Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II)

Jolanta Klovaite; Finn Gustafsson; Svend A Mortensen; Kåre Sander; Lars B Nielsen

doi:10.1016/j.jacc.2009.02.048

Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II)

Jolanta Klovaite, Finn Gustafsson, Svend A Mortensen, Kåre Sander, Lars B Nielsen

244 Citations (Scopus)

Abstract

OBJECTIVES: This study investigated the influence of the mechanical blood pump HeartMate II (HMII) (Thoratec Corporation, Pleasanton, California) on blood coagulation and platelet function.

BACKGROUND: HMII is an implantable left ventricular assist device used for the treatment of heart failure. Patients treated with HMII have increased bleeding tendencies.

METHODS: We measured agonist-induced platelet aggregation in 16 patients on HMII support.

RESULTS: The von Willebrand factor (vWF)-dependent ristocetin-induced platelet aggregation was impaired in 11 of the 16 patients, of which 12 had experienced at least 1 minor or major bleeding episode. The impaired ristocetin-induced platelet aggregation was associated both with decreased specific activity of plasma vWF, presumably due to lack of high molecular weight vWF multimers, as well as with attenuated function of the platelets themselves.

CONCLUSIONS: The results imply that HMII treatment is associated with impaired platelet aggregation, which may contribute to an increased tendency to bleed.

Original language	English
Journal	Journal of the American College of Cardiology
Volume	53
Issue number	23
Pages (from-to)	2162-7
Number of pages	6
ISSN	0735-1097
DOIs	https://doi.org/10.1016/j.jacc.2009.02.048
Publication status	Published - 9 Jun 2009
Externally published	Yes

Keywords

Adult
Anti-Bacterial Agents/adverse effects
Blood Platelets
Female
Heart Failure/therapy
Heart-Assist Devices/adverse effects
Hemorrhage/etiology
Humans
International Normalized Ratio
Male
Middle Aged
Platelet Aggregation
Platelet Aggregation Inhibitors
Ristocetin/adverse effects
Stroke Volume
Ventricular Dysfunction, Left/therapy
Ventricular Function, Left
Young Adult
von Willebrand Factor/physiology

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Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II). / Klovaite, Jolanta; Gustafsson, Finn; Mortensen, Svend A et al.
In: Journal of the American College of Cardiology, Vol. 53, No. 23, 09.06.2009, p. 2162-7.

Research output: Contribution to journal › Journal article › Research › peer-review

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abstract = "OBJECTIVES: This study investigated the influence of the mechanical blood pump HeartMate II (HMII) (Thoratec Corporation, Pleasanton, California) on blood coagulation and platelet function.BACKGROUND: HMII is an implantable left ventricular assist device used for the treatment of heart failure. Patients treated with HMII have increased bleeding tendencies.METHODS: We measured agonist-induced platelet aggregation in 16 patients on HMII support.RESULTS: The von Willebrand factor (vWF)-dependent ristocetin-induced platelet aggregation was impaired in 11 of the 16 patients, of which 12 had experienced at least 1 minor or major bleeding episode. The impaired ristocetin-induced platelet aggregation was associated both with decreased specific activity of plasma vWF, presumably due to lack of high molecular weight vWF multimers, as well as with attenuated function of the platelets themselves.CONCLUSIONS: The results imply that HMII treatment is associated with impaired platelet aggregation, which may contribute to an increased tendency to bleed.",

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author = "Jolanta Klovaite and Finn Gustafsson and Mortensen, \{Svend A\} and K{\aa}re Sander and Nielsen, \{Lars B\}",

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doi = "10.1016/j.jacc.2009.02.048",

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journal = "Journal of the American College of Cardiology",

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T1 - Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II)

AU - Klovaite, Jolanta

AU - Gustafsson, Finn

AU - Mortensen, Svend A

AU - Sander, Kåre

AU - Nielsen, Lars B

PY - 2009/6/9

Y1 - 2009/6/9

N2 - OBJECTIVES: This study investigated the influence of the mechanical blood pump HeartMate II (HMII) (Thoratec Corporation, Pleasanton, California) on blood coagulation and platelet function.BACKGROUND: HMII is an implantable left ventricular assist device used for the treatment of heart failure. Patients treated with HMII have increased bleeding tendencies.METHODS: We measured agonist-induced platelet aggregation in 16 patients on HMII support.RESULTS: The von Willebrand factor (vWF)-dependent ristocetin-induced platelet aggregation was impaired in 11 of the 16 patients, of which 12 had experienced at least 1 minor or major bleeding episode. The impaired ristocetin-induced platelet aggregation was associated both with decreased specific activity of plasma vWF, presumably due to lack of high molecular weight vWF multimers, as well as with attenuated function of the platelets themselves.CONCLUSIONS: The results imply that HMII treatment is associated with impaired platelet aggregation, which may contribute to an increased tendency to bleed.

AB - OBJECTIVES: This study investigated the influence of the mechanical blood pump HeartMate II (HMII) (Thoratec Corporation, Pleasanton, California) on blood coagulation and platelet function.BACKGROUND: HMII is an implantable left ventricular assist device used for the treatment of heart failure. Patients treated with HMII have increased bleeding tendencies.METHODS: We measured agonist-induced platelet aggregation in 16 patients on HMII support.RESULTS: The von Willebrand factor (vWF)-dependent ristocetin-induced platelet aggregation was impaired in 11 of the 16 patients, of which 12 had experienced at least 1 minor or major bleeding episode. The impaired ristocetin-induced platelet aggregation was associated both with decreased specific activity of plasma vWF, presumably due to lack of high molecular weight vWF multimers, as well as with attenuated function of the platelets themselves.CONCLUSIONS: The results imply that HMII treatment is associated with impaired platelet aggregation, which may contribute to an increased tendency to bleed.

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KW - Humans

KW - International Normalized Ratio

KW - Male

KW - Middle Aged

KW - Platelet Aggregation

KW - Platelet Aggregation Inhibitors

KW - Ristocetin/adverse effects

KW - Stroke Volume

KW - Ventricular Dysfunction, Left/therapy

KW - Ventricular Function, Left

KW - Young Adult

KW - von Willebrand Factor/physiology

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Severely impaired von Willebrand factor-dependent platelet aggregation in patients with a continuous-flow left ventricular assist device (HeartMate II)

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Keywords

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