduced in the 12 patients with left atrial pressureor = 10 mm Hg after BMV. These data indicate that platelet function, coagulation status, and fibrinolytic activity are increased regionally in the left atrium and in the systemic circulation in patients with MS and sinus rhythm in the absence of LA thrombus. Successful BMV induces a significant reduction of prethrombotic status in patients with low LA pressure after the procedure. Patients with high LA pressure after BMV maintain a high prethrombotic state and may be considered at an increased risk of thromboembolism after the procedure. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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