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Type: Journal article
Title: Atrial platelet reactivity in patients with atrial fibrillation
Author: Willoughby, S.
Roberts-Thomson, R.
Lim, H.
Schultz, C.
Prabhu, A.
De Sciscio, P.
Wong, C.
Worthley, M.
Sanders, P.
Citation: Heart Rhythm, 2010; 7(9):1178-1183
Publisher: Elsevier Inc.
Issue Date: 2010
ISSN: 1547-5271
Statement of
Scott R. Willoughby, Ross L. Roberts-Thomson, Han S. Lim, Carlee Schultz, Anisha Prabhu, Paolo De Sciscio, Christopher X. Wong, Matthew I. Worthley and Prashanthan Sanders
Abstract: Atrial fibrillation (AF) is associated with an increased risk of thrombus formation in the left but not the right atrium. The mechanisms underlying this differential effect on the atria are unknown.The purpose of this study was to examine whether atrial-specific differences in platelet activation are present in patients with AF.Nineteen patients (13 men and 6 women; age 60 +/- 2 years) with AF undergoing ablation in sinus rhythm were studied. Blood samples from the left atrium, right atrium, and femoral vein were obtained at the start of the procedure and analyzed by whole-blood flow cytometry for expression of platelet P-selectin (CD62P), vitronectin receptor (CD51/61), and active glycoprotein IIb/IIIa receptor (PAC-1). Platelet aggregation was evaluated using adenosine diphosphate (ADP)-induced whole-blood impedance aggregometry. Seven patients with left-sided accessory pathway also were studies as a reference group for the effect of transseptal puncture on platelet reactivity.Platelet P-selectin levels were significantly elevated in the left atrium compared to the right atrium (10.2% +/- 2.5% vs 8.6% +/- 2.3%, P <.05). CD51/61 and PAC-1 levels did not differ between sampling sites. ADP-induced platelet aggregation was significantly higher in the left atrium compared to the right atrium and femoral vein (P <.05 for both). Platelet P-selectin levels and ADP-induced platelet aggregation did not differ between sampling site in the reference group.In patients with AF, left atrial platelet reactivity is increased compared to the right atria and peripheral circulation. The study data suggest that the presence of chamber-specific platelet activation may explain, in part, the propensity for left atrial thrombus formation in patients with AF.
Keywords: Heart Atria; Blood Platelets; Humans; Atrial Fibrillation; P-Selectin; Electrocardiography; Catheter Ablation; Prognosis; Flow Cytometry; Follow-Up Studies; Platelet Aggregation; Adult; Middle Aged; Female; Male; Cardiac Catheterization
Rights: © 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
RMID: 0020096292
DOI: 10.1016/j.hrthm.2010.01.042
Appears in Collections:Medicine publications

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