Increased von Willebrand factor in the endocardium as a local predisposing factor for thrombogenesis in overloaded human atrial appendage
| Autor: | Shigeo Baba, Hitoshi Yokoyama, Koji Fukuda, Jun Watanabe, Koji Kumagai, Takuya Yagi, Yutaka Kagaya, Shigekazu Sato, Yukio Katori, Mitsumasa Fukuchi, Atsushi Iguchi, Koichi Tabayashi, Masahito Miura, Kunio Shirato |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart Diseases Endothelium Heart Valve Diseases Atrial Appendage Blood Pressure Coronary Disease Heart Septal Defects Atrial Immunoenzyme Techniques Von Willebrand factor Internal medicine Atrial Fibrillation von Willebrand Factor medicine Humans cardiovascular diseases Thrombus Atrium (heart) Microscopy Immunoelectron Endocardium Aged Heart Failure Blood Volume biology business.industry Thrombosis Atrial fibrillation Middle Aged medicine.disease medicine.anatomical_structure Intracranial Embolism biology.protein Cardiology cardiovascular system Female Endothelium Vascular business Cardiology and Cardiovascular Medicine |
| Zdroj: | Journal of the American College of Cardiology. 37(5):1436-1442 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/s0735-1097(01)01125-1 |
| Popis: | OBJECTIVES We investigated immunoreactive von Willebrand factor (vWF), a platelet adhesion molecule, in the endocardial endothelium and its relationship to thrombogenesis in the human atrial appendage. BACKGROUND Intra-atrial thrombogenesis is generally thought to be induced by blood stasis in the atrial appendage involved with atrial fibrillation (AF). Little attention has been paid to alterations of the endocardial endothelium on which the thrombus develops. METHODS Atrial appendage tissue was obtained at heart surgery or at autopsy from AF and non-AF cardiac patients and from noncardiac patients. Immunohistochemistry for endothelial cell markers including vWF, CD31, CD34 and endothelial nitric oxide synthase (eNOS) and platelet glycoprotein Ib/IX or IIb/IIIa was performed and semiquantitatively graded. RESULTS In contrast to the apparent immunostaining for CD31, CD34 and eNOS, only focal or little immunoreactive vWF was seen in the endocardium of noncardiac patients. Immunoreactive vWF in the endocardial endothelium was increased in most cardiac patients, particularly in the left, but not in the right, atrial appendage of patients with mitral valvular disease, irrespective of whether AF was present. Platelet adhesion/thrombus formation in the endocardium was found in limited sites in which the overlying endothelium was deficient in eNOS and CD34. When warfarin-treated cases were excluded, there was a significant correlation between the immunohistochemical grade for vWF and the degree of platelet adhesion/thrombus formation in the endocardium. CONCLUSIONS Immunoreactive vWF in the endocardial endothelium was increased in overloaded human atrial appendage, which may be a local predisposing factor for intraatrial thrombogenesis. |
| Databáze: | OpenAIRE |
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