The coagulation system changes in patients with chronic heart failure

Area of Science:

• Cardiology
• Hematology
• Stress Physiology

Background:

• Chronic heart failure (CHF) etiology is complex, involving systolic/diastolic dysfunction alongside neurohormonal, immune, and hemostatic system impairments.
• Predictive parameters for CHF course and complications remain an active area of research.
• Stress is a recognized contributor to various diseases, including CHF.

Purpose of the Study:

• To review recent studies investigating the relationship between the coagulation system and the development of chronic heart failure.
• To elucidate the impact of stress on hemostasis in the context of CHF.

Main Methods:

• Literature review of recent studies.
• Analysis of stress-induced hormonal changes.
• Examination of alterations in coagulation, fibrinolysis, endothelium, platelet activity, and cytokine profiles.

Main Results:

• Stress triggers increased concentrations of hormones like noradrenaline, renin, angiotensin II, aldosterone, and vasopressin.
• These hormonal changes are linked to significant coagulation system disorders, including elevated plasma coagulation factors (e.g., fibrinogen, VII, VIII), increased fibrinolysis markers (D-dimer), endothelial activation (e.g., interleukin-1, endothelin-1), heightened platelet activity (e.g., von Willebrand factor, P-selectin), and altered cytokine levels (e.g., TNF-α, IL-6).
• A decrease in E-selectin was also noted.

Conclusions:

• The study highlights a strong association between stress, coagulation system dysregulation, and chronic heart failure development.
• The precise role of individual coagulation factors in CHF pathogenesis requires further investigation.
• Additional research is necessary to fully understand these complex interactions.