Clinical significance of plasma von Willebrand Factor in vascular injury
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Plasma von Willebrand factor (vWF) was determined in various vascvlar diseases.MATERIALS and METHODS: A new method without utilizing a platelet aggregometer was employed to assess plasma vWF 1) in 20 normal healthy males (21-60 years, 35.7±2.24 (S. E.) years) to know the change in plasma vWF with age, 2) in 15 patients with diabetes mellitus who do not have macroangiopathy (6 males and 9 females, 38-75, 56.9±2.80 years, Scott 0-II: 10, III-IV: 5 cases), 3) in patients with myocardial infarction (6 cases in acute, 5 in convalescent stage), cerebral thrombosis (3 in acute, 2 in convalescence), arteriosclerosis obliterans (ASO) (6 in stage IV (Fontaine), 1 after operation) and with deep vein thrombosis (2 cases) in whom the plasma vWF was compared with the age-and sex-matched controls, and 4) in 16 patients with ischemic heart disease (9 males and 7 females, 39-73, 56.9±2.72 years) before and after isometric handgrip exercise (50% voluntary maximal contraction, 2 minutes). Platelet sensitivity to ADP-aggregation (Sano et al. Thrombosis and Haemostasis 37: 329, 1977) was examined concomitantly in patients with ischemic heart disease.The new method for measuaring plasma vWF level is as follows. Serially two-fold diluted plasma (2 to 1024 times, in Tris-saline pH 7.2 containing 12mg/ml bovine serum albumin), fixed and washed platelet suspension (6×105/μl, Macfarlane et al. 1975) and 3mg/ml ristocetin were mixed (25μl each) in Microtiter tray and agitated for 15 seconds. The maximal dilution to induce platelet aggregation was obtained microscopically and defined as the titer of plasma vWF (Fig. 1).RESULTS: 1) Plasma vWF titer correlated with age in healthy males. The regression line was n=2.18+0.06 Age when vWF titer was 2n (r=0.56, p<0.05).2) Plasma vWF titer was significantly higher in diabetics with advanced microangiopathy (Scott III-IV) (n=6.0±0.32 when vWF titer was 2n) comparing to the healthy controls (n=4.3±0.20) (p<0.005). In Scott 0-II group (n=3.7±0.26) no significant difference was observed comparing to the control.3) In acute stage of myocardial infarction and stage IV of ASO, vWF titer was significantly higher (p<0.05) comparing to the controls (Fig. 2).4) In ischemic heart disease patients, plasma vWF titer and platelet sensitivity to ADP-ag-gregation became significantly enhanced (p<0.005) after isometric exercise. In healthy subjects no enhancement was observed (Fig. 3).COMMENTS: The results suggest the close relationship between plasma vWF and vascular diseases.
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