Comparison between blood coagulability in the intra-atrial and peripheral regions during the acute phase after rapid atrial pacing

Yamada, Shusaku; Hirao, Daiki; Miura, Naoki; Iwanaga, Tomoko; Kawaguchi, Takae; Yoshimura, Aritada; Oomori, Takahiro; Nagasato, Tomoka; Maruyama, Ikuro; Fukushima, Ryuji

doi:10.1538/expanim.18-0100

Cited by 3 publications

(5 citation statements)

References 44 publications

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“…The time to initial clot formation (AR-chip T10) of blood collected from the right atrium and the occlusion time (OT) of both AR-and PL-chips were significantly shorter after 30 min of pacing compared to baseline. In contrast, no significant changes were observed in contemporaneous peripheral blood samples (31).…”

Section: Introductionmentioning

confidence: 69%

“…This study also assessed the effect of aspirin in 3 dogs and found that the PL-chip assay, but not the AR-chip assay, was affected by antiplatelet therapy (29). In two related experimental studies of atrial fibrillation induced by rapid atrial pacing, the T-TAS was used to evaluate the propensity of atrial thrombus development (30,31). The time to initial clot formation (AR-chip T10) of blood collected from the right atrium and the occlusion time (OT) of both AR-and PL-chips were significantly shorter after 30 min of pacing compared to baseline.…”

Section: Introductionmentioning

confidence: 99%

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A Novel Microchip Flow Chamber (Total Thrombus Analysis System) to Assess Canine Hemostasis

et al. 2020

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Hemorrhagic diseases are common in dogs. Current coagulation assays do not model all aspects of in vivo hemostasis and may not predict bleeding risk. The Total-Thrombus Analysis System (T-TAS) is a novel hemostasis assay system in which whole blood flows through microfluidic channels at defined shear rates to provide qualitative and quantitative evaluation of platelet function (PL-chip) and coagulation function (AR-chip). The present study evaluated the T-TAS in dogs with hereditary bleeding disorders and with acquired hemorrhagic syndromes (Group 1), and healthy controls (Group 2). Hereditary defects included von Willebrand's disease (VWD; n = 4), hemophilia A (n = 2), and canine Scott syndrome (n = 2). Acquired hemorrhagic disorders included neoplastic hemoperitoneum (n = 2) and acute hemorrhagic diarrhea syndrome (n = 1). Citrate anticoagulated samples were collected from diseased dogs (Group 1, n = 11) and controls (Group 2, n = 11) for coagulation screening tests, fibrinogen analyses, D-dimer concentration, antithrombin activity, von Willebrand Factor antigen, PFA-100 closure time (PFA-CT), and thromboelastography (TEG). Citrate and hirudin anticoagulated samples were used for T-TAS analyses at two shear rates. Qualitative thrombus formation in each chip was recorded using the T-TAS video camera. Numeric parameters, derived from the instrument software, included occlusion start time (OST; time to 10 kPa), occlusion time (OT; time to 60 kPa (PL-chip) or 80 kPa (AR-chip)), and area under the pressure curve (AUC). Correlations between continuous variables were evaluated by Spearman's rank. Continuous variables were compared between groups by Student's t-test or the Mann-Whitney U-test. Alpha was set at 0.05. In combined analyses of all dogs, significant correlations were identified between T-TAS variables, between the PFA-CT and PL-chip parameters and between TEG variables and AR-chip parameters. The prothrombin time correlated with the AR-chip AUC at both shear rates. In Group 1 dogs, the AR-chip AUC at low shear was significantly reduced compared with Group 2 dogs. Aberrant thrombus formation was seen in video images recorded from dogs with VWD and hemophilia A. The T-TAS AR-chip analysis distinguished dogs with bleeding risk compared to healthy controls. Initial evaluations of the T-TAS suggest it may aid characterization of hemostasis in patients at-risk of bleeding and assist with delineating bleeding phenotypes.

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Section: Introductionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

A Novel Microchip Flow Chamber (Total Thrombus Analysis System) to Assess Canine Hemostasis

et al. 2020

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“…Several reports of experimental models of rapid pacing‐induced atrial fibrillation (AF) in dogs were considered relevant to the PECO question. Two reports comparing the coagulability of blood sampled from the right atrium to that of peripheral blood showed evidence of hypercoagulability in atrial, but not peripheral, blood after induction of AF 138,139 . Another report demonstrated decreased trans‐mitral and left atrial appendage flow velocities during AF and following conversion to sinus rhythm compared to baseline measurements; this blood stasis may predispose to thrombosis 140 .…”

Section: Peco Question: Cardiac Arrhythmias (Dogs)mentioning

confidence: 99%

“…Two reports comparing the coagulability of blood sampled from the right atrium to that of peripheral blood showed evidence of hypercoagulability in atrial, but not peripheral, blood after induction of AF. 138,139 Another report demonstrated decreased trans-mitral and left atrial appendage flow velocities during AF and following conversion to sinus rhythm compared to baseline measurements; this blood stasis may predispose to thrombosis. 140 Induced AF in dogs also upregulates gene expression for some procoagulant mediators.…”

Section: Evidence Summarymentioning

confidence: 99%

2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1‐ Defining populations at risk

deLaforcade

Bacek

Blais

et al. 2022

J Vet Emergen Crit Care

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Objectives: To expand the number of conditions and interventions explored for their associations with thrombosis in the veterinary literature and to provide the basis for prescribing recommendations. Design: A population exposure comparison outcome format was used to represent patient, exposure, comparison, and outcome. Population Exposure Comparison Outcome questions were distributed to worksheet authors who performed comprehensive searches, summarized the evidence, and created guideline recommendations that were reviewed by domain chairs. The revised guidelines then underwent the Delphi survey process to reach consensus on the final guidelines. Diseases evaluated in this iteration included heartworm disease (dogs and cats), immune-mediated hemolytic anemia (cats), protein-losing nephropathy (cats), protein-losing enteropathy (dogs and cats), sepsis (cats), hyperadrenocorticism (cats), liver disease (dogs), congenital portosystemic shunts (dogs and cats) and the following interventions: IV catheters (dogs and cats), arterial catheters (dogs and cats), vascular access ports (dogs and cats), extracorporeal circuits (dogs and cats) and transvenous pacemakers (dogs and cats).Results: Of the diseases evaluated in this iteration, a high risk for thrombosis was defined as heartworm disease or protein-losing enteropathy. Low risk for thrombosis was defined as dogs with liver disease, cats with immune-mediated hemolytic anemia, protein-losing nephropathy, sepsis, or hyperadrenocorticism. Conclusions:Associations with thrombosis are outlined for various conditions and interventions and provide the basis for management recommendations. Numerous knowledge gaps were identified that represent opportunities for future studies.

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“…7,14,20 The T-TAS has also been used in the evaluation of a canine bleeding disorder 8 and in a canine model of atrial fibrillation. 17,18 However, the T-TAS has not been evaluated in detail in healthy dogs nor used to test the ability of the analyzer to detect inhibition with in vivo or in vitro drugs in dogs.…”

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confidence: 99%

Analysis of blood clotting with the total thrombus analysis system in healthy dogs

et al. 2021

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To date, coagulation tests are unable to reflect in vivo coagulation status in the same system, including platelet function, fibrin clot formation, and whole blood flow. The Total Thrombus Analysis System (T-TAS), which is a microfluidic assay that simulates conditions in vivo, measures whole blood flow at defined shear rates under conditions designed to assess platelet function (PL-chip) or coagulation and fibrin clot formation (AR-chip). The T-TAS records occlusion start time, occlusion time, and area under the curve. We evaluated this test in healthy control dogs. We also investigated the effect in vivo of acetylsalicylic acid (ASA), and the effect in vitro of an anticoagulation drug (dalteparin; low-molecular-weight heparin; LMWH). The CV of the AUC of both chips was good (CVs of 6.45% [PL] and 1.57% [AR]). The inhibition of platelet function by ASA was evident in the right-shift in the PL test pressure curve. The right-shift in the AR test pressure curves showed that the administration of LMWH inhibited both platelets and the coagulation cascade. The T-TAS may be useful in the evaluation of canine blood coagulation.

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Comparison between blood coagulability in the intra-atrial and peripheral regions during the acute phase after rapid atrial pacing

Cited by 3 publications

References 44 publications

A Novel Microchip Flow Chamber (Total Thrombus Analysis System) to Assess Canine Hemostasis

A Novel Microchip Flow Chamber (Total Thrombus Analysis System) to Assess Canine Hemostasis

2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1‐ Defining populations at risk

Analysis of blood clotting with the total thrombus analysis system in healthy dogs

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