非风湿性急性心房颤动发作时血浆vW因子、可溶性血栓调节素、纤维蛋白D二聚体的浓度  

Plasma von Willebrand factor, soluble thrombomodulin, and fibrin D-dimer concentrations in acute onset non-rheumatic atrial fibrillation

作　　者：Marn F. Rold an V. Climent V.E. 艾文婷 

机构地区：[1]Department of Cardiology, General Hospital of Alicante, Pintor Baeza s/n, Alicante 03002, Spain Dr.

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2005年第3期42-43,共2页

摘　　要：Objective: To investigate whether new onset acute atrial fibrillation (AF) of< 48 hours’duration creates a prothrombotic state in the absence of anticoagulation and to assess the evolution in research indices after spontaneous or pharmacological cardioversion. Methods: 24 patients were recruited with first onset acute non-rheumatic AF, in whom sinus rhythm was restored within 48 hours of arrhythmia onset, without anticoagulant treatment. Atrial mechanical function was assessed by transmitral inflow. Soluble thrombomodulin and von Willebrand factor concentrations (both as indices of endothelial damage or dysfunction) and fibrin D-dimer concentrations(as an index of thrombogenesis) were measured. Blood samples were drawn and echocardiographic studies were performed at days 1, 2, 7, and 30 after cardioversion. Research indices were compared with those of 24 healthy participants, 24 patientswith chronicAF, and 24 patientswith ischaemic heart disease in sinus rhythm. Results: Patients with AF had higher concentrations of soluble thrombomodulin(acute AF 12.1 (4.1) ng/ml; chronic AF 11.8(4.6) ng/ml), von Willebrand factor(acute AF 137.2(36.9)ng/ml; chronic AF 133.1(25.0)ng/ml), and fibrin Ddimer concentrations(acute AF 2.35(2.68)μg/ml; chronic AF 1.12(0.65)μg/ml) than did healthy controls (5.9(2.7)ng/ml, 86.7(33.2)ng/ml, and 0.39(0.28)μg/ml, respectively) and patients with ischaemic heart disease(7.4 (3.7)ng/ml,110.0(29.0)ng/ml, and 0.99(0.73)μg/ml, respectively)(all p < 0.05). Day 30 concentrations of fibrin D-dimer were higher in patients with acute AF than in patients with chronic AF(p=0.038) but sTM and vonWillebrand factor concentrations were not different (both not significant). There were no significant changes in research indices or echocardiographic parameters after cardioversion (all p >0.05). Conclusions: There was evidence among patients with acute onset AF of endothelial damage or dysfunction and increased thrombogenesis, which persisted up to 30 days after cardioversion.Objective: To investigate whether new onset acute atrial fibrillation (AF) of< 48 hours'duration creates a prothrombotic state in the absence of anticoagulation and to assess the evolution in research indices after spontaneous or pharmacological cardioversion. Methods: 24 patients were recruited with first onset acute non-rheumatic AF, in whom sinus rhythm was restored within 48 hours of arrhythmia onset, without anticoagulant treatment. Atrial mechanical function was assessed by transmitral inflow. Soluble thrombomodulin and von Willebrand factor concentrations (both as indices of endothelial damage or dysfunction) and fibrin D-dimer concentrations(as an index of thrombogenesis) were measured. Blood samples were drawn and echocardiographic studies were performed at days 1, 2, 7, and 30 after cardioversion. Research indices were compared with those of 24 healthy participants, 24 patientswith chronicAF, and 24 patientswith ischaemic heart disease in sinus rhythm. Results: Patients with AF had higher concentrations of soluble thrombomodulin(acute AF 12.1 (4.1) ng/ml; chronic AF 11.8(4.6) ng/ml), von Willebrand factor(acute AF 137.2(36.9)ng/ml; chronic AF 133.1(25.0)ng/ml), and fibrin Ddimer concentrations(acute AF 2.35(2.68)μg/ml; chronic AF 1.12(0.65)μg/ml) than did healthy controls (5.9(2.7)ng/ml, 86.7(33.2)ng/ml, and 0.39(0.28)μg/ml, respectively) and patients with ischaemic heart disease(7.4 (3.7)ng/ml,110.0(29.0)ng/ml, and 0.99(0.73)μg/ml, respectively)(all p < 0.05). Day 30 concentrations of fibrin D-dimer were higher in patients with acute AF than in patients with chronic AF(p=0.038) but sTM and vonWillebrand factor concentrations were not different (both not significant). There were no significant changes in research indices or echocardiographic parameters after cardioversion (all p >0.05). Conclusions: There was evidence among patients with acute onset AF of endothelial damage or dysfunction and increased thrombogenesis, which persisted up to 30 days after cardioversion.

关 键 词：急性心房颤动 vW 二聚体 慢性心房颤动 心房颤动患者 药物复律 窦性心律 窦性心率 缺血性心脏病 二尖瓣血流频谱 

分 类 号：R541.7[医药卫生—心血管疾病]