Siwaponanan Panjaree, Keawvichit Rassamon, Udompunturak Suthipol, Hunnangkul Saowalak, Reesukumal Kanit, Sukapirom Kasama, Pattanapanyasat Kovit, Krittayaphong Rungroj
Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Siriraj Center of Research Excellence in Microparticle and Exosome in Diseases, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Clin Cardiol. 2019 Apr;42(4):425-431. doi: 10.1002/clc.23158. Epub 2019 Feb 20.
Nonvalvular atrial fibrillation (AF) is the most common cardiac arrhythmia, and it is associated with the prothrombotic state. Circulating microparticles (cMPs) are membrane vesicles that are shed from many cell types in response to cell activation and cell apoptosis. Several studies reported that cMPs may play a role in the hypercoagulable state that can be observed in patients with AF. The aim of this study was to determine the levels of total cMPs and characterize their cellular origins in AF patients.
Atotal of 66 AF patients and 33 healthy controls were enrolled. This study investigated total cMP levels and their cellular origin in AF patients using polychromatic flow cytometry.
AF patients had significantly higher levels of total cMPs (median 36.38, interquartile range [IQR] 21.16-68.50 × 10 counts/mL vs median 15.21, IQR 9.91-30.86 × 10 counts/mL; P = 0.004), platelet-derived MPs (PMPs) (median 10.61, IQR 6.55-18.04 × 10 counts/mL vs median 7.83, IQR 4.44-10.26 × 10/mL; P = 0.009), and endothelial-derived MPs (EMPs CD31+ CD41-) (median 2.94, IQR 1.78-0.60 × 10 counts/mL vs median 1.16, IQR 0.71-2.30 × 10 counts/mL; P = 0.001) than healthy controls after adjusting for potential confounders. Phosphatidylserine positive MP (PS + MP) levels were similar compared between AF patients and healthy controls.
The results of this study revealed a marked increase in total cMP levels, and evidence of elevated endothelial damage and platelet activation, as demonstrated by increased PMP and EMP levels, in AF patients. Additional study is needed to further elucidate the role of cMPs (PMPs and EMPs) in the pathophysiology of and the complications associated with AF.
非瓣膜性心房颤动(AF)是最常见的心律失常,且与血栓前状态相关。循环微颗粒(cMPs)是在细胞活化和细胞凋亡时从多种细胞类型脱落的膜泡。多项研究报道,cMPs可能在AF患者中可观察到的高凝状态中起作用。本研究的目的是确定AF患者中总cMPs的水平并对其细胞来源进行表征。
共纳入66例AF患者和33例健康对照。本研究使用多色流式细胞术调查AF患者中总cMP水平及其细胞来源。
在校正潜在混杂因素后,AF患者的总cMPs水平(中位数36.38,四分位间距[IQR]21.16 - 68.50×10个计数/mL,而健康对照的中位数为15.21,IQR 9.91 - 30.86×10个计数/mL;P = 0.004)、血小板衍生微颗粒(PMPs)(中位数10.61,IQR 6.55 - 18.04×10个计数/mL,而健康对照的中位数为7.83,IQR 4.44 - 10.26×10/mL;P = 0.009)和内皮衍生微颗粒(EMPs CD31 + CD41 -)(中位数2.94,IQR 1.78 - 0.60×10个计数/mL,而健康对照的中位数为1.16,IQR 0.71 - 2.30×10个计数/mL;P = 0.001)均显著高于健康对照。AF患者和健康对照之间的磷脂酰丝氨酸阳性微颗粒(PS + MP)水平相似。
本研究结果显示,AF患者的总cMP水平显著升高,且PMP和EMP水平升高表明存在内皮损伤和血小板活化增加的证据。需要进一步研究以阐明cMPs(PMPs和EMPs)在AF病理生理学及相关并发症中的作用。