scholarly journals Antithrombin III Activity, Measured with a Chromogenic Substrate, in Patients with Hepatic Cirrhosis, with Prosthetic Heart Valves and During Parenteral Administration of Medroxyprogesterone Acetate as a Contraceptive Agent

1977 ◽  
Author(s):  
G. Baele ◽  
E. Matthys ◽  
G. De Cock ◽  
M. Thiery ◽  
F. Barbier

Antithrombin III (AT III) activity was assayed on heat defibrinated plasma using a synthetic chromogenic substrate, benzoyl-Phe-Val-Arg-p. nitroanilide. AT III activity in 30 normal subjects averaged 95% ± 18 (± 1 SD). As AT III is synthesized in the liver, we measured its activity in 72 samples from 44 patients with hepatic cirrhosis. The mean activity (49% ± 23) was significantly lower than in the control group. AT III activity was also measured in 32 patients with prosthetic heart valves receiving sodium warfarin therapy. The mean activity in this group (90% ± 23) fell in the normal range. It also did not differ significantly from the mean activity (95% ± 29) in a similar (matched for sex and age) group of 32 subjects, also treated with sodium warfarin but for other reasons than bearing a prosthetic heart valve. As low AT III levels have been reported in women using a combined oral contraceptive, we also measured AT III in 19 women receiving trimonthly injections of 150 mg of medroxyprogesterone acetate as contraception. AT III levels in this group of women (102% ± 23) were found to be normal. So the oestrogen in the combined contraceptive may be responsible for the reported fall in serum AT III activity.

Blood ◽  
1986 ◽  
Vol 67 (1) ◽  
pp. 93-98
Author(s):  
EA Knot ◽  
E de Jong ◽  
JW ten Cate ◽  
AH Iburg ◽  
CP Henny ◽  
...  

Purified human radioiodinated antithrombin III (125I-AT III) was used to study its metabolism in six members from three different families with a known hereditary AT III deficiency. Six healthy volunteers served as a control group. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and crossed immunoelectrophoresis (CIE) showed the purified AT III to be homogeneous. Amino acid analysis of the protein revealed a composition identical to a highly purified internal standard. The specific activity was 5.6 U/mg. Analysis of plasma radioactivity data was performed, using a three-compartment model. Neither plasma disappearance half-times nor fractional catabolic rate constants differed significantly between patients and control subjects. The mean absolute catabolic rate in the patient group was significantly lower than that of the control group at 2.57 +/- 0.44 and 4.46 +/- 0.80 mg/kg/day, respectively. In addition, the mean patient alpha 1-phase, flux ratio (k1,2 and k2,1) of the second compartment alpha 2-phase and influx (k3,1) of the third compartment were significantly reduced as compared with control values. It has been tentatively concluded that the observed reduction in the second compartment may be caused by a decrease in endothelial cell surface binding.


Author(s):  
S.M. Rajah ◽  
N. Sreeharan ◽  
S. Rao ◽  
D.A. Watson

The effect of Warfarin (W) was compared with a combination of Warfarin and Dipyridamole (W+D) on the incidence of arterial thrombo-embolism in patients with prosthetic heart valves in a prospective randomised study. Sixty-four and 53 patients were allocated to W and W+D. The two groups were comparable as regards age, sex, arrhythmias and site and type of valves. The dose of W was determined by regular monitoring of prothrombin ratio 0.9 - 3) and that of D by monitoring serum D levels to between 2 and 4 μmol/l. The mean period of follow-up was 26.98 months (range 1 to 36) for W and 22.02 months (range 1 to 36) for W+D. Six patients in W and 1 in W+D developed arterial thrombo-embolic episodes giving an incidence of 0.0035 per patient month for W and 0.0009 per patient month for W+D. An actuarial analysis of the yearly incidence of thrombo-embolism confirmed the superiority of W+D over W. Of the 6 failures in W, 5 were in sinus rhythm and 1 in atrial fibrillation and all had cerebral embolic episodes. The failure in W+D was a patient in atrial fibrillation who died suddenly 6 weeks after surgery and the post-mortem showed clots on both mitral and aortic prostheses.


Blood ◽  
1986 ◽  
Vol 67 (1) ◽  
pp. 93-98 ◽  
Author(s):  
EA Knot ◽  
E de Jong ◽  
JW ten Cate ◽  
AH Iburg ◽  
CP Henny ◽  
...  

Abstract Purified human radioiodinated antithrombin III (125I-AT III) was used to study its metabolism in six members from three different families with a known hereditary AT III deficiency. Six healthy volunteers served as a control group. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and crossed immunoelectrophoresis (CIE) showed the purified AT III to be homogeneous. Amino acid analysis of the protein revealed a composition identical to a highly purified internal standard. The specific activity was 5.6 U/mg. Analysis of plasma radioactivity data was performed, using a three-compartment model. Neither plasma disappearance half-times nor fractional catabolic rate constants differed significantly between patients and control subjects. The mean absolute catabolic rate in the patient group was significantly lower than that of the control group at 2.57 +/- 0.44 and 4.46 +/- 0.80 mg/kg/day, respectively. In addition, the mean patient alpha 1-phase, flux ratio (k1,2 and k2,1) of the second compartment alpha 2-phase and influx (k3,1) of the third compartment were significantly reduced as compared with control values. It has been tentatively concluded that the observed reduction in the second compartment may be caused by a decrease in endothelial cell surface binding.


1979 ◽  
Author(s):  
F. Panicucci ◽  
A. Sacripanti ◽  
E. Pinori ◽  
M. Vispi ◽  
B. Conte ◽  
...  

Determinations of AT-III activity, heparin cofactor activity, antifactor Xa activity and AT-III protein were carried out in 200 healthy adults, evenly distributed within age and sex groups, in 60 patients with cerebral thrombosis and in 20 oral contraceptive users. There was a positive correlation between AT-III protein and its activitiesin normal subjects and in patients with cerebral thrombosis. In oral contraceptive users the positive correlation was between AT-III protein and its activities, antifactor Xa activity excepted. The mean AT-III protein and heparin cofactor activity values decreased in males with age and were significantly lower in the groups between 50 and 70 years. The mean AT-III protein and heparin cofactor activity values decreased slightly in women in fertile age and were lower in the 40 to 50 age-group. The mean AT-III protein and its activities values did not show any variation in the patients with cerebral thrombosis. The mean antifactor Xa activity value in the women, taking the pill for 3 months, decreased, whereas the other AT-III activities and AT-III protein were unchanged.


2020 ◽  
Vol 7 (3) ◽  
pp. 90
Author(s):  
Othman Smadi ◽  
Anas Abdelkarim ◽  
Samer Awad ◽  
Thakir D. Almomani

The prosthetic heart valve is vulnerable to dysfunction after surgery, thus a frequent assessment is required. Doppler electrocardiography and its quantitative parameters are commonly used to assess the performance of the prosthetic heart valves and provide detailed information on the interaction between the heart chambers and related prosthetic valves, allowing early detection of complications. However, in the case of the presence of subaortic stenosis, the accuracy of Doppler has not been fully investigated in previous studies and guidelines. Therefore, it is important to evaluate the accuracy of the parameters in such cases to get early detection, and a proper treatment plan for the patient, at the right time. In the current study, a CFD simulation was performed for the blood flow through a Bileaflet Mechanical Heart Valve (BMHV) with concomitant obstruction in the Left Ventricle Outflow Tract (LVOT). The current study explores the impact of the presence of the subaortic on flow patterns. It also investigates the accuracy of (BMHV) evaluation using Doppler parameters, as proposed in the American Society of Echocardiography (ASE) guidelines.


1981 ◽  
Author(s):  
S Urano ◽  
M Nakagawa ◽  
T Kitani ◽  
Y Maeda ◽  
M Watada ◽  
...  

A radioimmunoassay method for antithrombin III (ATIII) was developed in order to detect the AT III levels correctly in plasma and tissues and the effect of heparin infusion was investigated on rat using this method and 125I labeled ATIII. Rat AT III was purified from rat defibrinated plasma by heparin sepharose affinity chromatography and gel filtrations. This purified AT III was used for the preparation of specific AT III antiserum. Labeling of AT III with 125I was performed according to the method by Hunter and Greenwood. Plasma level of AT III were significantly decreased in the treated group with heparin for 6 hours, although significant difference was not observed in AT III contents in various organs. The behavior of i.v. injected AT III laveled with 125I in the normal control and treated groups proved the difference on the half life of AT III. Control group gave 52 hours and it was shortened in the treated group. The percent radioactivity per ml plasma after 6 hours of heparin infusion was 1.16±0.51, and 2.01±0.38 in the control group, and significant difference was observed (p < 0.05). On the contrary the percent dose radioactivity per g tissue wet weight was significantly increased in the liver, lungs, and large intestine on the heparin treated group. The decreased amount of the intravenously injected laveled AT III appears to be trapped and metabolized in the various organs mainly in the liver during heparin infusion. The decrease of plasma AT III levels on the patients treated with heparin may be explained from these experimental results.


1981 ◽  
Author(s):  
H O Fredin ◽  
L Tengborn

The plasma levels of AT III were studied in 71 patients operated with total hip replacement. AT III was determined with amidolytic assay using the chromogenic substrate Coatest S-2238 (KabiDiagnostica, Sweden) as well as electroimmunochemically. Samples were drawn before the operation and 4-5 times the first week postoperatively. The results were adjusted to the hematocrit (Hcr) for each sample.The patients were randomly allocated to thromboprophylactic prevention with either Macrodex (Pharmacia, Sweden) or heparin with dihydroergotamine (Sandoz, Switzerland). Phlebography of the operated leg and perfusion/ventilation lung scanning was performed on the 10-14th postoperative day.Results. No difference in the AT III levels were seen in patients who developed postoperatively deep venous thrombosis and/or pulmonary embolism (DVT/PE) as compared to those who did not develop DVT/PE.No decrease of AT III was found postoperatively, when adjusted to HcrThe frequency of DVT/PE did not differ significantly between the two types of thromboembolic prophylaxis.Conclusion. Pre-operative determination of AT III, whether biologically or immunochemically, did not seem to be successful as screening method of patients to develop DVT/PE.


Perfusion ◽  
1999 ◽  
Vol 14 (5) ◽  
pp. 357-362 ◽  
Author(s):  
M Ranucci ◽  
A Cazzaniga ◽  
G Isgrò ◽  
A Ditta ◽  
A Boncilli ◽  
...  

Thirty patients scheduled for elective myocardial revascularization and having undergone preoperative heparin treatment have been admitted to this prospective, randomized study. The aim of the study was to test two different strategies for preserving circulating antithrombin III (AT-III) during cardiopulmonary bypass. Patients in the control group (group C, n = 10) were treated with a standard heparinization (300 IU/kg). Patients in group A ( n = 10) received the same management plus two doses of purified antithrombin III (1000 IU each). Patients in group GA received 200 IU/kg heparin and a continuous infusion of heparin (100 IU/kg/h) and gabexate mesilate (2 mg/kg/h) plus the same dose of antithrombin III as group A. Both group A and group GA demonstrated a preservation of circulating AT-III when compared to group C; this effect was more pronounced in group GA. The total heparin dosage was less in group GA than in groups A and C. Purified AT-III administration is recommended in heparin pretreated patients; the addition of gabexate mesilate to this protocol decreases the heparin requirement and increases the AT-III preservation.


Author(s):  
Caitlin Martin ◽  
Wei Sun

Bio-prosthetic heart valves (BHVs) with leaflets made of glutaraldehyde-treated bovine pericardium (GLBP), have been used extensively to replace diseased heart valves. BHVs display superior hemodynamics to mechanical valves and eliminate the need for anticoagulant therapy; however, they exhibit poor durability resulting from in vivo degradation and fatigue damage of the leaflets.


1987 ◽  
Vol 57 (03) ◽  
pp. 329-331 ◽  
Author(s):  
V De Stefano ◽  
G Leone ◽  
M P De Carolis ◽  
R Ferrelli ◽  
S De Carolis ◽  
...  

SummaryAntithrombin III (AT III) plasma levels were investigated in 18 full term neonates and 14 healthy preterm neonates. A control group of 20 healthy adults was also studied. AT III was measured as antigen concentration (Ag) and antithrombin or anti-factor Xa heparin cofactor (H. C.) activities. Crossed immunoelectrophoresis on heparin-agarose (H-CIE) was carried out on plasma samples; moreover the distribution of isoantithrombins was investigated on whole plasma by a technique of crossed immunoelectrofocusing (CIEF). AT III plasma levels in full term infants were significantly lower as compared to the adult values. The preterm newborns group showed a further significant decrease in AT III levels as compared to the full term neonates. In all infants AT III H-CIE runs displayed a single fast moving anodal peak, so that a normal binding to heparin was demonstrated. The CIEF AT III plasma pattern of the adults as well as of all neonates displayed three major peaks at pH range 5.2-4.9, a small amount of AT III at pH 4.9-4.8 and a minor peak at pH 4.8-4.6, so that it was concluded that the isoantithrombins plasma distribution in neonatal age is identical to that of the adult subjects. Four neonates whose mothers were affected by AT III congenital defect were also investigated: diagnosis of congenital deficiency was established in three cases.


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