{"id":218,"date":"2011-12-21T16:30:50","date_gmt":"2011-12-21T16:30:50","guid":{"rendered":"https:\/\/impact-r.com\/?p=218"},"modified":"2025-07-22T12:08:03","modified_gmt":"2025-07-22T12:08:03","slug":"impact-r-and-acquired-von-willebrand-disease-in-severe-aortic-stenosis","status":"publish","type":"post","link":"https:\/\/impact-r.com\/?p=218","title":{"rendered":"Impact-R and Acquired von Willebrand Disease in Severe Aortic Stenosis"},"content":{"rendered":"<p>The aortic valve is the valve between the left ventricle and the aorta, the main artery. It has three leaflets (tricuspid). When the left ventricle contracts, it pushes blood through the valves and into the aorta. When the left ventricle relaxes, the valves close, preventing the blood from flowing back into the left ventricle.<\/p>\n<p><a href=\"https:\/\/impact-r.com\/wp-content\/uploads\/2011\/12\/aortic-stenosis.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-219\" src=\"https:\/\/impact-r.com\/wp-content\/uploads\/2011\/12\/aortic-stenosis.jpg\" alt=\"\" width=\"264\" height=\"229\"><\/a>When the aortic opening becomes constricted or stenotic, the blood in the left ventricle cannot be pumped effectively into the aorta. Aortic stenosis (AS) is usually age-related and is caused by progressive calcification of any of the three leaflets of the valve.<\/p>\n<p>Severe aortic stenosis also causes an acquired form of <a href=\"https:\/\/impact-r.com\/von-willebrand-disease\/\" target=\"_blank\" rel=\"noopener noreferrer\">von Willebrand disease <\/a>(vWD type 2A). This is due to breakdown of the von Willebrand factor (vWF) by the increased turbulence around the stenotic valve. The increased turbulence causing high shear stress conditions predisposes the vWF to cleavage by an enzyme, ADAMTS-13. This enzyme is the 13<sup>th<\/sup> member of the class of enzymes known as <em>a disintegrin and metalloproteinase with a thrombospondin type 1 motif<\/em> also known as von Willebrand factor-cleaving protease (vWFCP).<\/p>\n<p><a href=\"https:\/\/impact-r.com\/wp-content\/uploads\/2011\/12\/VWF-MULTIMERS.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-220\" src=\"https:\/\/impact-r.com\/wp-content\/uploads\/2011\/12\/VWF-MULTIMERS-300x224.jpg\" alt=\"\" width=\"300\" height=\"224\" srcset=\"https:\/\/impact-r.com\/wp-content\/uploads\/2011\/12\/VWF-MULTIMERS-300x224.jpg 300w, https:\/\/impact-r.com\/wp-content\/uploads\/2011\/12\/VWF-MULTIMERS.jpg 900w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a>This acquired form of vWD causes bleeding in the AS patient. Whether the bleeding is due to platelet adhesion or to platelet aggregation has not been determined. This is the subject of the study done by Panzer, et.al. using the <a href=\"https:\/\/impact-r.com\/impact-r-laboratory-platelet-function-cone-and-plate-analyser\/\" target=\"_blank\" rel=\"noopener noreferrer\">IMPACT-R<\/a> machine. The study concludes that reduced levels of large vWF multimers associated with severe AS leads to impairment of both adhesion and aggregation of platelets. An abstract of the study can be found <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20024494\" target=\"_blank\" rel=\"noopener noreferrer\">here<\/a>.<\/p>\n<div>\n<div>\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>The aortic valve is the valve between the left ventricle and the aorta, the main artery. It has three leaflets (tricuspid). When the left ventricle contracts, it pushes blood through the valves and into the aorta. When the left ventricle relaxes, the valves close, preventing the blood from flowing back into the left ventricle. When [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[138,104,137,83,82,136,103,46,105],"class_list":["post-218","post","type-post","status-publish","format-standard","hentry","category-disorders-use-of-impact-r-in-research","tag-and-iii","tag-aortic-stenosis","tag-ii","tag-platelet-adhesion","tag-platelet-aggregation","tag-von-willebrands-disease-type-i","tag-vwd-type-2a","tag-vwf","tag-vwf-multimers"],"_links":{"self":[{"href":"https:\/\/impact-r.com\/index.php?rest_route=\/wp\/v2\/posts\/218","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/impact-r.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/impact-r.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/impact-r.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/impact-r.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=218"}],"version-history":[{"count":6,"href":"https:\/\/impact-r.com\/index.php?rest_route=\/wp\/v2\/posts\/218\/revisions"}],"predecessor-version":[{"id":381,"href":"https:\/\/impact-r.com\/index.php?rest_route=\/wp\/v2\/posts\/218\/revisions\/381"}],"wp:attachment":[{"href":"https:\/\/impact-r.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=218"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/impact-r.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=218"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/impact-r.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=218"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}