Document Detail

Endothelial dysfunction associated with chronic intravascular coagulation in secondary pulmonary hypertension.
MedLine Citation:
PMID:  12516685     Owner:  NLM     Status:  MEDLINE    
Altered endothelial anti-thrombotic properties have been observed in primary and secondary pulmonary hypertension. In the Eisenmenger syndrome, correlations of these abnormalities with the clinical status and occurrence of chronic intravascular coagulation (CIC) have not been confirmed. The purpose of this study was to investigate whether the occurrence of CIC, as determined by circulating levels of D-dimer is associated with changes in endothelial markers in Eisenmenger patients; and to identify variables that correlate with the severity of clinical presentation. Twenty-one patients were enrolled (ages, 4-52 years). Plasma levels of D-dimer, tissue plasminogen activator (t-PA), thrombomodulin, and von Willebrand factor antigen (vWF:Ag) were measured with enzyme-linked immunosorbent assay. Univariate and multivariate analyses were used to differentiate patients with stable (group 1, N=12) from those with unstable disease (group 2, N=9). Increased t-PA (p<0.0001) and vWF:Ag (p=0.001) and decreased thrombomodulin (p<0.0001) were associated with increased D-dimer levels (p=0.0201) in patients. Group 2 had a higher prevalence of affected women (p=0.0242), lower arterial oxygen saturation, and higher t-PA levels compared with group 1 (p<0.0001, discriminant analysis). t-PA and vWF:Ag correlated positively in group 2 (r=0.71, p=0.0309), but not in group 1 (r=0.25, p=NS). Two patients in group 2 but none in group 1 had episodes of pulmonary arterial thrombosis. Endothelial dysfunction is associated with evidence of CIC and correlates to some extent with the severity of symptoms in these patients.
Antonio Augusto Lopes; Lúcia Helena Caramurú; Nair Yukie Maeda
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis     Volume:  8     ISSN:  1076-0296     ISO Abbreviation:  Clin. Appl. Thromb. Hemost.     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2003-01-08     Completed Date:  2003-07-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9508125     Medline TA:  Clin Appl Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  353-8     Citation Subset:  IM    
Department of Pediatric Cardiology and Adult Congenital Heart Disease, Heart Institute, University of São Paulo, São Paulo, Brazil.
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MeSH Terms
Anoxia / blood,  pathology
Biological Markers / blood
Case-Control Studies
Child, Preschool
Chronic Disease
Disseminated Intravascular Coagulation / blood,  diagnosis,  pathology*
Eisenmenger Complex / blood,  pathology
Endothelium, Vascular / physiopathology*
Fibrin Fibrinogen Degradation Products / analysis
Hypertension, Pulmonary / blood*,  etiology
Middle Aged
Pulmonary Embolism
Thrombomodulin / blood
Tissue Plasminogen Activator / blood
von Willebrand Factor / analysis
Reg. No./Substance:
0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/Thrombomodulin; 0/fibrin fragment D; 0/von Willebrand Factor; EC Plasminogen Activator

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