Left atrial blood stasis and von willebrand factor-adamts13 homeostasis in atrial fibrillation

Naser Ammash, Ewa A. Konik, Robert D. McBane, Dong Chen, Julie I. Tange, Diane E. Grill, Regina M. Herges, Thomas G. McLeod, Paul Andrew Friedman, Waldemar E. Wysokinski

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objective-: Left atrial blood stasis is associated with increased risk for left atrial appendage thrombus (LAAT) and stroke in atrial fibrillation (AF). Von Willebrand factor (VWF) is associated with thromboembolism in AF. VWF thrombogenic activity is proportional to multimer size, which is regulated by VWF-cleaving protease (ADAMTS13). Methods and Results-: To assess the association between left atrial blood stasis and VWF-ADAMTS13 system, plasma VWF antigen (VWF:Ag), VWF activity (VWF:Act), and ADAMTS13 activity were measured in 414 consecutive patients with nonvalvular AF (age 63±13 years; 25% women) and in 100 patients (age 64±14 years; 39% women) with normal sinus rhythm. Spontaneous echocardiographic contrast (SEC), left atrial appendage emptying velocity, and LAAT were assessed by transesophageal echocardiography. Presence and intensity of SEC varied directly with VWF:Ag and VWF:Act but not with ADAMTS13 activity. AF patients with LAAT had higher VWF:Ag (200±61 versus 155±52, P=0.0006) and VWF:Act (179±57 versus 141±51 P=0.0026) compared with those without LAAT. VWF:Ag and VWF:Act were independent predictors of LAAT after adjustment for CHADS 2 score (P=0.0179 and P=0.0497, respectively). Conclusion-: The association between VWF and SEC may explain the thrombotic propensity in AF. Elevated VWF:Ag may help identify AF patients at risk for LAAT.

Original languageEnglish (US)
Pages (from-to)2760-2766
Number of pages7
JournalArteriosclerosis, Thrombosis, and Vascular Biology
Volume31
Issue number11
DOIs
StatePublished - Nov 2011

Fingerprint

von Willebrand Factor
Atrial Fibrillation
Homeostasis
Atrial Appendage
Thrombosis
Thromboembolism
Transesophageal Echocardiography
Stroke

Keywords

  • atrial fibrillation
  • stroke
  • thrombosis
  • von Willebrand factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ammash, N., Konik, E. A., McBane, R. D., Chen, D., Tange, J. I., Grill, D. E., ... Wysokinski, W. E. (2011). Left atrial blood stasis and von willebrand factor-adamts13 homeostasis in atrial fibrillation. Arteriosclerosis, Thrombosis, and Vascular Biology, 31(11), 2760-2766. https://doi.org/10.1161/ATVBAHA.111.232991

Left atrial blood stasis and von willebrand factor-adamts13 homeostasis in atrial fibrillation. / Ammash, Naser; Konik, Ewa A.; McBane, Robert D.; Chen, Dong; Tange, Julie I.; Grill, Diane E.; Herges, Regina M.; McLeod, Thomas G.; Friedman, Paul Andrew; Wysokinski, Waldemar E.

In: Arteriosclerosis, Thrombosis, and Vascular Biology, Vol. 31, No. 11, 11.2011, p. 2760-2766.

Research output: Contribution to journalArticle

Ammash, N, Konik, EA, McBane, RD, Chen, D, Tange, JI, Grill, DE, Herges, RM, McLeod, TG, Friedman, PA & Wysokinski, WE 2011, 'Left atrial blood stasis and von willebrand factor-adamts13 homeostasis in atrial fibrillation', Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 31, no. 11, pp. 2760-2766. https://doi.org/10.1161/ATVBAHA.111.232991
Ammash, Naser ; Konik, Ewa A. ; McBane, Robert D. ; Chen, Dong ; Tange, Julie I. ; Grill, Diane E. ; Herges, Regina M. ; McLeod, Thomas G. ; Friedman, Paul Andrew ; Wysokinski, Waldemar E. / Left atrial blood stasis and von willebrand factor-adamts13 homeostasis in atrial fibrillation. In: Arteriosclerosis, Thrombosis, and Vascular Biology. 2011 ; Vol. 31, No. 11. pp. 2760-2766.
@article{f2a81ba0d28a45e08c5848903898292b,
title = "Left atrial blood stasis and von willebrand factor-adamts13 homeostasis in atrial fibrillation",
abstract = "Objective-: Left atrial blood stasis is associated with increased risk for left atrial appendage thrombus (LAAT) and stroke in atrial fibrillation (AF). Von Willebrand factor (VWF) is associated with thromboembolism in AF. VWF thrombogenic activity is proportional to multimer size, which is regulated by VWF-cleaving protease (ADAMTS13). Methods and Results-: To assess the association between left atrial blood stasis and VWF-ADAMTS13 system, plasma VWF antigen (VWF:Ag), VWF activity (VWF:Act), and ADAMTS13 activity were measured in 414 consecutive patients with nonvalvular AF (age 63±13 years; 25{\%} women) and in 100 patients (age 64±14 years; 39{\%} women) with normal sinus rhythm. Spontaneous echocardiographic contrast (SEC), left atrial appendage emptying velocity, and LAAT were assessed by transesophageal echocardiography. Presence and intensity of SEC varied directly with VWF:Ag and VWF:Act but not with ADAMTS13 activity. AF patients with LAAT had higher VWF:Ag (200±61 versus 155±52, P=0.0006) and VWF:Act (179±57 versus 141±51 P=0.0026) compared with those without LAAT. VWF:Ag and VWF:Act were independent predictors of LAAT after adjustment for CHADS 2 score (P=0.0179 and P=0.0497, respectively). Conclusion-: The association between VWF and SEC may explain the thrombotic propensity in AF. Elevated VWF:Ag may help identify AF patients at risk for LAAT.",
keywords = "atrial fibrillation, stroke, thrombosis, von Willebrand factor",
author = "Naser Ammash and Konik, {Ewa A.} and McBane, {Robert D.} and Dong Chen and Tange, {Julie I.} and Grill, {Diane E.} and Herges, {Regina M.} and McLeod, {Thomas G.} and Friedman, {Paul Andrew} and Wysokinski, {Waldemar E.}",
year = "2011",
month = "11",
doi = "10.1161/ATVBAHA.111.232991",
language = "English (US)",
volume = "31",
pages = "2760--2766",
journal = "Arteriosclerosis, Thrombosis, and Vascular Biology",
issn = "1079-5642",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - Left atrial blood stasis and von willebrand factor-adamts13 homeostasis in atrial fibrillation

AU - Ammash, Naser

AU - Konik, Ewa A.

AU - McBane, Robert D.

AU - Chen, Dong

AU - Tange, Julie I.

AU - Grill, Diane E.

AU - Herges, Regina M.

AU - McLeod, Thomas G.

AU - Friedman, Paul Andrew

AU - Wysokinski, Waldemar E.

PY - 2011/11

Y1 - 2011/11

N2 - Objective-: Left atrial blood stasis is associated with increased risk for left atrial appendage thrombus (LAAT) and stroke in atrial fibrillation (AF). Von Willebrand factor (VWF) is associated with thromboembolism in AF. VWF thrombogenic activity is proportional to multimer size, which is regulated by VWF-cleaving protease (ADAMTS13). Methods and Results-: To assess the association between left atrial blood stasis and VWF-ADAMTS13 system, plasma VWF antigen (VWF:Ag), VWF activity (VWF:Act), and ADAMTS13 activity were measured in 414 consecutive patients with nonvalvular AF (age 63±13 years; 25% women) and in 100 patients (age 64±14 years; 39% women) with normal sinus rhythm. Spontaneous echocardiographic contrast (SEC), left atrial appendage emptying velocity, and LAAT were assessed by transesophageal echocardiography. Presence and intensity of SEC varied directly with VWF:Ag and VWF:Act but not with ADAMTS13 activity. AF patients with LAAT had higher VWF:Ag (200±61 versus 155±52, P=0.0006) and VWF:Act (179±57 versus 141±51 P=0.0026) compared with those without LAAT. VWF:Ag and VWF:Act were independent predictors of LAAT after adjustment for CHADS 2 score (P=0.0179 and P=0.0497, respectively). Conclusion-: The association between VWF and SEC may explain the thrombotic propensity in AF. Elevated VWF:Ag may help identify AF patients at risk for LAAT.

AB - Objective-: Left atrial blood stasis is associated with increased risk for left atrial appendage thrombus (LAAT) and stroke in atrial fibrillation (AF). Von Willebrand factor (VWF) is associated with thromboembolism in AF. VWF thrombogenic activity is proportional to multimer size, which is regulated by VWF-cleaving protease (ADAMTS13). Methods and Results-: To assess the association between left atrial blood stasis and VWF-ADAMTS13 system, plasma VWF antigen (VWF:Ag), VWF activity (VWF:Act), and ADAMTS13 activity were measured in 414 consecutive patients with nonvalvular AF (age 63±13 years; 25% women) and in 100 patients (age 64±14 years; 39% women) with normal sinus rhythm. Spontaneous echocardiographic contrast (SEC), left atrial appendage emptying velocity, and LAAT were assessed by transesophageal echocardiography. Presence and intensity of SEC varied directly with VWF:Ag and VWF:Act but not with ADAMTS13 activity. AF patients with LAAT had higher VWF:Ag (200±61 versus 155±52, P=0.0006) and VWF:Act (179±57 versus 141±51 P=0.0026) compared with those without LAAT. VWF:Ag and VWF:Act were independent predictors of LAAT after adjustment for CHADS 2 score (P=0.0179 and P=0.0497, respectively). Conclusion-: The association between VWF and SEC may explain the thrombotic propensity in AF. Elevated VWF:Ag may help identify AF patients at risk for LAAT.

KW - atrial fibrillation

KW - stroke

KW - thrombosis

KW - von Willebrand factor

UR - http://www.scopus.com/inward/record.url?scp=80054925033&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054925033&partnerID=8YFLogxK

U2 - 10.1161/ATVBAHA.111.232991

DO - 10.1161/ATVBAHA.111.232991

M3 - Article

C2 - 21852562

AN - SCOPUS:80054925033

VL - 31

SP - 2760

EP - 2766

JO - Arteriosclerosis, Thrombosis, and Vascular Biology

JF - Arteriosclerosis, Thrombosis, and Vascular Biology

SN - 1079-5642

IS - 11

ER -