Relationship between Flow Dynamics in the Left Atrium and Hemostatic Abnormalities in Patients with Nonvalvular Atrial Fibrillation.
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概要
- 論文の詳細を見る
To investigate the relationship between left atrial (LA) flow dynamics and hemostatic markers in nonvalvular atrial fibrillation (AF), 45 patients with nonvalvular AF who had not received anticoagulants were evaluated by transesophageal echocardiography. We determined the LA appendage flow and the presence of LA spontaneous echo contrast (SEC) or thrombus. We measured plasma levels of thrombin-antithrombin III complex (TAT), fibrinopeptide A, D-dimer, β-thromboglobulin, and platelet factor 4 in peripheral blood as hemostatic markers. The patients were divided into a low-velocity group (n=19; sum of peak emptying and filling LA appendage flow velocities<40cm/s) and a high-velocity group (n=26;≥40cm/s). The maximum LA diameter was significantly greater and the LA expansion fraction was significantly smaller in the low-velocity group than in the high-velocity group. LA SEC or thrombus was observed in 11 patients (58%) in the low-velocity group, but not in any patients in the high-velocity group (p<0.001). The plasma levels of TAT, fibrinopeptide A, D-dimer, β-thromboglobulin, and platelet facfor 4 were significantly higher in the low-velocity group than in the highvelocity group. The plasma levels of TAT, fibrinopeptide A, β-thromboglobulin, and platelet factor 4 were significantly higher in 8 patients without LA SEC or thrombus in the low-velocity group than in 26 patients in the high-velocity group. Patients with nonvalvular AF accompanied by an enlarged and dysfunctioning LA and a decreased LA appendage flow velocity had increased intravascular coagulation-fibrinolysis activity and platelet activation. These abnormalities may be closely related to the thrombogenetic state in patients with nonvalvular AF.
- International Heart Journal刊行会の論文
著者
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Fukuda Nobuo
Division Of Cardiology Nho Zentsuji National Hospital
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Takeichi Naoki
Division Of Cardiology And Clinical Research Zentsuji National Hospital
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SHINOHARA Hisanori
Division of Cardiology and Clinical Research, Zentsuji National Hospital
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TAMURA Yoshiyuki
Division of Cardiology and Clinical Research, Zentsuji National Hospital
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Oki Takashi
Second Department Of Internal Medicine
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Takeichi Naoki
Division of Cardiology and Clinical Research, Zentsuji National Hospital
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YUI Yasuko
Division of Cardiology and Clinical Research, Zentsuji National Hospital
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SOEKI Takeshi
Division of Cardiology and Clinical Research, Zentsuji National Hospital
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