Document Detail

Influence of atrial fibrillation on plasma von willebrand factor, soluble E-selectin, and N-terminal pro B-type natriuretic peptide levels in systolic heart failure.
MedLine Citation:
PMID:  18339785     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Endothelial dysfunction is present in patients with heart failure (HF) due to left ventricular systolic dysfunction, as well as in patients with atrial fibrillation (AF) who have normal cardiac function. It is unknown whether AF influences the degree of endothelial dysfunction in patients with systolic HF. METHODS: We measured levels of plasma von Willebrand factor (vWF) and E-selectin (as indexes of endothelial damage/dysfunction and endothelial activation, respectively; both enzyme-linked immunosorbent assay) in patients with AF and HF (AF-HF), who were compared to patients with sinus rhythm and HF (SR-HF), as well as in age-matched, healthy, control subjects. We also assessed the relationship of vWF and E-selectin to plasma N-terminal pro B-type natriuretic peptide (NTpro-BNP), a marker for HF severity and prognosis. RESULTS: One hundred ninety patients (73% men; mean age, 69.0 +/- 10.1 years [+/- SD]) with systolic HF were studied, who were compared to 117 healthy control subjects: 52 subjects (27%) were in AF, while 138 subjects (73%) were in sinus rhythm. AF-HF patients were older than SR-HF patients (p = 0.046), but left ventricular ejection fraction and New York Heart Association class were similar. There were significant differences in NT-proBNP (p < 0.0001) and plasma vWF (p = 0.003) between patients and control subjects. On Tukey post hoc analysis, AF-HF patients had significantly increased NT-proBNP (p < 0.001) and vWF (p = 0.0183) but not E-selectin (p = 0.071) levels when compared to SR-HF patients. On multivariate analysis, the presence of AF was related to plasma vWF levels (p = 0.018). Plasma vWF was also significantly correlated with NT-proBNP levels (Spearman r = 0.139; p = 0.017). CONCLUSIONS: There is evidence of greater endothelial damage/dysfunction in AF-HF patients when compared to SR-HF patients. The clinical significance of this is unclear but may have prognostic value.
Bethan Freestone; Finn Gustafsson; Aun Yeong Chong; Pernille Corell; Caroline Kistorp; Per Hildebrandt; Gregory Y H Lip
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-03-13
Journal Detail:
Title:  Chest     Volume:  133     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-07     Completed Date:  2008-06-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1203-8     Citation Subset:  AIM; IM    
Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK.
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MeSH Terms
Atrial Fibrillation / blood*,  complications,  physiopathology
Atrial Natriuretic Factor / blood*
Biological Markers / blood
E-Selectin / blood*
Endothelium, Vascular / physiopathology
Enzyme-Linked Immunosorbent Assay
Follow-Up Studies
Heart Failure, Systolic / blood*,  complications,  physiopathology
Heart Rate / physiology
Prospective Studies
Protein Precursors / blood*
Severity of Illness Index
Stroke Volume / physiology
Ventricular Function, Left / physiology
von Willebrand Factor / metabolism*
Reg. No./Substance:
0/Biological Markers; 0/E-Selectin; 0/N-terminal proatrial natriuretic peptide; 0/Protein Precursors; 0/von Willebrand Factor; 85637-73-6/Atrial Natriuretic Factor

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