Introduction: Atrial fibrillation (AF), a risk factor for stroke and systemic thromboembolism, is associated with unfavorable fibrin clot properties and increased thrombus formation in peripheral blood. The left atrial appendage (LAA) is known to be the primary site of thrombus formation.
Aim: We investigated the relative differences in plasma fibrin clot features including plasma fibrin clot permeability (K) and clot lysis time (CLT) between the right atrium (RA), right ventricle (RV), left atrium (LA), left ventricle (LV), LAA, and peripheral blood.
Methods: Sixteen patients with nonvalvular AF who stopped oral anticoagulant therapy at least 2 days before a LARIAT procedure participated in a single-center prospective study. We measured fibrinogen and plasminogen levels along with K, CLT, and endogenous thrombin potential (ETP) during the LARIAT procedure in blood obtained from the right femoral vein, RA, RV, LA, LV and LAA.
Results: LAA clot porosity was reduced by 16.2% compared to peripheral blood (p = 0.026), also after adjustment for fibrinogen levels (p = 0.038). K was similar for the RA, RV, LA, LV, and LAA (all p > 0.05). We found 14.7% prolonged CLT for clots prepared from blood samples obtained from the LAA compared to those prepared from peripheral blood, but no differences between the RA, RV, LA and LV (all p > 0.05) were found. There were no significant differences in other parameters, including ETP, between heart chambers.
Conclusions: Patients with AF are characterised by a local prothrombotic state as reflected by formation of compact fibrin clots in the LAA compared to peripheral blood, which may contribute to LAA thrombus formation and device-related thrombi.
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http://dx.doi.org/10.1016/j.ijcard.2019.09.053 | DOI Listing |
Radiol Case Rep
March 2025
University of Maryland School of Medicine, Department of Diagnostic Radiology and Nuclear Medicine, Division of Vascular and Interventional Radiology, Baltimore, MD, USA.
Splenic steal syndrome (SSS) post liver transplant is a potential cause of graft dysfunction in the setting of peripheral hepatic arterial bed resistance and redirection of blood flow to a dominant splenic artery resulting in reduction of hepatic arterial inflow. We report utilization of balloon occlusion of the proximal splenic artery as an objective measure to confirm the diagnosis of SSS in a patient with orthotopic liver transplant followed by successful treatment with proximal splenic artery embolization using Gelfoam and Amplatzer vascular plug. Written informed consent for the publication of this case report was obtained from the patient.
View Article and Find Full Text PDFFront Oncol
December 2024
Department of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, China.
Introduction: Despite the established influence of gut bacteria, the role of the gut virome in modulating colorectal cancer (CRC) patient chemotherapy response remains poorly understood. In this study, we investigated the impact of antiviral (AV) drug-induced gut virome dysbiosis on the efficacy of 5-FU in CRC treatment.
Methods: Using a subcutaneous CRC mouse model, we assessed tumor growth and immune responses following AV treatment, fecal microbiota transplantation (FMT), and 5-FU administration.
Eur J Case Rep Intern Med
December 2024
Department of Internal Medicine, Hospital de Santa Maria, ULS de Santa Maria, Lisbon, Portugal.
Unlabelled: Cytomegalovirus (CMV) is a human herpes virus with a worldwide seroprevalence of 60-100%, mainly known to cause severe life-threatening disease in immunocompromised patients. In immunocompetent hosts (IMCh), CMV causes a self-limiting mononucleosis-like infection, and severe pictures are less recognized. We report a case of a previously healthy 62-year-old woman evaluated in the Internal Medicine outpatient clinic for 3 weeks of progressive fatigue, generalised inflammatory arthralgias, hypogastric discomfort and daily persistent fever.
View Article and Find Full Text PDFMed Int (Lond)
December 2024
Department of Hematology, Dokuz Eylul University Hospital, Izmir 35000, Turkey.
Cold agglutinin syndrome is a form of acquired hemolytic anemia that typically arises from underlying conditions, such as infections, autoimmune disorders or lymphoid malignancies. The majority of patients remain asymptomatic and are diagnosed with anemia through routine complete blood count (CBC) testing. The present study describes the case of a male patient in his 50s who sought a second opinion at the authors' clinic due to newly detected anemia.
View Article and Find Full Text PDFBr J Cancer Res
June 2024
The John Conant Davis Myeloma and Amyloid Program, Tufts Medical Center, Boston, MA, USA.
Background: Early diagnosis of systemic light-chain amyloidosis (AL) is needed because 25% of patients die within months of diagnosis. In patients with monoclonal gammopathy of undetermined significance (MGUS) or smoldering multiple myeloma (SMM) of the λ isotype, we explored the use of 2 screening variables: a free light chain difference of 23mg/L between λ and k and presence of IGLV genes that occur more frequently in AL.
Methods: Patients contacted us and we sent HIPAA release and consent forms for discussion by phone.
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