使用连续流左心室辅助装置（HeartMate II）的患者中，血管性血友病因子依赖性血小板聚集严重受损。
Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II).
作者信息
Klovaite Jolanta, Gustafsson Finn, Mortensen Svend A, Sander Kåre, Nielsen Lars B
机构信息
Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Denmark.
出版信息
J Am Coll Cardiol. 2009 Jun 9;53(23):2162-7. doi: 10.1016/j.jacc.2009.02.048.
OBJECTIVES
This study investigated the influence of the mechanical blood pump HeartMate II (HMII) (Thoratec Corporation, Pleasanton, California) on blood coagulation and platelet function.
BACKGROUND
HMII is an implantable left ventricular assist device used for the treatment of heart failure. Patients treated with HMII have increased bleeding tendencies.
METHODS
We measured agonist-induced platelet aggregation in 16 patients on HMII support.
RESULTS
The von Willebrand factor (vWF)-dependent ristocetin-induced platelet aggregation was impaired in 11 of the 16 patients, of which 12 had experienced at least 1 minor or major bleeding episode. The impaired ristocetin-induced platelet aggregation was associated both with decreased specific activity of plasma vWF, presumably due to lack of high molecular weight vWF multimers, as well as with attenuated function of the platelets themselves.
CONCLUSIONS
The results imply that HMII treatment is associated with impaired platelet aggregation, which may contribute to an increased tendency to bleed.
目的
本研究调查了机械血泵HeartMate II（HMII，Thoratec公司，加利福尼亚州普莱森顿）对血液凝固和血小板功能的影响。
背景
HMII是一种用于治疗心力衰竭的植入式左心室辅助装置。接受HMII治疗的患者出血倾向增加。
方法
我们测量了16例接受HMII支持治疗患者的激动剂诱导的血小板聚集情况。
结果
16例患者中有11例的血管性血友病因子（vWF）依赖性瑞斯托霉素诱导的血小板聚集受损，其中12例经历过至少1次轻微或严重出血事件。瑞斯托霉素诱导的血小板聚集受损与血浆vWF的比活性降低有关，这可能是由于缺乏高分子量vWF多聚体，同时也与血小板自身功能减弱有关。
结论
结果表明，HMII治疗与血小板聚集受损有关，这可能导致出血倾向增加。
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