Thrombin generation, fibrin clot permeation and lysis in patients with severe mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair: Mitral Fibrin Study.
Pol Arch Intern Med
; 134(7-8)2024 08 08.
Article
em En
| MEDLINE
| ID: mdl-38752580
ABSTRACT
INTRODUCTION:
Intricate management of heart failure (HF), especially in the context of reduced ejection fraction, is further complicated by an elevated risk of thromboembolic events. Studies published so far offer inconclusive insight into the interplay between mitral regurgitation (MR) and the coagulation system.OBJECTIVES:
This study aimed to investigate the impact of transcatheter edgetoedge repair (TEER) on specific coagulation parameters in HF patients. PATIENTS ANDMETHODS:
A cohort of 31 HF patients with severe MR treated with TEER underwent a systematic evaluation at 3 visits (V1, V2, and V3). Coagulation parameters, including fibrinogen concentration, thrombin generation, fibrin clot permeability, and clot lysis time (CLT) were assessed (n = 27 at V2; n = 25 at V3).RESULTS:
TEER induced changes in fibrinogen levels (P = 0.01; V3 vs V2) and improved fibrin clot properties over 50day followup (P = 0.01; V3 vs V2). No significant differences were observed between time points in the analyzed blood clot parameters. Correlation analysis showed that baseline CLT was associated with ΔNterminal pro-Btype natriuretic peptide (NTproBNP) level (P = 0.049; r = 0.4). Multivariable analysis identified baseline CLT as an independent predictor of early postTEER NTproBNP change (R2 = 0.55; P = 0.02).CONCLUSIONS:
We found decreased level of fibrinogen and increased permeation coefficient over a median 50 (interquartile range, 32.5-75.5)-day postTEER followup, as compared with early postprocedural assessments. Other blood coagulation parameters remained unchanged from baseline at both followup time points after TEER. Finally, CLT was an independent predictor of early NTproBNP increase, emphasizing its role as an indicator of hemodynamic response to TEER.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrina
/
Trombina
/
Insuficiência da Valva Mitral
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article