fibrin and Mitral-Valve-Stenosis

Mesothelial/monocytic incidental cardiac excrescence (MICE) is a rare entity which is an amalgam of mesothelial cells, histiocytes, and fibrin, often found occasionally during cardiac valve replacement. We report a case in a 25-year-old Chinese female with serous mitral stenosis and patent foramen ovale. Routine and immunohistochemical stains and ultrastructure examination revealed the vegetation was predominantly composed of histocytes with scattered mesothelial cells. In fact nodular histiocytic/mesothelial hyperplasia (NHMH) is a similar lesion to MICE. MICE and NHMH could be unified, and NHMH may be a better choice.

Topics: Adult; Biomarkers; Epithelium; Female; Fibrin; Foramen Ovale, Patent; Heart Valve Prosthesis Implantation; Humans; Hyperplasia; Immunohistochemistry; Microscopy, Electron; Mitral Valve; Mitral Valve Stenosis; Monocytes; Terminology as Topic

Systemic thromboembolism is a major complication in patients with mitral stenosis, especially in those who have atrial fibrillation (AF). It has been suggested that there may be increased regional left atrial coagulation activity in such patients, despite normal systemic coagulation activity on peripheral blood sampling. Our aim was to investigate whether there were significant differences between intracardiac versus peripheral indexes of hypercoagulability in 25 patients (5 men; mean age 60 years) with mitral stenosis who were undergoing percutaneous balloon mitral valvuloplasty and who were all in chronic AF. Two days after halting warfarin therapy, intracardiac (right and left atria) and peripheral (venous and arterial) blood samples from patients were obtained and compared with levels in matched healthy controls in sinus rhythm. Thrombogenicity was assessed by levels of fibrin D-dimer, fibrinogen, indexes of platelet activation (soluble P-selectin and beta thromboglobulin [betaTG]) and indexes of endothelial dysfunction (soluble thrombomodulin [sTM] and von Willebrand factor [vWF]). There were no statistically significant differences in the various markers between the femoral vein and artery, left and right atria, and between the femoral vein and both atria (all p = NS). Plasma fibrinogen, vWf (both p <0.005), and D-dimer (p = 0.011) were significantly higher and levels of sP-selectin and sTM were lower (both p <0.005) in patients when compared with controls. There was no significant difference in plasma betaTG levels. Our results suggest that there is no significant variation in indexes of thrombogenesis, platelet activation, and endothelial dysfunction between left atrium, right atrium, and the peripheral artery or vein. Peripheral samples therefore do reflect atrial coagulation, platelet, and endothelial activities.

Topics: Atrial Fibrillation; beta-Thromboglobulin; Biomarkers; Blood Coagulation Factors; Blood Vessels; Catheterization; Female; Fibrin; Fibrinogen; Heart Atria; Heart Ventricles; Humans; Male; Middle Aged; Mitral Valve Stenosis; P-Selectin; Platelet Activation; Prognosis; Retrospective Studies; Risk Factors; Thrombophilia

Topics: Atrial Fibrillation; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinogen; Heart Atria; Humans; Mitral Valve Stenosis; Predictive Value of Tests; Thrombin; Thrombosis

Patients with mitral stenosis in sinus rhythm are in a prothrombotic state and have fibrinolytic dysfunction, shown by an increase in levels of the inhibitor of tissue plasminogen activator, D-dimer, and modified antithrombin III. This state may be observed even in patients without dilated left atria (diameter < or =45 mm).

Topics: Atrial Fibrillation; Echocardiography; Female; Fibrin; Humans; Immunoenzyme Techniques; Male; Middle Aged; Mitral Valve Stenosis; Plasminogen Activator Inhibitor 1; Statistics, Nonparametric; Thrombin; Tissue Plasminogen Activator

We report the first case in which a fluid-blood interface was identified at autopsy in a patient with acute intracerebral hematoma on anticoagulant therapy. Anticoagulation may be one of the major factors contributing to the production of an intracerebral blood sedimentation level.

Topics: Aged; Anticoagulants; Blood Sedimentation; Blood-Brain Barrier; Brain; Cerebral Hemorrhage; Fibrin; Heart Valve Prosthesis Implantation; Hematoma; Humans; Male; Mitral Valve Stenosis; Postoperative Complications; Warfarin

Topics: Arteriosclerosis; Collagen; Diabetes Mellitus; Fibrin; Geriatrics; Humans; Hyalin; Hypertension; Hypertension, Malignant; Hypertension, Pulmonary; Mitral Valve Stenosis; Pathology; Pyelonephritis