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首页> 外文期刊>The Journal of heart valve disease >Flow-induced platelet activation in mechanical heart valves.
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Flow-induced platelet activation in mechanical heart valves.

机译：机械心脏瓣膜中血流诱发的血小板活化。

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BACKGROUND AND AIM OF THE STUDY: A study was conducted to measure in vitro the procoagulant properties of platelets induced by flow through mechanical heart valves. METHODS: The procoagulant activity of platelets was measured using a real-time assay of platelet activation state (PAS), which was based on a modification of the prothrombinase method. Acetylated prothrombin was used instead of normal prothrombin in this assay in order to eliminate the positive feedback effect of thrombin. This enabled a direct comparison between thrombin generation rates in the assay and the flow stresses that induce platelet activation. Gel-filtered platelets (10(5) per microliters) were circulated through a left ventricular assist device with two Bjork-Shiley mono-leaflet mechanical heart valves mounted in opposition, and platelet activation state was measured over 30-min time courses. The results were compared with two configurations in which the leaflet motion of one of the valves was restricted (severely restricted and mildly restricted), mimicking defective function of a compromised valve in vivo, and with a control lacking valves. RESULTS: The severely restricted valve activated the platelets at a rate eight-fold higher than with unrestricted valves, and three-fold higher than with mildly restricted valves. Both restricted valves activated platelets at rates significantly higher than either the control (no valves) or the unrestricted valve. CONCLUSION: Flow through compromised mechanical heart valves causes platelet activation, which can be measured with a modified prothrombinase assay system. The ability to perform sensitive quantitative measurements in cardiovascular devices in vitro may have a significant impact on the design and development of these devices.
机译：研究的背景和目的：进行了一项研究，以体外测量流经机械心脏瓣膜的血小板的促凝特性。方法：采用凝血酶原酶法的改进方法，通过实时测定血小板活化状态（PAS）来测定血小板的促凝血活性。为了消除凝血酶的正反馈作用，在该试验中使用乙酰化的凝血酶原代替正常的凝血酶原。这可以直接比较测定中的凝血酶生成速率和诱导血小板活化的血流压力。凝胶过滤的血小板（每微升10（5））通过左心室辅助装置进行循环，左心室辅助装置将两个Bjork-Shiley单叶机械心脏瓣膜相对放置，并在30分钟的时间过程中测量血小板的活化状态。将结果与两种配置进行了比较，在两种配置中，一个瓣膜的瓣叶运动受到限制（严重限制和轻度限制），模仿了体内瓣膜受损的功能缺陷，而缺少瓣膜的对照组。结果：严格限制的瓣膜激活血小板的速度是非限制瓣膜的八倍，而轻度限制瓣膜的三倍。两个限制瓣膜激活血小板的速率均显着高于对照（无瓣膜）或非限制瓣膜。结论：流经受损的机械性心脏瓣膜可导致血小板活化，可使用改良的凝血酶原测定系统进行测定。在体外对心血管设备进行敏感的定量测量的能力可能会对这些设备的设计和开发产生重大影响。

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