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Correlation between left atrial size, prothrombotic state and markers of endothelial dysfunction in patients with
S Mondillo1, L Sabatini, E Agricola
1Laboratorio di Ematologia e Coagulazione, Università di Siena, Siena, Italy. mondillo@unisi.it
Insights
Chronic atrial fibrillation (AF) patients exhibit a prothrombotic state and endothelial dysfunction. This study found correlations between AF, coagulation factors, endothelial dysfunction markers, and left atrial size, suggesting interconnected pathology.
Area of Science:
- Cardiology
- Hematology
- Vascular Biology
Background:
- Atrial fibrillation (AF) is linked to a prothrombotic state and endothelial dysfunction.
- The relationship between these conditions and atrial dimensions remains unclear.
Purpose of the Study:
- To investigate the correlation between the prothrombotic state and endothelial dysfunction in chronic nonrheumatic AF.
- To determine if endothelial dysfunction relates to atrial dimension (endocardial damage).
Main Methods:
- Studied 45 patients with chronic nonrheumatic AF and 35 controls.
- Assessed systemic hemocoagulative activity, platelet activation markers (platelet factor 4, beta-thromboglobulin), fibrinolysis markers (D-dimer), and endothelial dysfunction markers (tissue plasminogen activator, plasminogen activator inhibitor, von Willebrand's factor, soluble thrombomodulin).
Main Results:
- Significantly elevated levels of fibrinogen, platelet activation markers, D-dimer, tissue plasminogen activator, plasminogen activator inhibitor, von Willebrand's factor, and soluble thrombomodulin were observed in AF patients compared to controls.
- Positive linear correlations were found between fibrinogen and endothelial dysfunction markers, as well as between left atrial volume and fibrinogen or endothelial dysfunction markers.
Conclusions:
- Chronic nonrheumatic AF is associated with a prothrombotic state and endothelial dysfunction.
- Evidence suggests a correlation between endothelial dysfunction, coagulation factors, and left atrial dimension in AF patients.
Abstract:
Atrial fibrillation is associated with a prothrombotic state and endothelial dysfunction. To understand whether the prothrombotic state was correlated with endothelial dysfunction and whether the latter was related to atrial dimension (endocardial damage), we studied systemic hemocoagulative activity and markers of endothelial dysfunction in 45 patients with chronic nonrheumatic atrial fibrillation and in 35 controls. We assessed fibrinogen, antithrombin III, protein C, markers of platelet activation (platelet factor 4 and beta-thromboglobulin) as markers of fibrinolysis, and D-dimer, tissue plasminogen activator, plasminogen activator inhibitor, von Willebrand's factor and soluble thrombomodulin as endothelial dysfunction. Plasma fibrinogen (P<0. 005), platelet factor 4 (P<0.001), thromboglobulin (P<0.001), D-dimer (P<0.03), tissue plasminogen activator (P<0.006), plasminogen activator inhibitor (P<0.04) and both von Willebrand's factor (P<0.0001) and soluble thrombomodulin (P<0.03) were significantly higher in the patients than in the controls. Positive significant linear correlations were found between fibrinogen and markers of endothelial dysfunction and left atrial volume and fibrinogen or markers of endothelial dysfunction. These findings confirm that chronic nonrheumatic atrial fibrillation is associated with a prothrombotic state but also suggest that there is a correlation between endothelial dysfunction, coagulation factors and left atrial dimension.