The coagulation system changes in patients with chronic heart failure

Aušra Mongirdienė^{1, 2}, Lolita Kuršvietienė², Artūras Kašauskas²

¹Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, ²Department of Biochemistry, Medical Academy, Lithuanian University of Health Sciences, Lithuania

Key words: chronic heart failure; coagulation system; fibrinogen; platelets; endothelium.

Summary. 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, thrombin-antithrombin 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.

Correspondence to A. Mongirdienė, Department of Biochemistry, Medical Academy, Lithuanian University of Health Sciences, Eivenių 4, 50161 Kaunas, Lithuania. E-mail: ausra.mongirdiene@mail.com

Received 27 June 2008, accepted 6 September 2010