Atalar Enver, Haznedaroglu Ibrahim C, Acil Tayfun, Ozer Necla, Kilic Harun, Ovunc Kenan, Aksoyek Serdar, Nazli Nasih, Kes Sirri, Kabakçi Giray, Kirazli Serafettin, Ozmen Ferhan
Department of Cardiology, Hacettepe University, Ankara, Turkey.
Platelets. 2003 Nov-Dec;14(7-8):407-11. doi: 10.1080/09537100310001638814.
It is well known that chronic atrial fibrillation (CAF) and paroxysmal atrial fibrillation (PAF) are associated with hypercoagulable state. However, pathological hemostatic changes during the paroxysmal supraventricular tachycardia (PSVT) have not yet been elucidated. To determine platelet activity in patients with PSVT, PAF and CAF, we examined the levels of beta-thromboglobulin (BTG) and platelet factor 4 (PF4) during tachyarrhythmia attacks. We measured the levels of BTG and PF4, as an index of platelet activation in 15 patients with PAF (9 men, mean age 45+/-11), and 14 patients with PSVT (8 men, mean age 40+/-10). Levels were compared to 22 age and sex matched healthy controls in sinus rhythm and with 25 patients with CAF (16 men, mean age 51+/-12). Blood samples were taken during arrhythmia and 24 hours after conversion to sinus rhythm. Patients taking medications or have clinical conditions that may affect the BTG and PF4 levels were excluded. In patients with PAF, BTG and PF4 levels were significantly higher than in controls (p<0.009, and p=0.002, respectively), and in patients with PSVT (p<0.004, and p=0.009, respectively), however, BTG and PF4 levels were significantly lower than CAF patients (p=0.002, and p=0.02, respectively). Moreover, BTG and PF4 levels were significantly decreased 24 hours after conversion to sinus rhythm (p<0.0001), and p=0.004, respectively). Although BTG and PF4 levels in patients with PSVT were significantly lower than in patients with PAF (p=0.04, and p=0.009, respectively) and CAF (p=0.0001, and p=0.0001, respectively), BTG and PF4 levels were similar to controls and did not change significantly after recovery to sinus rhythm (p=NS for all). These results indicate that there was no platelet activation in patients with PSVT during tachyarrhythmia but significantly increased platelet activity in PAF and CAF patients. There was a significant decrement of the platelet activity to a level of control subjects twenty-four hours after cardioversion of PAF.
众所周知，慢性房颤（CAF）和阵发性房颤（PAF）与高凝状态相关。然而，阵发性室上性心动过速（PSVT）期间的病理性止血变化尚未阐明。为了确定PSVT、PAF和CAF患者的血小板活性，我们在快速心律失常发作期间检测了β-血小板球蛋白（BTG）和血小板因子4（PF4）的水平。我们测量了15例PAF患者（9例男性，平均年龄45±11岁）和14例PSVT患者（8例男性，平均年龄40±10岁）的BTG和PF4水平，作为血小板活化指标。将这些水平与22例年龄和性别匹配的窦性心律健康对照以及25例CAF患者（16例男性，平均年龄51±12岁）进行比较。在心律失常期间和转为窦性心律24小时后采集血样。排除正在服用可能影响BTG和PF4水平的药物或有临床疾病的患者。在PAF患者中，BTG和PF4水平显著高于对照组（分别为p<0.009和p=0.002），在PSVT患者中也显著高于对照组（分别为p<0.004和p=0.009），然而，BTG和PF4水平显著低于CAF患者（分别为p=0.002和p=0.02）。此外，转为窦性心律24小时后，BTG和PF4水平显著降低（分别为p<0.0001和p=0.004）。虽然PSVT患者的BTG和PF4水平显著低于PAF患者（分别为p=0.04和p=0.009）和CAF患者（分别为p=0.0001和p=0.0001），但BTG和PF4水平与对照组相似，恢复窦性心律后无显著变化（所有p=无显著性差异）。这些结果表明，PSVT患者在快速心律失常期间无血小板活化，但PAF和CAF患者的血小板活性显著增加。PAF复律24小时后，血小板活性显著降低至对照受试者水平。
