title: Atomic force microscopy as a tool to evaluate the risk of cardiovascular diseases in patients.
abstract: The availability of biomarkers to evaluate the risk of cardiovascular diseases is limited. High fibrinogen levels have been identified as a relevant cardiovascular risk factor, but the biological mechanisms remain unclear. Increased aggregation of erythrocytes (red blood cells) has been linked to high plasma fibrinogen concentration. Here, we show, using atomic force microscopy, that the interaction between fibrinogen and erythrocytes is modified in chronic heart failure patients. Ischaemic patients showed increased fibrinogen-erythrocyte binding forces compared with non-ischaemic patients. Cell stiffness in both patient groups was also altered. A 12-month follow-up shows that patients with higher fibrinogen-erythrocyte binding forces initially were subsequently hospitalized more frequently. Our results show that atomic force microscopy can be a promising tool to identify patients with increased risk for cardiovascular diseases.
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
authors.forename: Ana Filipa
authors.initials: AF
authors.lastname: Guedes
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
authors.forename: Filomena A
authors.initials: FA
authors.lastname: Carvalho
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
authors.forename: Inês
authors.initials: I
authors.lastname: Malho
authors.affiliation: Heart Failure Unit, Cardiology Department, Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Lousada
authors.affiliation: Heart Failure Unit, Cardiology Department, Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Sargento
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal.
authors.forename: Nuno C
authors.initials: NC
authors.lastname: Santos
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D001809:Blood Viscosity; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D004912:Erythrocytes / Q000166:cytology / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000032:analysis / Q000378:metabolism; D006403:Hematologic Tests / Q000379:methods*; D006801:Humans; D008297:Male; D018625:Microscopy, Atomic Force / Q000379:methods*; D008875:Middle Aged; D011485:Protein Binding; D018570:Risk Assessment / Q000379:methods*
chemical_list: D015415:Biomarkers; D005340:Fibrinogen