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Thromb Haemost 2009; 102(03): 573-580
DOI: 10.1160/TH09-01-0036
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Levels of von Willebrand factor antigen and von Willebrand factor cleaving protease (ADAMTS13) activity predict clinical events in chronic heart failure

Tímea Gombos
1   IIIrd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
,
Veronika Makó
1   IIIrd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
,
László Cervenak
1   IIIrd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
,
Jana Papassotiriou
2   Department of Research, BRAHMS Aktiengesellschaft, Neuendorfstr. 25, D-16761 Hennigsdorf, Germany
,
Jan Kunde
4   Research Group of Inflammation Biology and Immunogenomics, Hungarian Academy of Sciences, Budapest, Hungary
,
Jolán Hársfalvi
3   Clinical Research Center, University of Debrecen, Debrecen, Hungary
,
Zsolt Förhécz
1   IIIrd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
,
Zoltán Pozsonyi
1   IIIrd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
,
Gábor Borgulya
4   Research Group of Inflammation Biology and Immunogenomics, Hungarian Academy of Sciences, Budapest, Hungary
,
Lívia Jánoskuti
1   IIIrd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
,
Zoltán Prohászka
4   Research Group of Inflammation Biology and Immunogenomics, Hungarian Academy of Sciences, Budapest, Hungary
› Author Affiliations
Further Information

Publication History

Received: 15 January 2009

Accepted after major revision: 13 June 2009

Publication Date:
22 November 2017 (online)

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Summary

Decreased activity of ADAMTS13, the von Willebrand factor (VWF) cleaving protease, was recently reported in cardiovascular diseases and in hepatic failure. Chronic heart failure (CHF) is characterised by abnormalities of left ventricular function accompanied by the failure of the liver and dysregulation of endothelial activation. Therefore, the aim of our study was to measure ADAMTS13 activity in CHF, and determine the prognostic value of VWF and ADAMTS13 on major clinical events in CHF.

ADAMTS13 activity (measured by FRETS-VWF73 substrate) was decreased in CHF (n = 152, left ventricular ejection fraction <45%), and it correlated negatively with B-type natriuretic peptide (BNP) NYHA (New York Heart Association) classes, markers of synthetic capacity of the liver and endothelial dysfunction (all p<0.005). Both, high VWF:Ag levels (hazard ratio [HR] 1.52, 95% confidence interval [CI] 1.189–1.943), and low ADAMTS13/VWF:Ag ratios (HR 0.70, 95% CI 0.58–0.84) independently and significantly predicted short-term (1 year followup) clinical adverse events in heart failure (HF).

Decreased activity of ADAMTS13 with concomitant high VWF:Ag levels is a significant independent predictor of clinical events in CHF. The levels of the two molecules may integrate the impaired synthetic capacity of the liver and the disturbed endothelial regulation and can therefore be a useful tool to predict clinical events in CHF.

Keywords

Heart failure - ADAMTS13 - von Willebrand factor - endothelial dysfunction - hepatic failure
 

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