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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
Procoagulant state in heart failure with preserved left ventricular ejection fraction
Borut Jug1, Nina Vene, Barbara Guzic Salobir
1Department of Vascular Diseases, Clinic of Internal Medicine, University Clinical Center Ljubljana, Ljubljana, Slovenia.
International Heart Journal
|October 8, 2009
Summary
Heart failure with preserved ejection fraction (HFpEF) is linked to a procoagulant state, indicated by elevated D-dimer, tPA, and PAI-1 levels. These markers suggest increased blood clotting activity in HFpEF patients compared to healthy individuals.
Area of Science:
- Cardiology
- Hematology
- Biochemistry
Background:
- Hemostasis activation in heart failure with preserved left ventricular ejection fraction (HFpEF) remains poorly understood.
- Previous research has not fully elucidated the impact of HFpEF on coagulation and fibrinolysis pathways.
Purpose of the Study:
- To compare hemostasis activation in patients with HFpEF, heart failure with impaired LVEF, and healthy controls.
- To investigate the relationship between LVEF status and specific coagulation/fibrinolysis biomarkers.
Main Methods:
- Biomarkers of coagulation and fibrinolysis, including D-dimer, tissue plasminogen activator (tPA), and plasminogen activator inhibitor-1 (PAI-1), were measured.
- Outpatients with chronic stable HFpEF (NYHA I-III) and heart failure with impaired LVEF, along with healthy controls, were enrolled.
Main Results:
- Patients with HFpEF exhibited significantly higher median D-dimer, PAI-1, and tPA antigen levels compared to healthy controls.
- While D-dimer levels were elevated in HFpEF, they were not as high as in patients with impaired LVEF.
- Age and NT-proBNP were independent predictors of D-dimer levels in patients with impaired LVEF, but not in those with HFpEF.
Conclusions:
- Heart failure with preserved LVEF is associated with a procoagulant state, evidenced by increased D-dimer, tPA, and PAI-1.
- Elevated tPA and PAI-1 levels are observed irrespective of LVEF status in heart failure patients.
- D-dimer levels are significantly higher in heart failure with impaired LVEF compared to HFpEF.
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