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European Heart Journal 1984 5(1):55-61;
Copyright © 1984 by the European Society of Cardiology.
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© 1984 The European Society of Cardiology

A prospective study of platelet metabolism in rheumatic heart disease. Effect of prosthetic heart valve

B. FAGHER and M. MONTI

Department of Internal Medicine, University Hospital Lund, Sweden

Received 21 March 1983; accepted 25 June 1983.

Correspondence to: Dr.Birger Fagher, Department of Internal Medicine, University Hospital, S-221 85 LUND, Sweden.

Abstract

The metabolic activity of platelets in patients with advanced rheumatic heart disease (RHD) was estimated by measurement of heat production in a microcalorimeter. Twenty-nine patients were randomly selected and prospectively followed before and after valve replacement with Bjork-Shiley prosthesis. Before the operation a significantly (P<0-02) elevated platelet heat production wasfound compared with normal subjects, 63 ±5 fW/cell and 59 ±4 fW/cell, respectively, probably due to the presence of a younger and metabolically more active platelet population. Platelet count before the operation was significantly lower than normal (P<0-001).Platelet heat production did not correlate with either type of valvular disease, the presence of valvular calcification or atrial fibrillation. After valve replacement the platelet heat productionsignificantly decreased (P<0-001) to 58±5 fW/cell and the platelet count normalized. The highest incidence of thromboembolic manifestations was in the immediate postoperative period. The greatest reductions in platelet heal production. 19% and 27% were observed in two patients with thromboembolic events, as compared with an average of 4% for therest of the operated patients without complications. The possible relationship between changes in platelet heat production and thromboembolism in patients with RHD is discussed.

Key Words: Platelet counts • platelet metabolism • rheumatic heart disease • prosthetic valves • thromboembolism


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