The coagulation system changes in patients with chronic heart failure

Abstract

Though heart failure can mainly be caused by systolic or diastolic dysfunction, the impairments of the neurohormonal, immune, and hemostatic systems are observed too. Therefore, it is not easy to determine etiology of the syndrome. Parameters that can be helpful to predict chronic heart failure, to evaluate its course and the risk of complications are still being searched. The aim of this article is to review the recent studies in order to find the links between the coagulation system and the development of chronic heart failure. Stress is a key factor for the development of most diseases including chronic heart failure too. Signals of emotional and physical stress via particular structures trigger an increase in concentrations of the following hormones: noradrenaline, renin, angiotensin II, aldosterone, vasopressin. It is proved that it causes the disorders of the coagulation system: an increase in the following factors of plasma coagulation (fibrinogen, VII, VIII, fibrinopeptide A, thrombinantithrombin complex), fibrinolysis (D-dimer), endothelium (interleukin 1, endothelin 1, vascular cell adhesion molecules, endothelial growth factor), platelet activity (von Willebrand factor, intercellular adhesion molecules, platelet factor 4, P-selectin, thromboxane A2, thromboglobulin, CD63P) and cytokines (tumor necrosis factor, interleukin 6) and decrease in E-selectin. The role of particular coagulation factors for the development of chronic heart failure has not been understood yet. Thus, it is necessary to carry out further studies.

Advanced Congestive Heart Failure Associated With Disseminated Intravascular Coagulopathy

“… 4 - 6 Other studies have also observed increased coagulation factors, fibrinolysis, and platelet activation. 7 The ultimate underlying mechanism may be due to tissue ischemia, stagnant blood flow, and increased α-adrenergic activity in CHF leading to DIC. Ventricular thrombi can be a consequence of activated coagulation pathway but may also “consume” coagulation factors locally leading to severe DIC.…”

Thromboelastographic evaluation of hemostatic functionin dogs with dilated cardiomyopathy

“…Coagulation abnormalities have been reported in patients that show different severities of heart diseases in human (7,19) and veterinary medicine (8,10,20), and thus therapeutic approaches have been suggested to protect patients from these problems (17). Coagulation activation and related complications such as thromboembolism were reported, especially in cats with hypertrophic cardiomyopathy (17,21).…”

Proteomic biomarkers of recovered heart function

“…The top GeneGo process network was ‘Blood coagulation’ ( Figure C ), as many of the identified biomarkers are known to be involved in this process: coagulation factor IX, coagulation factor X, prothrombin, antithrombin‐III, vitamin K‐dependent protein C, vitamin K‐dependent protein S, and alpha‐2‐antiplasmin. A link between the development of chronic HF and abnormalities in blood coagulation has been shown previously . Higuchi et al found that protein S was up‐regulated in mouse myocardium in different aetiological models of HF, and hypothesized that this up‐regulation may have a protective role in the failing heart .…”