Tissue factor is unregulated in microvascular endothelial cells of patients with heart failure.
OBJECTIVE
Several lines of evidence point to hypercoagulability as an important factor for heart failure (HF) pathogenesis.


METHODS
We hypothesised that endothelial tissue factor (TF) expression reflects altered tissue haemostasis which is related to the severity of HF. Accordingly, we investigated TF expression in the biopsies of 60 patients with HF and 22 without HF. In addition, we assessed the relationship between endothelial TF expression and clinical markers of HF severity.


RESULTS
The control subjects without HF presented absent or weak TF expression in few microvessels, while the endomyocardial biopsies of patients with HF, capillary vessels presented both weak and severe staining patterns by immunohistochemistry usually with regional distribution. This was collaborated by the immune electron microscopic study. The severe microvessel TF antigen expression was found in 11 (18.3%) patients with HF. The endothelial TF expression was inversely associated with left ventricular ejection fraction (r=-0.42, p=0.001) and positively with N-terminal brain natriuretic peptide (r=0.36, p<0.023), markers of HF severity.


CONCLUSIONS
Regional upregulation of the TF in the capillary endothelial cells suggests local myocardial thrombogenicity. Furthermore, the relationship between endothelial TF and HF severity would be keeping in line with the hypothesis that an altered tissue haemostasis is most profoundly expressed in patients with severe HF. Weak TF expression found in several microvessels of the biopsy specimens patients without HF pathology might be potentially related to a low basal level of activation of the clotting system in normal individuals.
Department of Histology, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland.
Edyta
E
Reichman-Warmusz
Department of Biochemistry, School of Pharmacy, Medical University of Silesia in Katowice, Sosnowiec, Poland.
Dorota
D
Domal-Kwiatkowska
Department of Histology, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland.
Natalia
N
Matysiak
Department of Surgery, Municipal Hospital, Jaworzno, Poland.
Józef
J
Kurek
Faculty of Biomedical Engineering, Silesian University of Technology in Gliwice, Zabrze, Poland.
Dominik
D
Spinczyk
Department of Histology, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland.
Damian
D
Dudek
Department of Histology, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland.
Krzysztof
K
Helewski
Department of Histology, School of Medicine with the Division of Dentistry, Medical University of Silesia in Katowice, Zabrze, Poland Silesian Centre for Heart Disease, Zabrze, Poland.
Romuald
R
Wojnicz
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D002196:Capillaries / Q000737:chemistry* / Q000648:ultrastructure; D016022:Case-Control Studies; D003331:Coronary Vessels / Q000737:chemistry* / Q000648:ultrastructure; D042783:Endothelial Cells / Q000737:chemistry* / Q000648:ultrastructure; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D016253:Microscopy, Immunoelectron; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D010446:Peptide Fragments / Q000032:analysis; D012720:Severity of Illness Index; D013318:Stroke Volume; D013925:Thromboplastin / Q000032:analysis*; D015854:Up-Regulation; D016277:Ventricular Function, Left
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D013925:Thromboplastin
BLOOD VESSELS; CLOTTING; ELECTRON MICROSCOPY; HEART; IMMUNOHISTOCHEMISTRY