Cortés Gerardo Muñoz, Viveros Sandoval Martha Eva, Areán Martínez Carlos Arturo, Vega Gómez Helios Eduardo, López Castañeda Sandra Edith, García Anel Gómez
Laboratory of Haemostasis and Vascular Biology. Faculty of Medical and Biological Sciences "Dr. Ignacio Chavez". Michoacan University of San Nicolas de Hidalgo. Biomedical Research Center of Michoacán. Mexican Social Security Institute. Morelia, Michoacán, México.
Laboratory of Haemostasis and Vascular Biology. Faculty of Medical and Biological Sciences "Dr. Ignacio Chavez". Michoacan University of San Nicolas de Hidalgo. Morelia, Michoacán, México.
J Atr Fibrillation. 2014 Dec 31;7(4):1124. doi: 10.4022/jafib.1124. eCollection 2014 Dec.
Atrial Fibrillation (AF) is the most common cardiac arrhythmia of clinical significance; it increases the risk of mortality due to stroke. The mechanisms behind cerebral thromboembolism in AF are associated with a prothrombotic state, demonstrated by higher levels of von Willebrand Factor (vWF), a multimeric glycoprotein that plays a crucial role in platelet adhesion and aggregation and it has been proposed as a biomarker of endothelial dysfunction. Plasma vWF levels are elevated in patients with nonvalvular Atrial Fibrillation (NVAF) associated to the presence of cardiovascular risk factors. The variability in vWF plasma levels in healthy subjects has a wide distribution, but there is no description available of the variability in AF patients and among types of AF. The aim of this study was to determine the variability of vWF plasma concentrations in patients with NVAF, associated to cardiovascular risk factors. Search strategy included PubMed and Ovid. Keywords used were "Atrial Fibrillation" and "von Willebrand Factor". It includes original articles, with analysis of plasma vWF levels by ELISA, without acute stroke. Review articles and meta-analysis were excluded. Reviewed studies include 22 trials and 6542 patients with nonvalvular AF associated to cardiovascular disease risk factors: age, sex, hypertension, heart failure, diabetes mellitus, prior stroke, coronary artery disease. Variability in vWF plasma levels was wide, with minimum values of 77 IU/dl and maximum values of 245 IU/dl and a mean of 146 IU/dl. Age of patients ranged between 54 and 78 years, and the percentage of males ranged between 23% and 80%. According to type of AF vWF levels were as follows, in paroxysmal AF: 92-264 IU/dl; persistent AF: 76-234 IU/dl; permanent AF: 91-247 IU/dl. The variability in vWF plasma levels is affected by risk factors and the AF type, however vWF levels in AF patients are higher when compared with healthy subjects.
心房颤动（AF）是具有临床意义的最常见心律失常；它会增加因中风导致的死亡风险。AF患者发生脑栓塞的机制与血栓前状态有关，血管性血友病因子（vWF）水平升高可证明这一点，vWF是一种多聚体糖蛋白，在血小板黏附和聚集过程中起关键作用，并且它已被提议作为内皮功能障碍的生物标志物。与心血管危险因素相关的非瓣膜性心房颤动（NVAF）患者血浆vWF水平升高。健康受试者血浆vWF水平的变异性分布广泛，但尚无关于AF患者以及不同类型AF之间变异性的描述。本研究的目的是确定与心血管危险因素相关的NVAF患者血浆vWF浓度的变异性。检索策略包括PubMed和Ovid。使用的关键词是“心房颤动”和“血管性血友病因子”。纳入的文章为原始文章，通过酶联免疫吸附测定法（ELISA）分析血浆vWF水平，且无急性中风情况。排除综述文章和荟萃分析。纳入的研究包括22项试验以及6542例与心血管疾病危险因素（年龄、性别、高血压、心力衰竭、糖尿病、既往中风、冠状动脉疾病）相关的非瓣膜性AF患者。血浆vWF水平的变异性很大，最小值为77 IU/dl，最大值为245 IU/dl，平均值为146 IU/dl。患者年龄在54至78岁之间，男性比例在23%至80%之间。根据AF类型，vWF水平如下：阵发性AF为92 - 264 IU/dl；持续性AF为76 - 234 IU/dl；永久性AF为91 - 247 IU/dl。血浆vWF水平的变异性受危险因素和AF类型影响，然而AF患者的vWF水平与健康受试者相比更高。
