Abstract:
:During cardiopulmonary bypass (CPB) mechanical stress and the contact of blood with artificial surfaces lead to the activation of pro- and anticoagulant systems and the complement cascade, and to changes in cellular components. This phenomenon causes the "postperfusion-syndrome", with leukocytosis, increased capillary permeability, accumulation of interstitial fluid, and organ dysfunction. In this study, we focused on the influence of the extracorporeal circulation, sternotomy, and heparin administration on the activation of coagulation and fibrinolysis. In 15 patients we investigated coagulation parameters before, during and post CPB, i.e., fibrinogen, antithrombin (AT) III, thrombin-antithrombin complex (TAT), prothrombin fragments F1 + 2 (F1 + 2), factor (F) XIIa, tissue factor (TF), and parameters of the fibrinolytic system, i.e., plasmin-antiplasmin-complex (PAP), D-dimer, tissue-plasminogen-activator (tPA), urokinase-type plasminogen activator (uPA), and plasminogen-activator inhibitor type 1 (PAI 1). The results demonstrate distinct alterations in the above mentioned parameters. Despite administration of a high dose of heparin (activated clotting time [ACT] > 450s) combined with a low dose of aprotinin, activation of the coagulation and fibrinolytic pathways was observed. We found this activation was mainly caused by CPB and not by sternotomy. The activation of coagulation was due to foreign surface contact (F XII => F XIIa) as well as to an effect of tissue factor release in the late phase of CPB. The enhanced fibrinolytic activity during CPB was, at least in part, caused by tPA and was followed by PAI 1 release.
journal_name
Heart Vesselsjournal_title
Heart and vesselsauthors
Grossmann R,Babin-Ebell J,Misoph M,Schwender S,Neukam K,Hickethier T,Elert O,Keller Fdoi
10.1007/BF01747190subject
Has Abstractpub_date
1996-01-01 00:00:00pages
310-7issue
6eissn
0910-8327issn
1615-2573journal_volume
11pub_type
杂志文章abstract::We have theoretically proposed "systolic pressure-volume area" (PVA) as a measure of total mechanical energy generated by ventricular contraction. We then experimentally showed that PVA closely correlates with left ventricular oxygen consumption (Vo2) regardless of ventricular loading conditions in a stable contractil...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/BF02058751
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pub_type: 临床试验,杂志文章
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journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/BF01744743
更新日期:1993-01-01 00:00:00
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journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/BF02125099
更新日期:1991-01-01 00:00:00
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doi:10.1007/s00380-003-0735-7
更新日期:2004-03-01 00:00:00
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doi:10.1007/s00380-019-01371-8
更新日期:2019-09-01 00:00:00
abstract::Although a previous randomized study showed that the use of atrial natriuretic peptide (carperitide) improved the long-term prognosis of patients with heart failure, its effect on short-term prognosis remains unclear. We retrospectively identified patients who were admitted to our tertiary-care center with acute decom...
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doi:10.1007/s00380-017-0952-0
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journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-012-0299-5
更新日期:2013-11-01 00:00:00
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journal_title:Heart and vessels
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Several coronary angiographic studies have reported that enlarged and tortuous epicardial coronary arteries are characteristic of patients with left ventricular concentric hypertrophy (LVCH). Recently, we showed that small volumes opacified by contrast medium can be accurately measured by 64-multislice computed tomogr...
journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-011-0230-5
更新日期:2013-03-01 00:00:00
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journal_title:Heart and vessels
pub_type: 杂志文章
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journal_title:Heart and vessels
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更新日期:2017-02-01 00:00:00
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更新日期:2018-07-01 00:00:00
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journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/s00380-020-01681-2
更新日期:2020-08-20 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00380-019-01471-5
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journal_title:Heart and vessels
pub_type: 杂志文章
doi:10.1007/BF01744500
更新日期:1995-01-01 00:00:00
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journal_title:Heart and vessels
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journal_title:Heart and vessels
pub_type: 杂志文章
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journal_title:Heart and vessels
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更新日期:1996-01-01 00:00:00