Document Detail


Procoagulant state in heart failure with preserved left ventricular ejection fraction.
MedLine Citation:
PMID:  19809208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The impact of heart failure with preserved left ventricular ejection fraction (LVEF) on activated hemostasis is still unclear. We sought to compare the activation of hemostasis in patients with heart failure with preserved LVEF, with impaired LVEF, and in healthy controls. Biomarkers of coagulation and fibrinolysis (D-dimer, tPA and PAI-1) were determined in outpatients with chronic stable (NYHA I-III), optimally managed heart failure with preserved LVEF (n = 46) and with impaired LVEF (n = 52), and in healthy age- and gender-matched controls (n = 14). In comparison to healthy controls, patients with heart failure and preserved LVEF had increased median D-dimer levels (606 [330-1222] microg/L versus 174 [86-249] microg/L; P < 0.001), and median PAI-1 (20 [15.3-33.1] microg versus 6.2[3.4-8.9] microg/L; P < 0.001) and tPA antigen concentrations (9.6 [8.1-13.3] versus 3.6 [2.2-5.0] microg/L; P < 0.001). However, unlike tPA and PAI antigens, D-dimer levels in preserved LVEF did not reach values as high as in impaired LVEF (917 [454-1185] microg/L; P = 0.013). Moreover, in patients with impaired LVEF, but not in those with preserved LVEF, age and NT-proBNP emerged as independent predictors of log-transformed D-dimer levels. Heart failure with preserved LVEF is associated with a procoagulant state as determined by increased levels of D-dimer, tPA and PAI-1 antigens. D-dimer levels are significantly higher in patients with impaired LVEF, while tPA and PAI-1 levels are increased regardless of LVEF.
Authors:
Borut Jug; Nina Vene; Barbara Guzic Salobir; Miran Sebestjen; Miso Sabovic; Irena Keber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International heart journal     Volume:  50     ISSN:  1349-2365     ISO Abbreviation:  -     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-10-07     Completed Date:  2009-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  591-600     Citation Subset:  IM    
Affiliation:
Department of Vascular Diseases, Clinic of Internal Medicine, University Clinical Center Ljubljana, Ljubljana, Slovenia.
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Fibrin Fibrinogen Degradation Products / analysis
Heart Failure / physiopathology*
Hemostasis
Humans
Male
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain / blood
Peptide Fragments / blood
Plasminogen Inactivators / blood
Stroke Volume
Tissue Plasminogen Activator / blood
Ventricular Dysfunction, Left / physiopathology
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/Peptide Fragments; 0/Plasminogen Inactivators; 0/fibrin fragment D; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; EC 3.4.21.68/Tissue Plasminogen Activator

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