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Relationship between hemostatic abnormalities and neuroendocrine activity in heart failure
E Sbarouni1, A Bradshaw, F Andreotti
1Department of Medicine Cardiology and Haematology, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
American Heart Journal
|March 1, 1994
Summary
Heart failure patients exhibit hemostatic dysfunction, including platelet activation and elevated viscosity. These abnormalities may increase the risk of thromboembolism and stem partly from neuroendocrine activation.
Area of Science:
- Cardiology
- Hematology
- Internal Medicine
Background:
- Thromboembolism is a significant complication in heart failure patients.
- Understanding the link between heart failure and hemostatic dysfunction is crucial for risk stratification and management.
Purpose of the Study:
- To investigate hemostatic function in patients with stable chronic heart failure.
- To correlate hemostatic measures with the severity of heart failure.
Main Methods:
- Studied 21 patients with stable chronic heart failure.
- Assessed hemostatic function, including plasma and blood viscosity, platelet activation markers (fibrinopeptide A, D-dimer, von Willebrand factor), and neuroendocrine factors (angiotensin II, endothelin).
- Correlated hemostatic measures with clinical evaluation, neuroendocrine activation, radionuclide ventriculography, and cardiopulmonary exercise testing.
Main Results:
- Elevated plasma and blood viscosity were observed in all patients.
- Evidence of platelet activation was present in all patients.
- Elevated plasma concentrations of fibrinopeptide A, D-dimer, and von Willebrand factor were common.
- These hemostatic variables showed poor interrelation and weak correlation with heart failure severity.
- Plasma concentrations of angiotensin II and endothelin were correlated, with endothelin also correlating with von Willebrand factor.
Conclusions:
- Patients with chronic heart failure exhibit significant hemostatic abnormalities.
- These abnormalities may predispose individuals to thromboembolic events.
- Neuroendocrine activation may contribute to the observed hemostatic dysfunction in heart failure.