Batko Jakub, Rusinek Jakub, Słomka Artur, Litwinowicz Radosław, Burysz Marian, Bartuś Magdalena, Lakkireddy Dhanunjaya R, Lee Randall J, Natorska Joanna, Ząbczyk Michał, Kapelak Bogusław, Bartuś Krzysztof
CAROL-Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland.
Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, 85-094 Bydgoszcz, Poland.
Diseases. 2023 Dec 29;12(1):8. doi: 10.3390/diseases12010008.
Left atrial appendage occlusion affects systemic coagulation parameters, leading to additional patient-related benefits. The aim of this study was to investigate the differences in coagulation factor changes 6 months after epicardial left atrial appendage occlusion in patients with different LAA morphometries. This is the first study to analyze these relationships in detail. A prospective study of 22 consecutive patients was performed. Plasminogen, fibrinogen, tPA concentration, PAI-1, TAFI and computed tomography angiograms were performed. Patients were divided into subgroups based on left atrial appendage body and orifice diameter enlargement. The results of blood tests at baseline and six-month follow-up were compared. In a population with normal LAA body size and normal orifice diameter size, a significant decrease in analyzed clotting factors was observed between baseline and follow-up for all parameters except plasminogen. A significant decrease between baseline and follow-up was observed with enlarged LAA body size in all parameters except TAFI, in which it was insignificant and plasminogen, in which a significant increase was observed. Occlusion of the left atrial appendage is beneficial for systemic coagulation. Patients with a small LAA may benefit more from LAA closure in terms of stabilizing their coagulation factors associated with potential thromboembolic events in the future.
左心耳封堵术会影响全身凝血参数，从而给患者带来额外的益处。本研究的目的是调查不同左心耳形态的患者在心外膜左心耳封堵术后6个月凝血因子变化的差异。这是第一项详细分析这些关系的研究。对22例连续患者进行了一项前瞻性研究。检测了纤溶酶原、纤维蛋白原、组织型纤溶酶原激活物（tPA）浓度、纤溶酶原激活物抑制剂-1（PAI-1）、凝血酶激活的纤溶抑制物（TAFI）并进行了计算机断层扫描血管造影。根据左心耳主体和开口直径增大情况将患者分为亚组。比较了基线和六个月随访时的血液检测结果。在左心耳主体大小和开口直径大小正常的人群中，除纤溶酶原外，所有参数在基线和随访之间均观察到分析的凝血因子显著下降。在左心耳主体大小增大的情况下，除TAFI（其变化不显著）和纤溶酶原（观察到显著增加）外，所有参数在基线和随访之间均观察到显著下降。左心耳封堵术对全身凝血有益。左心耳较小的患者在稳定与未来潜在血栓栓塞事件相关的凝血因子方面可能从左心耳封堵术中获益更多。
