Negreva Mariya, Zarkova Ana, Prodanova Krasimira, Petrov Petar
Department of Cardiology, Medical University of Varna, Varna, Bulgaria.
National Specialized Hospital for Active Treatment of Hematologic Diseases, Sofia, Bulgaria.
Cardiol Res. 2020 Feb;11(1):22-32. doi: 10.14740/cr972. Epub 2020 Jan 26.
Atrial fibrillation (AF) is a hypercoagulable state. However, the intimate mechanisms leading to impaired coagulation and the timing of their activation are unclear. The aim of the study was to investigate the factors that initiate the coagulation cascade in the early hours (up to 48 h) of clinical manifestation of paroxysmal atrial fibrillation (PAF).
Tissue factor (TF) level, coagulation activity of factor VII (FVIIa), factor XII (FXIIa) and factor XI (FXIa) were measured in plasma of 51 non-anticoagulated patients (26 men and 25 women, aged 59.84 ± 11.42 years) and 52 controls (26 men and 26 women, aged 59.50 ± 10.53 years) by enzyme-linked immunoassays and kinetic assays.
TF was higher in the PAF group (268.63 ± 90.62 pg/mL vs. 170.21 ± 66.19 pg/mL, P < 0.001) as well as FVIIa (170.82±59.39% vs. 95.17±37.90%, P < 0.001), FXIIa (218.31±84.04% vs. 148.41±53.94%, P < 0.001) and FXIa (178.41±55.94% vs. 111.75±37.33%, P < 0.001). Regression analysis showed that in the first 6 h of the disease, increase in time led to increase in FXIIa (r = 0.25, P < 0.05), FXIa (r = 0.75, P < 0.05), TF level (r = 0.25, P < 0.05) and FVIIa (r = 0.25, P < 0.05).
Hemocoagulation changes were observed even < 6 h after the onset of the disease. They suggest that PAF has an early tendency for hypercoagulability, with the involvement of the intrinsic and extrinsic pathways of coagulation.
心房颤动（AF）是一种高凝状态。然而，导致凝血功能受损的具体机制及其激活时间尚不清楚。本研究旨在探讨阵发性心房颤动（PAF）临床表现早期（至48小时）启动凝血级联反应的因素。
采用酶联免疫分析法和动力学分析法，检测了51例未抗凝患者（26例男性和25例女性，年龄59.84±11.42岁）和52例对照者（26例男性和26例女性，年龄59.50±10.53岁）血浆中的组织因子（TF）水平、凝血因子VII（FVIIa）、凝血因子XII（FXIIa）和凝血因子XI（FXIa）的凝血活性。
PAF组的TF水平（268.63±90.62 pg/mL vs. 170.21±66.19 pg/mL，P<0.001）、FVIIa（170.82±59.39% vs. 95.17±37.90%，P<0.001）、FXIIa（218.31±84.04% vs. 148.41±53.94%，P<0.001）和FXIa（178.41±55.94% vs. 111.75±37.33%，P<0.001）均高于对照组。回归分析显示，在疾病发生的最初6小时内，时间延长导致FXIIa（r = 0.25，P<0.05）、FXIa（r = 0.75，P<0.05）、TF水平（r = 0.25，P<0.05）和FVIIa（r = 0.25，P<0.05）升高。
在疾病发作后不到6小时就观察到血液凝固变化。这表明PAF早期有高凝倾向，涉及内源性和外源性凝血途径。
