Platelet and Blood Clotting Activation in Patients With Mitral Valve Prolapse

Platelets and atrial fibrillation

“…Some studies have shown an increase in platelet activation in patients with severe mitral regurgitation [40] in association with mitral valve prolapse, when compared to patients with mitral valve prolapse and mild to moderate mitral regurgitation, which was independent of age and left atrial size. However, other studies failed to demonstrate the same effect [41] , but instead report increased activation of the coagulation system and thrombin generation in these patients.…”

Relation of the severity of mitral regurgitation to thromboembolic risk in patients with atrial fibrillation

“…Recent guidelines for the management of patients with AF recommend that anticoagulation treatment should be tailored individually according to comorbidities [2]. Although several studies have demonstrated lower prevalence of embolic events in patients with mitral regurgitation (MR), [5][6][7][8][9][10] others have not [11][12][13]. It remains unclear, therefore, whether MR can reduce embolic events in AF.…”

The Thrombogenic Role of Platelets in Valvular Atrial Fibrillation

“…Some studies have shown an increase in platelet activation in patients with severe mitral regurgitation (Tse et al, 1997) in association with mitral valve prolapse, when compared to patients with mitral valve prolapse and mild to moderate mitral regurgitation, which was independent of age and left atrial size. However, other studies failed to demonstrate the same effect (Martini et al, 1996), but instead report increased activation of the coagulation system and thrombin generation in these patients. For example, Karatasakis et al, 1995 showed that significant mitral regurgitation correlates with a lower incidence of spontaneous echo contrast, thrombi and embolization in patients with rheumatic mitral valve disease.…”

“…Also, some studies on the platelets have failed to demonstrate an association of platelet activation with pure mitral valve prolapse alone (Tse et al, 1997), suggesting that if the predisposition of mitral valve prolapse to thromboembolism were true, it may well operate via a mechanism other than platelet activation alone. Perhaps the severity of mitral regurgitation in mitral valve prolapse may be a factor as reported by Martini et al, 1996 who studied the platelet and coagulation activation in patients with mitral valve prolapse and suggested that mitral valve prolapse is not responsible per se for blood clotting activation, but in patients with severe mitral insufficiency an increase in thrombin generation can occur. These alterations in hemostatic system may represent a mechanism by which mitral regurgitation increases the risk of thromboembolic events in patients with mitral valve prolapse.…”