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Do atrial differences in endothelial damage, leukocyte and platelet activation, or tissue factor activity contribute

Laurence Jesel1, Thomas Arentz, Claudia Herrera-Siklody

  • 1University of Strasbourg, EA7293 Stress vasculaire et tissulaire, Strasbourg, France.

Journal of Cardiovascular Electrophysiology
|November 1, 2013
PubMed

Insights

In atrial fibrillation (AF), thrombi commonly form in the left atrium, but this study found no increased thrombogenic status there. Instead, right atrial endothelial-derived microparticles and tissue factor activity were slightly elevated.

Area of Science:

  • Cardiology
  • Hematology
  • Biomedical Research

Background:

  • Atrial fibrillation (AF) is associated with thrombus formation predominantly in the left atrium.
  • The underlying reasons for this left atrial predilection remain unclear.

Purpose of the Study:

  • To investigate potential atrial-specific differences in endothelial damage, leukocyte activation, platelet stimulation, and tissue factor activity in AF patients.
  • To explore the thrombogenic status of the left versus right atrium in individuals with AF.

Main Methods:

  • Blood samples were collected from the left and right atria of 22 AF patients undergoing pulmonary vein isolation.
  • Microparticle (MP) levels, procoagulant activity, cellular origin, platelet reactivity (P-selectin, PAC-1), and platelet aggregation were analyzed.
  • Assays included capture assays for MPs, functional prothrombinase and tissue factor assays, flow cytometry, and whole blood aggregometry.

Main Results:

  • No significant atrial-specific differences were observed in total procoagulant MPs, leukocyte-derived MPs, or platelet-derived MPs.
  • Endothelial-derived MPs and tissue factor activity were slightly higher in the right atrium compared to the left atrium (P < 0.05).
  • Collagen-induced platelet aggregation was also slightly elevated in the right atrium.

Conclusions:

  • The study found no evidence supporting an increased thrombogenic status within the left atrium of AF patients.
  • The observed slight elevation of endothelial-derived MPs and tissue factor activity in the right atrium does not explain the left atrial thrombus predilection in AF.
Abstract

Keywords:
apoptosisarrhythmiamicroparticlesstrokethrombosistissue factor

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