Endothelial-driven increase in plasma thrombin generation characterising a new hypercoagulable phenotype in acute heart failure Batric Popovic, Faiez.

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Endothelial-driven increase in plasma thrombin generation characterising a new hypercoagulable phenotype in acute heart failure Batric Popovic, Faiez Zannad, Huguette Louis, Isabelle Clerc-Urmès, Cécile Lakomy, Sébastien Gibot, Cécile V. Denis, Patrick Lacolley, Véronique Regnault International Journal of Cardiology Volume 274, Pages 195-201 (January 2019) DOI: 10.1016/j.ijcard.2018.07.130 Copyright © 2018 Elsevier B.V. Terms and Conditions

Fig. 1 Acute heart failure increases thrombin generation and impairs activated protein C sensitivity. Thrombin generation was triggered by 0.5 pM tissue factor and monitored with the calibrated automated thrombography assay. A and B) Representative thrombin generation curves in platelet-rich plasma (PRP) adjusted to 150 × 109 platelets/L or in platelet-free plasma (PFP) + 4 μM phosphatidyl-serine/-ethanolamine/-choline vesicles respectively. C and D) Inhibition of endogenous thrombin potential (ETP) by activated protein C (APC) in PRP or in PFP + 4 μM phosphatidyl-serine/-ethanolamine/-choline vesicles respectively. CT, control non-heart failure cardiology patient; CHF, CHF patient; Ad, ADHF patient at hospital admission; PostDis, ADHF patient at the post-discharge time-point. International Journal of Cardiology 2019 274, 195-201DOI: (10.1016/j.ijcard.2018.07.130) Copyright © 2018 Elsevier B.V. Terms and Conditions

Fig. 2 Markers of endothelial activation and circulating nucleosomes are increased in ADHF patients at hospital admission. Levels of VWF (A), FVIII (B) and DNA complexed with histones (E) were measured in plasma by ELISA. Endothelium-derived extracellular vesicles (eEVs) were enumerated by flow cytometry (C and D). The ability of plasmas from patients to induce NET formation in control neutrophils was assessed by a fluorescence plate assay (F). Results are expressed in arbitrary fluorescence units (AFU). Each dot within vertical scatter plots represents a single patient; the mean ± SEM is depicted. CT, control non-heart failure cardiology patient; CHF, CHF patient; Ad, ADHF patient at hospital admission; Dis, ADHF patient at the day of discharge; PostDis, ADHF patient at the post-discharge time-point. International Journal of Cardiology 2019 274, 195-201DOI: (10.1016/j.ijcard.2018.07.130) Copyright © 2018 Elsevier B.V. Terms and Conditions