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Left ventricular assist device implantation causes platelet dysfunction and proinflammatory platelet-neutrophil interaction
- Source :
- Platelets. 33:132-140
- Publication Year :
- 2020
- Publisher :
- Informa UK Limited, 2020.
-
Abstract
- Blood flow through left ventricular assist devices (LVAD) may induce activation and dysfunction of platelets. Dysfunctional platelets cause coagulation disturbances and form platelet-neutrophil conjugates (PNC), which contribute to inflammatory tissue damage. This prospective observational cohort study investigated patients, who underwent implantation of a LVAD (either HeartMate II (HM II) (n = 7) or HeartMate 3 (HM 3) (n = 6)) and as control patients undergoing coronary artery bypass grafting (CABG) and/or aortic valve replacement (AVR) (n = 10). We performed platelet and leukocyte flow cytometry, analysis of platelet activation markers, and platelet aggregometry. Platelet CD42b expression was reduced at baseline and perioperatively in HM II/3 compared to CABG/AVR patients. After surgery the platelet activation marker β-thromboglobulin and platelet microparticles increased in all groups while platelet aggregation decreased. Platelet aggregation was more significantly impaired in LVAD compared to CABG/AVR patients. PNC were higher in HM II compared to HM 3 patients. We conclude that LVAD implantation is associated with platelet dysfunction and proinflammatory platelet-leukocyte binding. These changes are less pronounced in patients treated with the newer generation LVAD HM 3. Future research should identify device-specific LVAD features, which are associated with the least amount of platelet activation to further improve LVAD therapy.
- Subjects :
- Blood Platelets
0301 basic medicine
medicine.medical_specialty
Neutrophils
Platelet dysfunction
medicine.medical_treatment
030204 cardiovascular system & hematology
Systemic inflammation
Proinflammatory cytokine
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Platelet
Prospective Studies
business.industry
Hematology
General Medicine
Blood flow
equipment and supplies
030104 developmental biology
Coagulation
Ventricular assist device
Cardiology
Blood Platelet Disorders
Heart-Assist Devices
medicine.symptom
business
Subjects
Details
- ISSN :
- 13691635 and 09537104
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Platelets
- Accession number :
- edsair.doi.dedup.....bd4caca0dd7fbab755a3f063a28c706a