On possible role of endothelial dysfunction in development of acute venous thrombosis

Bryushkov A.Yu.¹, Ershov P.V.², Sergeeva N.A.^2,3, Bogachev V.Yu.^2,3

1) Research Center of Cardiovascular surgery named after A.N. Bakulev,
2) Chair of Faculty Surgery No 1 of the Russian National Research Medical University named after N.I. Pirogov,
3) Municipal Clinical Hospital No 1 named after N.I. Pirogov, Moscow, Russia

The study included a total of 18 patients (12 women and 6 men, aged from 22 to 51 years, mean age 34 years) with newly onset unilateral acute thrombosis of deep veins in the system of inferior vena cava, confirmed by the findings of ultrasound duplex scanning. The patients had no apparent risk factors for venous thromboembolic complications, they had not used antiplatelet drugs during the last month and were characterized by a low level of risk for cardiovascular complications. Along with general clinical examination the patients were subjected to measuring the quantitative level of the von Willebrand factor (vWF), resistance to activated C-protein conditioned by V factor mutation, D-dimer, qualitative assessment of the level of C-reactive protein by a highly sensitive method, as well as integral assessment of the links of blood coagulation and fibrinolysis by means of thromboelastography.

Eighteen (100%) patients had the vWF level above the norm, four (22.2%) patients were found to have resistance to activated C protein conditioned by factor V mutation, these patients had non-O (I) blood group. In twelve (66.7%) patients the quantitative level of D-dimer remained within the normal limits, and in 6 patients the D-dimer level was above the norm. The findings of thromboelastography demonstrated decreased activity of blood platelets. Fibrinolysis (LY30 and LY60) in the absolute majority of the examined patients was lowered. Six (33.3%) patients when comparing the LY30 and LY60 levels had no significant elevation of the index (<1%), four (22.2%) patients when comparing LY30 and LY60 showed an elevation of the index (>3.8%). The mean level of C-reactive protein (4.93 mg/l) exceeded the median of the reference values (2.5 mg/l) and in five (27.8%) out of 18 patients the value was two times higher than the reference ones.

The obtained experimental data suggest that acute venous thrombosis is accompanied by alterations in the work of the coagulation and fibrinolytic systems, associated with endothelial dysfunction.

KEY WORDS: acute venous thrombosis, endothelial dysfunction, von Willebrand factor.

P. 96

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