凝血系统在特发性心肌病中被激活。

The coagulation system is activated in idiopathic cardiomyopathy.

作者信息

Yamamoto K, Ikeda U, Furuhashi K, Irokawa M, Nakayama T, Shimada K

机构信息

Department of Cardiology, Jichi Medical School, Tochigi, Japan.

出版信息

J Am Coll Cardiol. 1995 Jun;25(7):1634-40. doi: 10.1016/0735-1097(95)00049-a.

DOI:10.1016/0735-1097(95)00049-a

PMID:7539015

Abstract

OBJECTIVES

We investigated the plasma levels of molecular markers for platelet activity and the thrombotic and fibrinolytic status in patients with hypertrophic cardiomyopathy and dilated cardiomyopathy to determine the activating site of coagulation in these disorders.

BACKGROUND

A thromboembolic event is a serious complication in patients with idiopathic cardiomyopathy. However, the activating site of the coagulation system in idiopathic cardiomyopathy has not been fully investigated.

METHODS

We determined the plasma levels of molecular markers for platelet activity (platelet factor 4 and beta-thromboglobulin), thrombotic status (fibrinopeptide A and thrombin-antithrombin III complex) and fibrinolytic status (D-dimer and plasmin-alpha 2-plasmin inhibitor complex) in 13 patients with hypertrophic cardiomyopathy, 17 patients with dilated cardiomyopathy and 20 normal subjects.

RESULTS

Plasma levels of platelet factor 4, beta-thromboglobulin and plasmin-alpha 2-plasmin inhibitor complex did not differ significantly among the three groups, whereas plasma levels of fibrinopeptide A and thrombin-antithrombin III complex in both patient groups were significantly higher than those in normal subjects. Plasma levels of D-dimer in patients with dilated cardiomyopathy were significantly higher than those in patients with hypertrophic cardiomyopathy and normal groups. In patients with hypertrophic cardiomyopathy, both fibrinopeptide A and thrombin-antithrombin III complex levels were significantly correlated with left atrial diameter. In patients with dilated cardiomyopathy, fibrinopeptide A and thrombin-antithrombin III complex levels showed a positive correlation with left ventricular end-diastolic volume and a negative correlation with fractional shortening of the left ventricle.

CONCLUSIONS

The activated coagulation system in patients with hypertrophic and dilated cardiomyopathy may be triggered by left atrial dilation in hypertrophic cardiomyopathy and left ventricular enlargement and dysfunction in dilated cardiomyopathy.

摘要

目的

我们研究了肥厚型心肌病和扩张型心肌病患者血小板活性分子标志物的血浆水平以及血栓形成和纤溶状态，以确定这些疾病中凝血的激活部位。

背景

血栓栓塞事件是特发性心肌病患者的严重并发症。然而，特发性心肌病中凝血系统的激活部位尚未得到充分研究。

方法

我们测定了13例肥厚型心肌病患者、17例扩张型心肌病患者和20名正常受试者的血小板活性分子标志物（血小板因子4和β-血小板球蛋白）、血栓形成状态（纤维蛋白肽A和凝血酶-抗凝血酶III复合物）和纤溶状态（D-二聚体和纤溶酶-α2-纤溶酶抑制物复合物）的血浆水平。

结果

三组患者的血小板因子4、β-血小板球蛋白和纤溶酶-α2-纤溶酶抑制物复合物的血浆水平无显著差异，而两组患者的纤维蛋白肽A和凝血酶-抗凝血酶III复合物的血浆水平均显著高于正常受试者。扩张型心肌病患者的D-二聚体血浆水平显著高于肥厚型心肌病患者和正常组。在肥厚型心肌病患者中，纤维蛋白肽A和凝血酶-抗凝血酶III复合物水平均与左心房直径显著相关。在扩张型心肌病患者中，纤维蛋白肽A和凝血酶-抗凝血酶III复合物水平与左心室舒张末期容积呈正相关，与左心室缩短分数呈负相关。