Coagulation changes during presyncope and recovery.

Orthostatic stress activates the coagulation system. The extent of coagulation activation with full orthostatic load leading to presyncope is unknown. We examined in 7 healthy males whether presyncope, using a combination of head up tilt (HUT) and lower body negative pressure (LBNP), leads to coagul...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Gerhard Cvirn, Axel Schlagenhauf, Bettina Leschnik, Martin Koestenberger, Andreas Roessler, Andreas Jantscher, Karoline Vrecko, Guenther Juergens, Helmut Hinghofer-Szalkay, Nandu Goswami
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7c9e70b6f2524d61886c1bb931a831f1
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:7c9e70b6f2524d61886c1bb931a831f1
record_format	dspace
spelling	oai:doaj.org-article:7c9e70b6f2524d61886c1bb931a831f12021-11-18T07:09:56ZCoagulation changes during presyncope and recovery.1932-620310.1371/journal.pone.0042221https://doaj.org/article/7c9e70b6f2524d61886c1bb931a831f12012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22876309/?tool=EBIhttps://doaj.org/toc/1932-6203Orthostatic stress activates the coagulation system. The extent of coagulation activation with full orthostatic load leading to presyncope is unknown. We examined in 7 healthy males whether presyncope, using a combination of head up tilt (HUT) and lower body negative pressure (LBNP), leads to coagulation changes as well as in the return to baseline during recovery. Coagulation responses (whole blood thrombelastometry, whole blood platelet aggregation, endogenous thrombin potential, markers of endothelial activation and thrombin generation), blood cell counts and plasma mass density (for volume changes) were measured before, during, and 20 min after the orthostatic stress. Maximum orthostatic load led to a 25% plasma volume loss. Blood cell counts, prothrombin levels, thrombin peak, endogenous thrombin potential, and tissue factor pathway inhibitor levels increased during the protocol, commensurable with hemoconcentration. The markers of endothelial activation (tissue factor, tissue plasminogen activator), and thrombin generation (F1+2, prothrombin fragments 1 and 2, and TAT, thrombin-antithrombin complex) increased to an extent far beyond the hemoconcentration effect. During recovery, the markers of endothelial activation returned to initial supine values, but F1+2 and TAT remained elevated, suggestive of increased coagulability. Our findings of increased coagulability at 20 min of recovery from presyncope may have greater clinical significance than short-term procoagulant changes observed during standing. While our experiments were conducted in healthy subjects, the observed hypercoagulability during graded orthostatic challenge, at presyncope and in recovery may be an important risk factor particularly for patients already at high risk for thromboembolic events (e.g. those with coronary heart disease, atherosclerosis or hypertensives).Gerhard CvirnAxel SchlagenhaufBettina LeschnikMartin KoestenbergerAndreas RoesslerAndreas JantscherKaroline VreckoGuenther JuergensHelmut Hinghofer-SzalkayNandu GoswamiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e42221 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Gerhard Cvirn Axel Schlagenhauf Bettina Leschnik Martin Koestenberger Andreas Roessler Andreas Jantscher Karoline Vrecko Guenther Juergens Helmut Hinghofer-Szalkay Nandu Goswami Coagulation changes during presyncope and recovery.
description	Orthostatic stress activates the coagulation system. The extent of coagulation activation with full orthostatic load leading to presyncope is unknown. We examined in 7 healthy males whether presyncope, using a combination of head up tilt (HUT) and lower body negative pressure (LBNP), leads to coagulation changes as well as in the return to baseline during recovery. Coagulation responses (whole blood thrombelastometry, whole blood platelet aggregation, endogenous thrombin potential, markers of endothelial activation and thrombin generation), blood cell counts and plasma mass density (for volume changes) were measured before, during, and 20 min after the orthostatic stress. Maximum orthostatic load led to a 25% plasma volume loss. Blood cell counts, prothrombin levels, thrombin peak, endogenous thrombin potential, and tissue factor pathway inhibitor levels increased during the protocol, commensurable with hemoconcentration. The markers of endothelial activation (tissue factor, tissue plasminogen activator), and thrombin generation (F1+2, prothrombin fragments 1 and 2, and TAT, thrombin-antithrombin complex) increased to an extent far beyond the hemoconcentration effect. During recovery, the markers of endothelial activation returned to initial supine values, but F1+2 and TAT remained elevated, suggestive of increased coagulability. Our findings of increased coagulability at 20 min of recovery from presyncope may have greater clinical significance than short-term procoagulant changes observed during standing. While our experiments were conducted in healthy subjects, the observed hypercoagulability during graded orthostatic challenge, at presyncope and in recovery may be an important risk factor particularly for patients already at high risk for thromboembolic events (e.g. those with coronary heart disease, atherosclerosis or hypertensives).
format	article
author	Gerhard Cvirn Axel Schlagenhauf Bettina Leschnik Martin Koestenberger Andreas Roessler Andreas Jantscher Karoline Vrecko Guenther Juergens Helmut Hinghofer-Szalkay Nandu Goswami
author_facet	Gerhard Cvirn Axel Schlagenhauf Bettina Leschnik Martin Koestenberger Andreas Roessler Andreas Jantscher Karoline Vrecko Guenther Juergens Helmut Hinghofer-Szalkay Nandu Goswami
author_sort	Gerhard Cvirn
title	Coagulation changes during presyncope and recovery.
title_short	Coagulation changes during presyncope and recovery.
title_full	Coagulation changes during presyncope and recovery.
title_fullStr	Coagulation changes during presyncope and recovery.
title_full_unstemmed	Coagulation changes during presyncope and recovery.
title_sort	coagulation changes during presyncope and recovery.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/7c9e70b6f2524d61886c1bb931a831f1
work_keys_str_mv	AT gerhardcvirn coagulationchangesduringpresyncopeandrecovery AT axelschlagenhauf coagulationchangesduringpresyncopeandrecovery AT bettinaleschnik coagulationchangesduringpresyncopeandrecovery AT martinkoestenberger coagulationchangesduringpresyncopeandrecovery AT andreasroessler coagulationchangesduringpresyncopeandrecovery AT andreasjantscher coagulationchangesduringpresyncopeandrecovery AT karolinevrecko coagulationchangesduringpresyncopeandrecovery AT guentherjuergens coagulationchangesduringpresyncopeandrecovery AT helmuthinghoferszalkay coagulationchangesduringpresyncopeandrecovery AT nandugoswami coagulationchangesduringpresyncopeandrecovery
_version_	1718423859582992384

Coagulation changes during presyncope and recovery.

Ejemplares similares