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Thrombo-hemorrhagic liability in children with congenital heart diseases

Shebl Said Shebl1, Walid Ahmed Naguib El-Shehaby1, Yasmin Shebl Said1

  • 1Pediatrics Department, Faculty of Medicine, Tanta University, Egypt.

Hematology/Oncology and Stem Cell Therapy
|September 5, 2017
PubMed

Insights

Congenital heart disease (CHD) patients exhibit altered hemostasis, with cyanotic CHD showing more significant platelet and endothelial cell activation. These findings suggest a unique balance between thrombogenicity and bleeding risk in CHD patients.

Area of Science:

  • Pediatric Cardiology
  • Hematology
  • Vascular Biology

Background:

  • Congenital heart disease (CHD) is associated with poorly understood hemostatic abnormalities.
  • Platelet and endothelial cell activation are implicated in CHD pathophysiology.

Purpose of the Study:

  • To evaluate platelet and vascular endothelial cell activation markers in children with CHD.
  • To assess bleeding liability in these patients.
  • To correlate these markers with clinical presentation.

Main Methods:

  • Study included 20 cyanotic CHD (CCHD), 20 acyanotic CHD (ACHD), and 20 healthy children (ages 1-10).
  • Evaluated clinical data, complete blood count, oxygen saturation, echocardiography, bleeding/coagulation times, PT, PTT, FDPs, plasma soluble P-selectin, E-selectin, and platelet factor 4 (PF4).

Main Results:

  • CCHD and ACHD patients showed prolonged PT/PTT and lower platelet counts, more pronounced in CCHD.
  • Significantly elevated PF4, P-selectin, and E-selectin levels were observed in CCHD and ACHD compared to controls.
  • Oxygen saturation negatively correlated with P-selectin, E-selectin, and PF4 in CCHD patients.

Conclusions:

  • CHD patients display a complex hemostatic profile with increased risk for both thrombosis and hemorrhage.
  • This hemostatic variability may represent an adaptive mechanism to maintain balance.
  • Further large-scale studies are needed to establish normal ranges for thrombohemorrhagic parameters in CHD.
Abstract

Keywords:
CHDEndothelialPF4PlateletSelectins

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