Tissue factor expression in atrial endothelia associated with nonvalvular atrial fibrillation: Possible involvement in intracardiac thrombogenesis

Yoichi Nakamura, Kazufumi Nakamura, Kengo Fukushima-Kusano, Keiko Ohta, Hiromi Matsubara, Tsutomu Hamuro, Chikao Yutani, Tohru Ohe

Research output: Contribution to journalArticle

144 Citations (Scopus)

Abstract

Introduction: Tissue factor plays a key role in the extrinsic coagulation pathway and is induced by inflammatory cytokines. Atrial myocarditis has been detected recently in some patients with lone atrial fibrillation. Virchow's triad of low blood flow, hypercoagulability, and endothelial dysfunction, enhances thrombus formation. The present study was designed to elucidate the role of endothelial dysfunction in thrombogenesis associated with nonvalvular atrial fibrillation. Material and methods: We investigated tissue factor expression in the endothelia of left atrial appendages obtained from seven patients with nonvalvular atrial fibrillation and cardiogenic thromboembolism. Tissues were divided into 7-13 sections and compared with control specimens from four patients who died of noncardiac events. Expression of tissue factor, von Willebrand factor and tissue factor pathway inhibitor was evaluated by immunohistochemistry. Results: Histopathologically, inflammatory cells infiltrated the endocardium and all seven patients showed features of persistent myocarditis. Activated T cells [15.3±9.4 cells/high power field (HPF, mean±S.D.) vs. control 2.2±4.4/HPF (P=0.0294)] and a few macrophages [5.1±8.4 cells/HPF vs. control 2.4±3.5 cells/HPF (P=NS)] infiltrated the endocardium. Tissue factor was overexpressed in the endothelia particularly in tissues containing inflammatory cells and denuded matrix of the endocardium, compared with the control group. Von Willebrand factor, but not tissue factor pathway inhibitor, was also overexpressed in these tissues. Conclusion: Tissue factor expression induced by local inflammation is involved in the pathogenesis of thrombosis in patients with nonvalvular atrial fibrillation.

Original languageEnglish
Pages (from-to)137-142
Number of pages6
JournalThrombosis Research
Volume111
Issue number3
DOIs
Publication statusPublished - 2003

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Thromboplastin
Atrial Fibrillation
Endothelium
Endocardium
Myocarditis
von Willebrand Factor
Thrombosis
Atrial Appendage
Thrombophilia
Thromboembolism
Immunohistochemistry
Macrophages
Cytokines
Inflammation
T-Lymphocytes
Control Groups
lipoprotein-associated coagulation inhibitor

Keywords

  • Embolism
  • Myocarditis
  • Thrombogenesis
  • von Willebrand factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Hematology

Cite this

Tissue factor expression in atrial endothelia associated with nonvalvular atrial fibrillation : Possible involvement in intracardiac thrombogenesis. / Nakamura, Yoichi; Nakamura, Kazufumi; Fukushima-Kusano, Kengo; Ohta, Keiko; Matsubara, Hiromi; Hamuro, Tsutomu; Yutani, Chikao; Ohe, Tohru.

In: Thrombosis Research, Vol. 111, No. 3, 2003, p. 137-142.

Research output: Contribution to journalArticle

Nakamura, Yoichi ; Nakamura, Kazufumi ; Fukushima-Kusano, Kengo ; Ohta, Keiko ; Matsubara, Hiromi ; Hamuro, Tsutomu ; Yutani, Chikao ; Ohe, Tohru. / Tissue factor expression in atrial endothelia associated with nonvalvular atrial fibrillation : Possible involvement in intracardiac thrombogenesis. In: Thrombosis Research. 2003 ; Vol. 111, No. 3. pp. 137-142.
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T1 - Tissue factor expression in atrial endothelia associated with nonvalvular atrial fibrillation

T2 - Possible involvement in intracardiac thrombogenesis

AU - Nakamura, Yoichi

AU - Nakamura, Kazufumi

AU - Fukushima-Kusano, Kengo

AU - Ohta, Keiko

AU - Matsubara, Hiromi

AU - Hamuro, Tsutomu

AU - Yutani, Chikao

AU - Ohe, Tohru

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N2 - Introduction: Tissue factor plays a key role in the extrinsic coagulation pathway and is induced by inflammatory cytokines. Atrial myocarditis has been detected recently in some patients with lone atrial fibrillation. Virchow's triad of low blood flow, hypercoagulability, and endothelial dysfunction, enhances thrombus formation. The present study was designed to elucidate the role of endothelial dysfunction in thrombogenesis associated with nonvalvular atrial fibrillation. Material and methods: We investigated tissue factor expression in the endothelia of left atrial appendages obtained from seven patients with nonvalvular atrial fibrillation and cardiogenic thromboembolism. Tissues were divided into 7-13 sections and compared with control specimens from four patients who died of noncardiac events. Expression of tissue factor, von Willebrand factor and tissue factor pathway inhibitor was evaluated by immunohistochemistry. Results: Histopathologically, inflammatory cells infiltrated the endocardium and all seven patients showed features of persistent myocarditis. Activated T cells [15.3±9.4 cells/high power field (HPF, mean±S.D.) vs. control 2.2±4.4/HPF (P=0.0294)] and a few macrophages [5.1±8.4 cells/HPF vs. control 2.4±3.5 cells/HPF (P=NS)] infiltrated the endocardium. Tissue factor was overexpressed in the endothelia particularly in tissues containing inflammatory cells and denuded matrix of the endocardium, compared with the control group. Von Willebrand factor, but not tissue factor pathway inhibitor, was also overexpressed in these tissues. Conclusion: Tissue factor expression induced by local inflammation is involved in the pathogenesis of thrombosis in patients with nonvalvular atrial fibrillation.

AB - Introduction: Tissue factor plays a key role in the extrinsic coagulation pathway and is induced by inflammatory cytokines. Atrial myocarditis has been detected recently in some patients with lone atrial fibrillation. Virchow's triad of low blood flow, hypercoagulability, and endothelial dysfunction, enhances thrombus formation. The present study was designed to elucidate the role of endothelial dysfunction in thrombogenesis associated with nonvalvular atrial fibrillation. Material and methods: We investigated tissue factor expression in the endothelia of left atrial appendages obtained from seven patients with nonvalvular atrial fibrillation and cardiogenic thromboembolism. Tissues were divided into 7-13 sections and compared with control specimens from four patients who died of noncardiac events. Expression of tissue factor, von Willebrand factor and tissue factor pathway inhibitor was evaluated by immunohistochemistry. Results: Histopathologically, inflammatory cells infiltrated the endocardium and all seven patients showed features of persistent myocarditis. Activated T cells [15.3±9.4 cells/high power field (HPF, mean±S.D.) vs. control 2.2±4.4/HPF (P=0.0294)] and a few macrophages [5.1±8.4 cells/HPF vs. control 2.4±3.5 cells/HPF (P=NS)] infiltrated the endocardium. Tissue factor was overexpressed in the endothelia particularly in tissues containing inflammatory cells and denuded matrix of the endocardium, compared with the control group. Von Willebrand factor, but not tissue factor pathway inhibitor, was also overexpressed in these tissues. Conclusion: Tissue factor expression induced by local inflammation is involved in the pathogenesis of thrombosis in patients with nonvalvular atrial fibrillation.

KW - Embolism

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KW - Thrombogenesis

KW - von Willebrand factor

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