Langhorn Rebecca, Bach Maiken B T, Gravgaard Anne Sofie, Graversen Nanna, Olsen Caroline L, Monrad Karoline H, Koch Jørgen, Schrøder Anders S, Willesen Jakob L, Kristensen Annemarie T, Nielsen Lise N
Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
J Vet Intern Med. 2025 Sep-Oct;39(5):e70250. doi: 10.1111/jvim.70250.
Arterial thromboembolism (ATE) is a known complication of cardiomyopathies (CM) in cats. Hypercoagulability is believed to be one predisposing factor.
Assess applicability of global hemostatic tests for evaluating the systemic hemostatic state in cats with CM with concurrent ATE (CM + ATE).
Six cats with CM + ATE, 11 cats with CM, and 13 healthy cats.
Prospective case-control study (2016-2020). Echocardiography, whole blood thromboelastography (TEG), and thrombin generation testing (TGT) were performed. Hypercoagulability was defined for TEG as shortened reaction time (R), shortened kinetics (K), increased angle, or increased maximal amplitude and for TGT as decreased lag time, decreased time to peak, increased peak, or increased endogenous thrombin potential (ETP). If ≥ 1 parameter showed significant hypercoagulability compared with healthy cats, and no parameter showed significant hypocoagulability, the patient was considered hypercoagulable. The opposite criteria defined hypocoagulability.
Hypocoagulability was detected for cats with CM + ATE compared with both cats with CM and healthy cats, characterized by significantly prolonged R and K on TEG as well as significantly increased time-to-peak and decreased peak and ETP on TGT. Additionally, some thrombocytopenia was considered likely in cats with CM + ATE, but could not be fully evaluated because of a high prevalence of concurrent platelet aggregation.
A systemic hypocoagulable state was detected in cats with CM with concurrent ATE. Similar hemostatic paradoxes in human patients with thrombosis have been suggested to be related to platelet exhaustion, local endocardial hypercoagulability, or alterations in regulatory proteins.
动脉血栓栓塞（ATE）是猫心肌病（CM）已知的一种并发症。高凝状态被认为是一个诱发因素。
评估整体止血试验在评估并发ATE的CM猫（CM + ATE）全身止血状态中的适用性。
6只患有CM + ATE的猫、11只患有CM的猫和13只健康猫。
前瞻性病例对照研究（2016 - 2020年）。进行了超声心动图、全血血栓弹力图（TEG）和凝血酶生成试验（TGT）。TEG将高凝状态定义为反应时间（R）缩短、动力学（K）缩短、角度增加或最大振幅增加，TGT将高凝状态定义为滞后时间缩短、达到峰值时间缩短、峰值增加或内源性凝血酶潜力（ETP）增加。如果与健康猫相比，≥1个参数显示出显著的高凝状态，且没有参数显示出显著的低凝状态，则该患者被认为具有高凝性。相反的标准定义为低凝性。
与患有CM的猫和健康猫相比，患有CM + ATE的猫检测到低凝状态，其特征是TEG上的R和K显著延长，以及TGT上的达到峰值时间显著增加、峰值和ETP降低。此外，患有CM + ATE的猫可能存在一些血小板减少，但由于并发血小板聚集的发生率较高，无法进行全面评估。
在并发ATE的CM猫中检测到全身低凝状态。人类血栓形成患者中类似的止血矛盾现象被认为与血小板耗竭、局部心内膜高凝状态或调节蛋白改变有关。
