Goswami Nandu, Brix Bianca, Roessler Andreas, Koestenberger Martin, Reibnegger Gilbert, Cvirn Gerhard
Physiology Division, Otto Loewi Research Center, Medical University of Graz, 8036 Graz, Austria.
Department of Pediatric Cardiology, Medical University of Graz, 8036 Graz, Austria.
J Clin Med. 2020 Sep 27;9(10):3118. doi: 10.3390/jcm9103118.
It has been reported that women have a higher number of heart attacks in the "follicular phase" of the menstrual cycle. We, therefore, tested the hypothesis that women in the follicular phase exhibit higher coagulability. As lower body negative pressure (LBNP) has been used previously to assess coagulation changes in whole blood (WB) samples in men and women, effects of menstrual phase on coagulation was assessed during LBNP.
Seven women, all healthy young participants, with no histories of thrombotic disorders and not on medications, were tested in two phases of the menstrual cycle (early follicular (EF) and mid-luteal (ML)). LBNP was commenced at -10 mmHg and increased by -10 mmHg every 5 min until a maximum of -40 mmHg. Recovery up to 10 min was also monitored. Blood samples were collected at baseline, at end of LBNP, and at end of recovery. Hemostatic profiling included comparing the effects of LBNP on coagulation values in both phases of the menstrual cycle using standard coagulation tests, calibrated automated thrombogram, thrombelastometry, impedance aggregometry, and markers of thrombin formation.
LBNP led to coagulation activation determined in both plasma and WB samples. During both phases, coagulation was affected during LBNP, as reflected in their decreased partial thromboplastin time (PTT) and elevated coagulation factor VIII FVIII, F1 + 2, and thrombin-antithrombin (TAT) levels. Additionally, during the ML phase, greater PT [%] and shorter time to peak (ttPeak) values (implying faster maximum thrombin formation) suggest that women in the ML phase are relatively hypercoagulable compared to the early follicular phase.
These results suggest that thrombosis occurs more during the midluteal phase, a finding with substantial medical implications.
据报道，女性在月经周期的“卵泡期”心脏病发作次数较多。因此，我们检验了这样一个假设，即处于卵泡期的女性具有更高的凝血能力。由于先前已使用下体负压（LBNP）来评估男性和女性全血（WB）样本中的凝血变化，因此在LBNP期间评估了月经周期阶段对凝血的影响。
七名健康的年轻女性参与者，无血栓形成疾病史且未服用药物，在月经周期的两个阶段（卵泡早期（EF）和黄体中期（ML））进行测试。LBNP从-10 mmHg开始，每5分钟增加-10 mmHg，直至最大-40 mmHg。还监测了长达10分钟的恢复情况。在基线、LBNP结束时和恢复结束时采集血样。止血分析包括使用标准凝血试验、校准自动血栓图、血栓弹力图、阻抗聚集法以及凝血酶形成标志物，比较LBNP对月经周期两个阶段凝血值的影响。
LBNP导致血浆和WB样本中均出现凝血激活。在两个阶段中，LBNP期间凝血均受到影响，这反映在部分凝血活酶时间（PTT）降低以及凝血因子VIII FVIII、F1 + 2和凝血酶 - 抗凝血酶（TAT）水平升高。此外，在ML期，更高的PT [%]和更短的达到峰值时间（ttPeak）值（意味着更快的最大凝血酶形成）表明，与卵泡早期相比，处于ML期的女性相对具有高凝性。
这些结果表明，血栓形成在黄体中期更为常见，这一发现具有重大的医学意义。
