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Platelet distribution width can be a useful marker of decreased platelet activity after percutaneous mitral balloon valvuloplasty

Year 2019, , 348 - 352, 30.09.2019
https://doi.org/10.18663/tjcl.542806

Abstract

Aim:
Increased platelet
activity and elevated mean platelet volume (MPV) has been
demonstrated in patients with rheumatic mitral stenosis (RMS).
However,
platelet
distribution width (PDW) and
the
impact of percutaneous mitral balloon valvuloplasty (PMBV) on PDW has
never been studied. Therefore, we aimed to investigate whether PMBV
decreases PDW in patients with RMS.

Material
and
Methods:
Symptomatic patients with severe RMS undergoing PMBV were included.
Echocardiographic characteristics and hematologic parameters was
measured just before and 1 month after the PMBV procedure.

Results:
A total of 30 patients (24 female, mean age: 49.8±13.2 years) were
included the study. Mean transmitral pressure gradient, pulmonary
artery pressures and left atrium diameter decreased but mitral valve
area increased significantly after PMBV. PMBV procedure significantly
decreased PDW in patients with RMS (13.5±2.3 vs 12.4±1.9 fL, before
and after procedure, respectively; p<0.0001). MPV was decreased
after PMBV but it was not statistically significant (10.9±0.8 vs
10.6±0.9 fL, p=0.056). Platelet count was significantly increased
after procedure (250±62.6 vs 273.5±78.6 x103/ul, p=0.035). In
linear regression analysis, an independent relationship was found in
magnitude of PDW decrease and magnitude of increase in mitral valve
area (ẞ:0.491, p=0.046).




Conclusion:
PMBV
is associated with a significant decrease in PDW 1 month after the
procedure.
There
was a significant correlation between the magnitude of decrease in
PDW and magnitude of increase in mitral valve area after PMBV.

References

  • 1. Harb SC, Griffin BP. Mitral Valve Disease: a Comprehensive Review. Curr Cardiol Rep 2017; 19: 73.
  • 2. Tengiz I, Ercan E, Sahin F et al. Presence of factors that activate platelet aggregation in mitral stenotic patients’ plasma. Curr Control Trials Cardiovasc Med 2005; 6: 2.
  • 3. Chen MC, Wu CJ,Yip HK et al. Left atrial platelet activity with rheumatic mitral stenosis: correlation study of severity and platelet p-selectin expression by flow cytometry. Chest 2003; 124: 1663-69.
  • 4. Chen MC, Wu CJ, Chang HW et al. Mechanism of reducing platelet activity by percutaneous transluminal mitral valvuloplasty in patients with rheumatic mitral stenosis. Chest. 2004; 125: 1629-34.
  • 5. Kataoka H, Yano S, Tamura A, Mikuriya Y. Hemostatic changes induced by percutaneouus mitral valvuloplasty. Am Heart J 1993; 125: 777-82.
  • 6. Zaki A, Salama M, El Masry M et al. Immediate effect of balloon valvulplasty on hemostatic changes in mitral stenosis. Am J Cardiol. 2000;85 (3):370-375.
  • 7. Chiang CW, Lo SK, Cheng NJ, Lin PJ, Chang CH. Predictors of systemic embolism in patients with mitral stenosis. A prospective study. Ann Intern Med 1998; 128: 885-89.
  • 8. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hipokratia 2010; 14: 28-32.
  • 9. Varol E, Ozaydın M, Turker Y, Alaca S. Mean platelet volume, an indicator of platelet activation, is increased in patients with mitral stenosis and sinus rhytm. Scand J Clin Lab Invest 2009; 69: 708-12.
  • 10. Boyacı A, Topaloğlu S, Yılmaz S, et al. Regional left atrial coagulation and fibrinolytic activities in patients with mitral stenosis. Jpn Heart J 2004; 45: 779-88.
  • 11. Erdoğan D, İçli A, Aksoy F, Yücel H et al. Percutaneous mitral balloon valvuloplasty reduces mean platelet volume in patients with rheumatic mitral stenosis. Scandinavian Journal of Clinical and Laboratory Investigation, 2012; 72: 452-58.
  • 12. Wilkins GT, Weyman AE, Abascal VM, Block PC, Palacios IF. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J 1988; 60: 299-308.
  • 13. Golebiewska EM. Poole AW. Platelet secretion: From haemostasis to wound healing and beyond. Blood Rev. 2015; 29: 153–62.
  • 14. Yılmaz F, Koklu E, Kızılırmak Yılmaz F et al. Evaluation of mean platelet volume and platelet distribution width in patients with asymptomatic intermediate carotid artery plaque. Kardiol POL 2017; 75: 35-41.
  • 15. Cetin M, Bakırcı EM, Baysal E, et al. Increased platelet distribution width is associated with ST-segment elevtion myocardial infarction and thrombolysis failure. Angiology. 2014; 65: 737-43.
  • 16. Chen MC, Chang HW, Juang SS, Yip HK, Wu CJ. Increased plasma levels of soluble P-selectin in rheumatic mitral stenosis. Chest 2004; 126: 54-58.
  • 17. Topaloğlu S, Boyacı A, Ayaz S et al. Coagulation, fibrinolytic system activation and endothelial dysfunction in patients with mitral stenosis and sinus rhytm. Angiology 2007; 58: 85-91.
  • 18. Stein PD, Sabbah HN. Turbulance blood flow in the ascending aorta of humans with normal and diseased aortic valves. Circ Res 1976; 39: 58-65.
  • 19. Yu SK, Latour JG, Marchandise B et al. Shear stres-induced changes in platelet reactivity. Thromb Haemost 1978; 40: 551-560.
  • 20. Block PC, Palacios IF, Block EH, Tuzcu EM, Griffin B. Late follow up after percutaneous balloon mitral valvotomy. Am J Cardiol 1992; 69: 537-41.
  • 21. Hasan-Ali H, Mosad E. Changes in platelet, coagulation, and fibrinolytic activities in mitral stenosis after percutaneous mitral valvotomy: role of hemodynamic changes aand systemic inflammation. Clin Appl Thromb Hemost. 2015; 21: 339-47.

Trombosit dağılım genişliği, perkütan mitral balon valvüloplasti sonrası azalmış trombosit aktivitesinin yararlı bir göstergesi olabilir

Year 2019, , 348 - 352, 30.09.2019
https://doi.org/10.18663/tjcl.542806

Abstract

Amaç:
Romatizmal
mitral darlığı (RMD) olan hastalarda artmış trombosit aktivitesi
ve yüksek ortalama trombosit hacmi (MPV) gösterilmiştir. Bununla
birlikte, trombosit dağılım genişliği (PDW) ve perkütan mitral
balon valvüloplasti'nin (PMBV) PDW üzerindeki etkisi hiç
çalışılmamıştır. Bu nedenle, RMD'lı hastalarda PMBV işleminin
PDW üzerine etkisini araştırmayı amaçladık.

Gereç
ve Yöntemler
:
PMBV
uygulanan ciddi RMD'lı semptomatik hastalar dahil edildi.
Ekokardiyografik özellikler ve hematolojik parametreler PMBV
işleminden hemen önce ve bir ay sonra ölçüldü.

Bulgular:
Çalışmaya
toplam 30 hasta (24 kadın, ortalama yaş: 49,8 ± 13,2 yıl) dahil
edildi. Ortalama transmitral basınç gradyanı, pulmoner arter
basınçları ve sol atriyum çapı azaldı, ancak mitral kapak alanı
PMBV'den sonra anlamlı olarak arttı. PMBV prosedürü RMD'lı
hastalarda PDW'yi anlamlı şekilde azalttı (sırasıyla 13.5 ± 2.3
vs 12.4 ± 1.9 fL, prosedürden önce ve sonra; p <0.0001). MPV,
PMBV'den sonra azaldı, ancak istatistiksel olarak anlamlı değildi
(10.9 ± 0.8'e karşılık 10.6 ± 0.9 fL, p = 0.056). Trombosit
sayısı işlem sonrası anlamlı olarak arttı (250 ± 62.6 vs 273.5
± 78.6 x 103 / ul, p = 0.035). Lineer regresyon analizinde, PDW
azalmasının büyüklüğü ile mitral kapak alanındaki artışın
büyüklüğü arasında bağımsız bir ilişki bulundu (ẞ: 0.491,
p = 0.046).




Sonuç:
PMBV, işlemden 1 ay sonra PDW'de belirgin bir azalma ile
ilişkilidir. PMBV'den sonra PDW'deki düşüşün büyüklüğü ile
mitral kapak alanındaki artışın büyüklüğü arasında anlamlı
bir ilişki vardır.

References

  • 1. Harb SC, Griffin BP. Mitral Valve Disease: a Comprehensive Review. Curr Cardiol Rep 2017; 19: 73.
  • 2. Tengiz I, Ercan E, Sahin F et al. Presence of factors that activate platelet aggregation in mitral stenotic patients’ plasma. Curr Control Trials Cardiovasc Med 2005; 6: 2.
  • 3. Chen MC, Wu CJ,Yip HK et al. Left atrial platelet activity with rheumatic mitral stenosis: correlation study of severity and platelet p-selectin expression by flow cytometry. Chest 2003; 124: 1663-69.
  • 4. Chen MC, Wu CJ, Chang HW et al. Mechanism of reducing platelet activity by percutaneous transluminal mitral valvuloplasty in patients with rheumatic mitral stenosis. Chest. 2004; 125: 1629-34.
  • 5. Kataoka H, Yano S, Tamura A, Mikuriya Y. Hemostatic changes induced by percutaneouus mitral valvuloplasty. Am Heart J 1993; 125: 777-82.
  • 6. Zaki A, Salama M, El Masry M et al. Immediate effect of balloon valvulplasty on hemostatic changes in mitral stenosis. Am J Cardiol. 2000;85 (3):370-375.
  • 7. Chiang CW, Lo SK, Cheng NJ, Lin PJ, Chang CH. Predictors of systemic embolism in patients with mitral stenosis. A prospective study. Ann Intern Med 1998; 128: 885-89.
  • 8. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hipokratia 2010; 14: 28-32.
  • 9. Varol E, Ozaydın M, Turker Y, Alaca S. Mean platelet volume, an indicator of platelet activation, is increased in patients with mitral stenosis and sinus rhytm. Scand J Clin Lab Invest 2009; 69: 708-12.
  • 10. Boyacı A, Topaloğlu S, Yılmaz S, et al. Regional left atrial coagulation and fibrinolytic activities in patients with mitral stenosis. Jpn Heart J 2004; 45: 779-88.
  • 11. Erdoğan D, İçli A, Aksoy F, Yücel H et al. Percutaneous mitral balloon valvuloplasty reduces mean platelet volume in patients with rheumatic mitral stenosis. Scandinavian Journal of Clinical and Laboratory Investigation, 2012; 72: 452-58.
  • 12. Wilkins GT, Weyman AE, Abascal VM, Block PC, Palacios IF. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J 1988; 60: 299-308.
  • 13. Golebiewska EM. Poole AW. Platelet secretion: From haemostasis to wound healing and beyond. Blood Rev. 2015; 29: 153–62.
  • 14. Yılmaz F, Koklu E, Kızılırmak Yılmaz F et al. Evaluation of mean platelet volume and platelet distribution width in patients with asymptomatic intermediate carotid artery plaque. Kardiol POL 2017; 75: 35-41.
  • 15. Cetin M, Bakırcı EM, Baysal E, et al. Increased platelet distribution width is associated with ST-segment elevtion myocardial infarction and thrombolysis failure. Angiology. 2014; 65: 737-43.
  • 16. Chen MC, Chang HW, Juang SS, Yip HK, Wu CJ. Increased plasma levels of soluble P-selectin in rheumatic mitral stenosis. Chest 2004; 126: 54-58.
  • 17. Topaloğlu S, Boyacı A, Ayaz S et al. Coagulation, fibrinolytic system activation and endothelial dysfunction in patients with mitral stenosis and sinus rhytm. Angiology 2007; 58: 85-91.
  • 18. Stein PD, Sabbah HN. Turbulance blood flow in the ascending aorta of humans with normal and diseased aortic valves. Circ Res 1976; 39: 58-65.
  • 19. Yu SK, Latour JG, Marchandise B et al. Shear stres-induced changes in platelet reactivity. Thromb Haemost 1978; 40: 551-560.
  • 20. Block PC, Palacios IF, Block EH, Tuzcu EM, Griffin B. Late follow up after percutaneous balloon mitral valvotomy. Am J Cardiol 1992; 69: 537-41.
  • 21. Hasan-Ali H, Mosad E. Changes in platelet, coagulation, and fibrinolytic activities in mitral stenosis after percutaneous mitral valvotomy: role of hemodynamic changes aand systemic inflammation. Clin Appl Thromb Hemost. 2015; 21: 339-47.
There are 21 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Orıgınal Artıcle
Authors

Müjgan Tek

Mehmet Serkan Çetin 0000-0002-3983-0496

Publication Date September 30, 2019
Published in Issue Year 2019

Cite

APA Tek, M., & Çetin, M. S. (2019). Platelet distribution width can be a useful marker of decreased platelet activity after percutaneous mitral balloon valvuloplasty. Turkish Journal of Clinics and Laboratory, 10(3), 348-352. https://doi.org/10.18663/tjcl.542806
AMA Tek M, Çetin MS. Platelet distribution width can be a useful marker of decreased platelet activity after percutaneous mitral balloon valvuloplasty. TJCL. September 2019;10(3):348-352. doi:10.18663/tjcl.542806
Chicago Tek, Müjgan, and Mehmet Serkan Çetin. “Platelet Distribution Width Can Be a Useful Marker of Decreased Platelet Activity After Percutaneous Mitral Balloon Valvuloplasty”. Turkish Journal of Clinics and Laboratory 10, no. 3 (September 2019): 348-52. https://doi.org/10.18663/tjcl.542806.
EndNote Tek M, Çetin MS (September 1, 2019) Platelet distribution width can be a useful marker of decreased platelet activity after percutaneous mitral balloon valvuloplasty. Turkish Journal of Clinics and Laboratory 10 3 348–352.
IEEE M. Tek and M. S. Çetin, “Platelet distribution width can be a useful marker of decreased platelet activity after percutaneous mitral balloon valvuloplasty”, TJCL, vol. 10, no. 3, pp. 348–352, 2019, doi: 10.18663/tjcl.542806.
ISNAD Tek, Müjgan - Çetin, Mehmet Serkan. “Platelet Distribution Width Can Be a Useful Marker of Decreased Platelet Activity After Percutaneous Mitral Balloon Valvuloplasty”. Turkish Journal of Clinics and Laboratory 10/3 (September 2019), 348-352. https://doi.org/10.18663/tjcl.542806.
JAMA Tek M, Çetin MS. Platelet distribution width can be a useful marker of decreased platelet activity after percutaneous mitral balloon valvuloplasty. TJCL. 2019;10:348–352.
MLA Tek, Müjgan and Mehmet Serkan Çetin. “Platelet Distribution Width Can Be a Useful Marker of Decreased Platelet Activity After Percutaneous Mitral Balloon Valvuloplasty”. Turkish Journal of Clinics and Laboratory, vol. 10, no. 3, 2019, pp. 348-52, doi:10.18663/tjcl.542806.
Vancouver Tek M, Çetin MS. Platelet distribution width can be a useful marker of decreased platelet activity after percutaneous mitral balloon valvuloplasty. TJCL. 2019;10(3):348-52.


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