Chronic Thromboembolic Pulmonary Hypertension, Pulmonary Artery Hypertension
Conditions
Keywords
Blood coagulation disorders, Platelets, Thrombin, Treatment
Brief summary
The objective of the present study is to assess blood coagulation disorders in patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension. The investigators aim to evaluate any possible coagulation abnormalities related to the patients' primary disease and any possible effects the pulmonary hypertension- specific therapy may have on hemostasis.
Detailed description
Pulmonary hypertension (PH) is a chronic, progressive, pulmonary vascular disease with a multifactorial etiology and a not fully elucidated pathophysiological background. There is a complex and not adequately understood association between PH and the coagulation process. The aim of the present study is to evaluate hemostasis in patients with PH classified as category 1 of the World Health Organization Pulmonary Hypertension Group (Pulmonary Arterial Hypertension, PAH) and 4 (Chronic Thromboembolic Pulmonary Hypertension, CTEPH). Patients with CTEPH are diagnosed as inoperable. The investigators perform diagnostic tests on blood samples collected directly from the pulmonary artery during the right heart catheterization performed as part of the patients' routine medical care for the diagnosis of the disease or for follow-up 6 months after the initiation of PH-specific treatment. All blood samples are processed by platelet function analyzer-100 (PFA-100), light transmission aggregometry (LTA), rotational thromboelastometry (ROTEM) and endogenous thrombin potential (ETP).The primary objective of the study is to assess platelet function, coagulation and anti-coagulation pathways and fibrinolysis in PAH and inoperable CTEPH patients and to investigate the possible effects of PH- specific therapy on hemostasis.
Interventions
DIAGNOSTIC_TESTPlatelet function analyzer-100
The PFA-100 system evaluates primary hemostasis in whole blood samples.
DIAGNOSTIC_TESTLight transmission aggregometry
Light transmission aggregometry is the gold standard method for assessing platelet function.
DIAGNOSTIC_TESTRotational thromboelastometry
ROTEM is a viscoelastic method for hemostasis testing in whole blood.This assay investigates the interaction of blood cells, coagulation factors and their inhibitors during clotting and subsequent fibrinolysis.
DIAGNOSTIC_TESTEndogenous thrombin potential
The endogenous thrombin potential assesses the amount of thrombin which can be generated after the in vitro activation of coagulation and represents the balance between pro- and anti-coagulant forces in plasma.
Sponsors
National and Kapodistrian University of Athens
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Pulmonary Arterial Hypertension, * Chronic Thromboembolic Pulmonary Hypertension.
Exclusion criteria
* renal insufficiency, * hepatic insufficiency, * thyroid dysfunction, * malignancy, * active infections, * receiving anticoagulant or antiplatelet therapy, * history of hemostatic disorders irrelevant to their primary disease, * abnormal red blood counts.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PFA-100 in detection of platelet abnormalities in PAH and CTEPH patients. | 6 months | Change in the percentage of PAH and CTEPH patients who are detected with platelet abnormalities in PFA-100 testing from the date of the first right heart catheterization performed for the diagnosis of their disease (before treatment implementation) to the date of the second right heart catheterization performed for follow-up (after treatment implementation) at 6 months. |
| Light transmission aggreggometry in detection of platelet abnormalities in PAH and CTEPH patients. | 6 months | Change in the percentage of PAH and CTEPH patients who are detected with platelet abnormalities in LTA testing from the date of the first right heart catheterization performed for the diagnosis of their disease (before treatment implementation) to the date of the second right heart catheterization performed for follow-up (after treatment implementation) at 6 months. |
| ROTEM in detection of coagulation abnormalities in PAH and CTEPH patients. | 6 months | Change in the percentage of PAH and CTEPH patients who are detected with coagulation abnormalities in ROTEM testing from the date of the first right heart catheterization performed for the diagnosis of their disease (before treatment implementation) to the date of the second right heart catheterization performed for follow-up (after treatment implementation) at 6 months. |
| Endogenous thrombin potential in detection of thrombin abnormalities in PAH and CTEPH patients. | 6 months | Change in the percentage of PAH and CTEPH patients who are detected with thrombin deficits in endogenous thrombin potential testing from the date of the first right heart catheterization performed for the diagnosis of their disease (before treatment implementation) to the date of the second right heart catheterization performed for follow-up (after treatment implementation) at 6 months. |
Countries
Greece
Contacts
Primary ContactEleni Vrigkou, MD, MSc
Backup ContactArgyrios Tsantes, MD, PhD
Outcome results
None listed