Search for: [Abstract = "Calcific aortic stenosis \(AS\) is the most common form of valvular heart disease in adults. The early lesions in aortic valve leaflets are similar to those observed in atherosclerosis. It has been shown that AS is a prothrombotic state, characterized by increased thrombin formation and platelet activation, which is accompanied by systemic inflammation. Despite extensive research efforts, there is no effective treatment of the progression of AS. The presence of symptoms including heart failure, angina, dizziness and syncope in a patient with AS requires aortic valve replacement, because delay of the therapy worsens the prognosis. The management of asymptomatic AS patients is controversial. Several studies performed over the past decades have aimed to established the optimal treatment in this group of patients.In 2013, Natorska et al. have reported that hypofibrinolysis is more common in AS patients than in controls. Moreover, it is known that exercise can induce a prothrombotic state. It has been suggested that beneficial effects of physical activity on the risk of cardiovasculardisease may result at least in part from increased fibrinolysis. To our knowledge, there have been no published studies on the effect of exercise on blood coagulation and fibrinolysis in AS patients. The present study was performed to evaluate potential differences in the haemostatic response to exercise stress test in AS patients.The study included 33 adult patients with asymptomatic moderate\-to\-severe AS and 33 controls. The exclusion criteria were\: history of angina, dizziness or syncope, heart failure, left ventricular \(LV\) ejection fraction \(EF\) <50%, history of myocardial infarction, stroke or venous thromboembolism, history or current atrial fibrillation, hyper\- or hypothyroidism, diabetes treated with insulin, oral anticoagulant therapy, severe comorbidities and acute infection. Blood glucose, creatinine, lipid profile, aminotransferases, thyroid\-stimulating hormone, high\-sensitivity C\-reactive protein and routine coagulation parameters \(activated partial thromboplastin time, prothrombin time\-international normalized ratio, fibrinogen\) were determined on admission in all patients. Transthoracic echocardiography and stress echocardiography were performed in all subjects. We also measured intima\-media thickness and ankle brachial pressure index to assess atherosclerotic vascular disease in other arteries. Markers of thrombin generation \(prothrombin 1\+2 fragments \[F1\+2\], peak thrombin generated \[Cmax\], free tissue factor pathway inhibitor, platelet activation \(soluble CD40 ligand \[sCD40L\]\), fibrinolysis \(PAI\-1, TAFI antigen and activity, plasminogen, α2\-antiplasmin, plasma soluble thrombomodulin \[TM\], tissue plasminogen activator \[tPA\] antigen, D\-dimer, clot lysis time \[CLT\]\), von Willebrand factor \(vWF\) antigen, vWF factor activity, VIII factor activity and troponin T were determined four times\: at rest, at peak exercise, one hour and 24 hours after exercise.Measurement of the peak thrombin generated was performed using calibrated automated thrombography using the assay by Hemker et al.. Measurement of CLT with the modified method by Lisman et al. was based on the assessment of lysis efficiency mediated by tissue plasminogen activator \(t\-PA\) after addition of tissue factor \(TF\) and phospholipids to plasma."]

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