Circulating markers of endothelium damage, proinflammatory markers, and cell stimulation estimated with circulating microparticles appear to be valuable tools in determining the severity of PAH.
D-Dimers are elevated in patients with AAD and provide valuable diagnostic and prognostic information. In patients with acute chest pain and elevated D-Dimer, a diagnosis of AAD should also be considered. D-Dimer might be a useful complementary tool to the current diagnostic work-up of patients with suspected AAD.
SummaryIn the present study, we explored the microparticles involved in the control of hemostatic equilibrium, i.e microparticles originating from platelet, endothelial cells and total MP defined as annexin V positive microparticles. Our aim was to analyze the level and procoagulant activity of these microparticles in normal pregnancy and pregnancies complicated with preeclampsia or isolated intrauterine growth restriction. We reported increased levels of platelet and endothelial microparticles in normal pregnancy compared to non pregnant healthy women. Number of annexin V microparticles was significantly increased together with their procoagulant activity. In pathological pregnancies, significant reduction in platelet microparticle number was found in preeclampsia. The procoagulant activity generated by the total annexin V MP was unchanged, suggesting that the microparticles remaining in the circulation were pro-coagulant. This study evidenced that microparticles constitute a cellular marker of a proinflammatory and procoagulant responses in normal pregnancy. In pregnancies with vascular complications, circulating MP with procoagulant potential may be part of the exacerbation of these responses.
Background: In obesity, metabolic stress and inflammation in injured tissues could favour enhanced shedding of procoagulant microparticles (MPs). At sites of endothelium injury, the swift recruitment of procoagulant leukocyte-derived MPs enables the initiation of blood coagulation and thrombus growth. Objectives: In obese females, we sought to evaluate the impact of a very low-calorie diet (VLCD) on procoagulant MP levels, fibrinolytic status, inflammation and endothelium damage. Methods: Circulating biomarkers of vascular damage, fibrinolytic status, platelet activation and inflammation were measured before, 30 and 90 days after starting a short-term VLCD. MPs were measured by flow cytometry and capture assays. Their procoagulant potential was quantified using functional prothrombinase assays and their cellular origin were determined using flow cytometry (endothelium, platelet, leukocyte, lymphocyte and erythrocyte-derived MP) or capture assays. Results: A total of 24 obese females (39 ± 10 years) with a mean body mass index of 35 ± 4 kg m À2 were prospectively enroled. Procoagulant leukocyte-derived MPs were associated with the waist circumference at baseline (r ¼ 0.534; P ¼ 0.010) and at 90 days follow-up (r ¼ 0.487; P ¼ 0.021). At 90 days, weight reduction (À9.8%) was associated with a lowering of blood pressure, improvement of metabolic parameters and a significant reduction of plasminogen activator inhibitor-1 (PAI-1) (À38%), procoagulant platelet-derived MPs (À43%), leukocyte-derived MPs (À28%) and leptin (À32%) levels. Conclusion: In obese females, a short-term VLCD results in an overall improvement of the haemostatic balance characterized by the reduction of PAI-levels, diminished release of platelet and leukocyte-derived MPs and a reduction in leptin levels, an adipocyte-derived cytokine.
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