Abstract：
Aim of this study is to evaluate any differences in VWF antigen, VWF activity and ADAMTS-13 activity before and after successful and non-successful Percutaneous Transluminal Angioplasty (PTA) in subjects with type 2 diabetes (T2DM) complicated by Chronic limb-threatening ischemia (CLTI) in diabetic foot vasculopathy.
In this prospective observational pilot study, we enrolled 35 T2DM subjects who underwent lower limb PTA. Transcutaneous oximetry was performed in all patients before and 6 weeks after PTA. The change in oxygen partial pressure (TcpO2) before and after PTA was expressed as TcpO2-delta (ΔTcpO2). VWF antigen, VWF activity and ADAMTS-13 activity were measured before and 6 weeks after PTA; changes were expressed as delta and ratio from baseline.
Subjects with ∆TcpO2 < 15 mmHg presented higher ΔVWF activity (p = 0.050) and lower ADAMTS-13 activity ratio (p = 0.080). Subjects with ∆TcpO2 < 30 mmHg showed lower ADAMTS-13 activity Δ and ratio (p = 0.028).
VWF antigen levels and VWF activity may potentially affect PTA outcome. Higher levels of VWF could derive from VWF release as consequence of PTA-induced mechanical endothelial damage and/or oxidative stress-induced modifications of VWF structure with impairment of VWF-ADAMTS13 interactions.
In this prospective observational pilot study, we enrolled 35 T2DM subjects who underwent lower limb PTA. Transcutaneous oximetry was performed in all patients before and 6 weeks after PTA. The change in oxygen partial pressure (TcpO2) before and after PTA was expressed as TcpO2-delta (ΔTcpO2). VWF antigen, VWF activity and ADAMTS-13 activity were measured before and 6 weeks after PTA; changes were expressed as delta and ratio from baseline.
Subjects with ∆TcpO2 < 15 mmHg presented higher ΔVWF activity (p = 0.050) and lower ADAMTS-13 activity ratio (p = 0.080). Subjects with ∆TcpO2 < 30 mmHg showed lower ADAMTS-13 activity Δ and ratio (p = 0.028).
VWF antigen levels and VWF activity may potentially affect PTA outcome. Higher levels of VWF could derive from VWF release as consequence of PTA-induced mechanical endothelial damage and/or oxidative stress-induced modifications of VWF structure with impairment of VWF-ADAMTS13 interactions.
摘要：
这项研究的目的是评估VWF抗原的任何差异，2型糖尿病（T2DM）合并糖尿病足血管病变中慢性威胁肢体缺血（CLTI）的受试者成功和未成功的经皮经腔血管成形术（PTA）前后的VWF活性和ADAMTS-13活性。
方法：在这项前瞻性观察性试点研究中，我们招募了35名接受下肢PTA的T2DM受试者。在PTA之前和之后6周，对所有患者进行了经皮血氧测定。PTA前后氧分压（TcpO2）的变化表示为TcpO2-δ（ΔTcpO2）。VWF抗原，在PTA之前和之后6周测量VWF活性和ADAMTS-13活性;变化表示为与基线的增量和比率。
结果：ΔTcpO2<15mmHg的受试者表现出较高的ΔVWF活性（p=0.050）和较低的ADAMTS-13活性比（p=0.080）。ΔTcpO2<30mmHg的受试者显示较低的ADAMTS-13活性Δ和比率(p=0.028)。
结论：VWF抗原水平和VWF活性可能潜在地影响PTA结果。由于PTA诱导的机械内皮损伤和/或氧化应激诱导的VWF结构修饰以及VWF-ADAMTS13相互作用的损害，VWF的较高水平可能来自VWF释放。
方法：在这项前瞻性观察性试点研究中，我们招募了35名接受下肢PTA的T2DM受试者。在PTA之前和之后6周，对所有患者进行了经皮血氧测定。PTA前后氧分压（TcpO2）的变化表示为TcpO2-δ（ΔTcpO2）。VWF抗原，在PTA之前和之后6周测量VWF活性和ADAMTS-13活性;变化表示为与基线的增量和比率。
结果：ΔTcpO2<15mmHg的受试者表现出较高的ΔVWF活性（p=0.050）和较低的ADAMTS-13活性比（p=0.080）。ΔTcpO2<30mmHg的受试者显示较低的ADAMTS-13活性Δ和比率(p=0.028)。
结论：VWF抗原水平和VWF活性可能潜在地影响PTA结果。由于PTA诱导的机械内皮损伤和/或氧化应激诱导的VWF结构修饰以及VWF-ADAMTS13相互作用的损害，VWF的较高水平可能来自VWF释放。
