PB0015 - Left atrium size is associated with fibrin clot ultrastructure in patients with acute myocardial infarction

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

AS

Aleksander Siniarski

Assistant
Jagiellonian University Medical College, Department of Coronary Artery Disease and Heart Failure
Krakow, Malopolskie, Poland

Co-Author(s)

stephen R. baker, PhD

Assistant Professor
Wake Forest University
Winston-Salem, North Carolina, United States
KS

Konrad Stępień

Assistant
Jagiellonian University Medical College
Krakow, Malopolskie, Poland
Robert A. S. Ariens, PhD

Professor
Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
Leeds, England, United Kingdom
AG

Andrzej Gackowski

Professor
Jagiellonian University Medical College
Krakow, Malopolskie, Poland
GG

Grzegorz Gajos

Professor
Jagiellonian University Medical College
Kraków, Malopolskie, Poland
JN

Jadwiga Nessler

Professor
Jagiellonian University Medical College
Kraków, Malopolskie, Poland

Background: Patients with coronary artery disease (CAD) form denser clots with increased stiffness, and higher resistance to fibrinolysis, even when accounting for fibrinogen levels. CAD is associated with disturbances in echocardiographic measurements including impaired ejection fraction, wall motion abnormalities or dilation of heart chambers. Measurements of the heart chambers such as the left atrium could be important to predict thromboembolic risk. We hypothesize that echocardiographic parameters are associated with fibrin clot properties.

Aims: The aim of this study was to assess whether fibrin clot ultrastructure correlates with echocardiographic indicators in patients with AMI.

Methods: We analysed 21 patients hospitalized within 12 hours from the onset of first clinical symptoms of AMI. Clot formation was assessed using standard turbidity measurements. Clot structure was analysed using laser scanning confocal microscopy, scanning electron microscopy (SEM), and permeation experiments, while individual fiber size and internal structure were compared using turbidimetric analysis. Clot breakdown was determined using turbidity. Plasminogen was measured by, and fibrinogen by the Clauss method. Transthoracic echocardiography was used to determine heart chambers size including left atrial size and left atrial volume index.

Results: In simple regression analysis, LA diameter assessed in PLAX (Figure 1, panel A and C) and LVEF were significantly associated with fibrin clot density (Figure 1, panel B and D). Importantly, LVEF and LA diameter were not associated with each other (P = 0.4). Moreover, LAV and LAVI were significantly, negatively correlated with Lag time (r=-0.42; p=0.026 for both). Other fibrin clot and lysis characteristics failed to demonstrate association with measurements of the LA.

Conclusion(s): Our study indicates that LA size could serve as an important clinical factor associated with clot density and thus prothrombotic risk.