Bozdemir Volkan, Kirimli Onder, Akdeniz Bahri, Ulgenalp Ayfer, Aslan Abdurrahman, Kala Veli, Ozel Erdem, Senarslan Omer, Badak Ozer, Bariş Nezihi, Güneri Sema
Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
Anadolu Kardiyol Derg. 2010 Jun;10(3):209-15. doi: 10.5152/akd.2010.059.
The role of coagulation parameters left atrial thrombus formation in atrial fibrillation has not been investigated before. We aimed to investigate the association between the beta-fibrinogen gene polymorphism or glycoprotein IIIa gene polymorphism and presence of left atrial (LA) thrombus or spontaneous echo contrast (SEC) in patients with atrial fibrillation (AF).
Forty-seven patients with AF, in whom transesophageal echocardiography was performed, were included to this cross-sectional observational study. Patients were divided in two groups; those with LA thrombus (n=24) were assigned to group 1 and those without thrombus in group 2 (n=23). DNA analysis was conducted to determine gene polymorphism in all patients. Mann-Whitney U test or Chi-square tests were used for statistical analysis.
There were no significant differences between groups regarding to demographic and clinical characteristics. The frequency of beta-fibrinogen 455 G/A polymorphism was higher (37.5%) in group 1 as compared to group 2 (15.1%) but it did not reach statistical difference (p=0.23). When we added patients with severe SEC in the study group (patients with severe SEC and/or thrombus n=27) the difference (44.40%-10%) reached the statistical difference (p=0.01). Glycoprotein IIIa Pl A1/A2 polymorphism was not different between groups with (p=0.82) or without SEC (p=0.73).
In patients with atrial fibrillation, beta-fibrinogen 455 G/A gene polymorphism is associated with the presence of left atrial thrombus and severe SEC. Beta-fibrinogen 455 G/A gene polymorphism may be a promising marker for the prediction of thromboembolism risk in patients with atrial fibrillation.
凝血参数在心房颤动左心房血栓形成中的作用此前尚未得到研究。我们旨在研究β-纤维蛋白原基因多态性或糖蛋白IIIa基因多态性与心房颤动（AF）患者左心房（LA）血栓或自发显影（SEC）之间的关联。
本横断面观察性研究纳入了47例行经食管超声心动图检查的AF患者。患者分为两组；有LA血栓的患者（n = 24）被分配到第1组，无血栓的患者被分配到第2组（n = 23）。对所有患者进行DNA分析以确定基因多态性。采用Mann-Whitney U检验或卡方检验进行统计分析。
两组在人口统计学和临床特征方面无显著差异。第1组β-纤维蛋白原455 G/A多态性的频率（37.5%）高于第2组（15.1%），但未达到统计学差异（p = 0.23）。当我们将严重SEC患者纳入研究组时（严重SEC和/或血栓患者n = 27），差异（44.40% - 10%）达到统计学差异（p = 0.01）。糖蛋白IIIa Pl A1/A2多态性在有SEC（p = 0.82）或无SEC（p = 0.73）的组之间无差异。
在心房颤动患者中，β-纤维蛋白原455 G/A基因多态性与左心房血栓和严重SEC的存在相关。β-纤维蛋白原455 G/A基因多态性可能是预测心房颤动患者血栓栓塞风险的一个有前景的标志物。
