1. von Willebrand Factor and Management of Heart Valve Disease
- Author
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Caterina Casari, Annabelle Dupont, Antoine Rauch, Mickael Rosa, Emmanuelle Jeanpierre, Sophie Susen, Basile Verdier, Peter J. Lenting, Camille Paris, Hughes Spillemaeker, Cedric Delhaye, Nicolas Debry, Flavien Vincent, Valentin Loobuyck, André Vincentelli, and Eric Van Belle
- Subjects
medicine.medical_specialty ,biology ,Clinical events ,business.industry ,Point-of-care testing ,Disease ,030204 cardiovascular system & hematology ,3. Good health ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Von Willebrand factor ,hemic and lymphatic diseases ,medicine ,biology.protein ,Biomarker (medicine) ,In patient ,030212 general & internal medicine ,Heart valve ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business - Abstract
For decades, numerous observations have shown an intimate relationship between von Willebrand factor (VWF) multimer profile and heart valve diseases (HVD). The current knowledge of the unique biophysical properties of VWF helps us to understand the longstanding observations concerning the bleeding complications in patients with severe HVD. Not only does the analysis of the VWF multimer profile provide an excellent evaluation of HVD severity, it is also a strong predictor of clinical events. Also of importance, VWF responds within minutes to any significant change in hemodynamic valve status, making it an accurate marker of the quality of surgical and transcatheter therapeutic interventions. The authors provide in this review a practical, comprehensive, and evidence-based framework of the concept of VWF as a biomarker in HVD, advocating for its implementation into the clinical decision-making process besides usual clinical and imaging evaluation. They also delineate critical knowledge gaps and research priorities to definitely validate this concept.
- Published
- 2019
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