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Enhanced platelet activity in atrial septal defect.

Mehmet Gungor Kaya1, Deniz Elcik, Bekir Calapkorur

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Platelet activation, indicated by elevated mean platelet volume (MPV), is present in atrial septal defect (ASD) and linked to pulmonary vascular disease. Device closure of ASD significantly reverses this platelet hyperactivity.

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Area of Science:

  • Cardiology
  • Hematology
  • Pulmonary Hypertension

Background:

  • Enhanced platelet activity, measured by mean platelet volume (MPV), is a known characteristic of pulmonary arterial hypertension.
  • Atrial septal defect (ASD) can lead to pulmonary vascular disease, but the role of platelet activation in this context is less understood.

Purpose of the Study:

  • To investigate platelet activation in adults with ASD.
  • To determine the relationship between platelet activation and pulmonary vascular disease severity in ASD patients.
  • To assess the impact of transcatheter ASD device closure on platelet activity.

Main Methods:

  • Prospective enrollment of 76 consecutive patients undergoing transcatheter ASD closure and 40 healthy controls.
  • Collection of blood samples for MPV measurement and transthoracic echocardiography to assess systolic pulmonary arterial pressures (PAP) and right ventricular end-diastolic diameters.
  • Comparison of MPV, PAP, and ventricular dimensions before and 6 months after ASD device closure.

Main Results:

  • Baseline MPV levels were significantly higher in ASD patients compared to controls (10.1 ± 1.3 fl vs. 8.6 ± 0.9 fl).
  • A positive correlation was found between MPV and systolic PAP in ASD patients (r=0.542).
  • Six months post-device closure, MPV, systolic PAP, and right ventricular end-diastolic diameters significantly decreased, returning to levels comparable to healthy individuals.

Conclusions:

  • Adults with ASD exhibit enhanced platelet activity, evidenced by elevated MPV.
  • This platelet hyperactivity is associated with the severity of pulmonary vascular disease in ASD.
  • Transcatheter closure of ASD effectively reverses platelet activation and improves pulmonary hemodynamics.