VPB0148 - ADAMTS-13 activity and silent brain infarction in patients with non-ischemic dilated cardiomyopathy

Sunday, July 10, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Co-Author(s)

RG

RUBÉN GÓMEZ DE ANTONIO

Internal Resident Doctor
Deparment of Hematology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
TORRELODONES, Madrid, Spain
PM

Pablo Martínez-Legazpi

Department of Mathematical Physics and Fluids, Facultad de Ciencias, Universidad Nacional de Educaci
Department of Mathematical Physics and Fluids, Facultad de Ciencias, Universidad Nacional de Educación a Distancia, UNED, and CIBERCV, Madrid, Spain
Madrid, Madrid, Spain
ER

Elena Rodríguez González

Medical Doctor
Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBERCV, Madrid, Spain
Madrid, Madrid, Spain
AF

Ana Fernández ávila

Medical Doctor
Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBERCV, Madrid, Spain
Madrid, Madrid, Spain
GP

Goria Pérez Rus

Medical Doctor
Deparment of Hematology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Madrid, Madrid, Spain
JD

José Luis Díez Martín

Medical Doctor
Deparment of Hematology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Madrid, Madrid, Spain
JB

Javier Bermejo Thomas

Medical Doctor
Department of Cardiology, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, and CIBERCV, Madrid, Spain
Madrid, Madrid, Spain

Presenting Author(s)

CP

Cristina Pascual Izquierdo

Medical Doctor
Deparment of Hematology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Madrid, Madrid, Spain

Background: Von Willebrand factor levels (VWF) and ADAMTS-13 activity have been recently described as predictors of thromboembolic events in patients with non-valvular atrial fibrillation. Furthermore, left ventricular flow analysis by can predict mural thrombosis and cerebral microembolisms.

Aims: To investigate if hemostasis parameters combined with intraventricular flow analysis from echocardiography predict the silent brain infarction (SBI) in patients with non-ischemic dilated cardiomyopathy (NIDCM).

Methods: This is a prospective and non-interventional study. We included 80 patients with NIDCM in sinus rhythm and without history of thromboembolic episodes. Basal characteristics at inclusion were collected, including the hemostasis parameters evaluation, cerebral magnetic resonance (CMR) and intraventricular flow from echocardiography. Echocardiography images were post-processed to determine the residence time of the blood (the time each blood particle remains inside the LV), and the shear stresses blood experience during its transit in the LV. The presence of SBI was evaluated using CMR images. We used Student's t-test and the Spearman's test to compare variables and to conduct correlation analysis, respectively. Informed consent was obtained and this study was approved by a medical ethics committee.

Results: SBI was detected in 8 (12%) patients. None of the clinical factors and none of the hemostasis parameters analyzed correlated with the presence of SBI (Table 1). Blood shear stress in regions of high persistence (long residence time) in the LV was a good predictor of SBI (p < 0.001, ROC-AUC (Bootstraped):0.81). ADAMTS13 activity and PT correlated with blood shear stress (p=0.04, p=0.01, respectively) (Figure1).

Conclusion(s): VWF levels, ADAMTS13 activity and other hemostasis parameters were not predictors of SCI. Blood shear stress was a good predictor of SSI. This variable has been related to incremental platelet activation in other series. ADAMTS13 activity and PT shown to be associated with blood shear stresses in the LV, allowing for further investigation.