Relationship Between Coagulation Markers And Right Ventricular Volume Overload In Congestive Heart Failure

Objective: Heart failure is associated with activation of thrombin-related pathways,which predicts a poor prognosis.This study was designed to determine the relationship between coagulation markers and right ventricular volume overload in patients with chronic heart failure.Methods: We collected data of clinical characteristics,echocardiograph and coagulation parameters in 274 heart failure patients who were hospitalized in the Cardiology Division,the first hospital of Hebei Medical University from January 2018 to July 2019.The relationship between the coagulation markers and the parameters of echocardiography were analyzed in different types of heart failure(heart failure with reduced ejection fraction[HFr EF],heart failure with median ejection fraction[HFmr EF] and heart failure with preserved ejection fraction[HFp EF]).Echocardiographic parameters include left ventricular ejection fraction,left ventricular end diastolic diameter,left ventricular end systolic diameter,right ventricular transverse diameter,which were standardized by body surface area.Coagulation markers include D-dimer,fibrin(FIB),international standard ratio(INR),prothrombin time(PT),activated partial thromboplastin time(APTT),thromboplastin time(TT),prothrombin time activity,activated partial thromboplastin time ratio.Results:In HFp EF group,FIB and prothrombin time activity had an inversely correlation with right ventricular transverse diameter(r=-0.201,P<0.05;r=-0.418,P <0.01),D-dimer,INR,PT,APTT,TT and activated partial thromboplastin time ratio had a positive correlation with the right ventricular transverse diameter(P <0.05).In HFr EF group,prothrombin time activity had an inversely correlation with right ventricular transverse diameter(r=-0.475,P <0.01),INR,PT,TT and activated partial thromboplastin timeratio had a positive correlation with right ventricular transverse diameter(P<0.05).However,in HFmr EF group,only D-dimer had a positive correlation with the right ventricular transverse diameter(P <0.01),other coagulation markers were not significantly related to the right ventricular transverse diameter.Conclusions: There was a significant positive correlation between the prolongation of bleeding time and right ventricular transverse diameter(i.e.,volume load)in patients with chronic heart failure.However,since this was an observational study,further investigation is needed to verify our results.