{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:35:43Z","timestamp":1787841343737,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2018,7,1]],"date-time":"2018-07-01T00:00:00Z","timestamp":1530403200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2017,8,3]],"date-time":"2017-08-03T00:00:00Z","timestamp":1501718400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The precise mechanisms of the increased incidence of hemostatic abnormalities in congenital heart disease (CHD) have not been determined. The aim of the study was to evaluate some indicators of activation of platelets and vascular endothelial cells in patients with CHD, evaluation of bleeding liability of these patients, and correlation with the clinical presentation of these patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This work was carried out on 20 patients with cyanotic congenital heart diseases (CCHD), 20 patients with acyanotic congenital heart diseases (ACHD), and 20 healthy children who served as the control group, aged between 1 and 10 years. All were subjected to full clinical examination, complete blood count, oxygen saturation, echocardiography, bleeding and coagulation times, PT, PTT, FDPs, plasma soluble P-selectin, E-selectin, and platelet factor 4 (PF4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There was significant prolongation of PT and PTT, and there was a significant lowering of platelet counts. These results were obtained in CCHD and ACHD, but were more significant in CCHD patients. There was a significant elevation in PF4 (55.0 \u00b1 25.5 ng\/mL), P-selectin (128.9 \u00b1 42.44 ng\/dL), and E-selectin (9461.5 \u00b1 1701.24 pg\/mL) levels in children with CCHD as compared to those with ACHD (PF4, 21 \u00b1 7.94 ng\/mL; P-selectin, 80.1 \u00b1 13.2 ng\/mL; E-selectin, 7969.6 \u00b1 2127.5 pg\/mL), and significant increase in both groups when compared to the control group (PF4, 8.1 \u00b14.7 ng\/mL; P-selectin, 27.83 \u00b1 9.73 ng\/mL; E-selectin, 6750.00 \u00b1 3204.00 pg\/ mL). There was a significant negative correlation between oxygen saturation, plasma P-selectin (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = -0.865), E-selectin (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = -0.401), and PF4 (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      = -0.792) in patients with CCHD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patients with CHD-both cyanotic and acyanotic-have variable degrees of increased liability for both thrombosis and hemorrhage that represents some sort of adaptation to preserve hemostasis and to protect these patients against the clinical presentation of both thrombosis and bleeding. This is to say that CHD patients have their own point of balance between thrombogenicity and bleeding liability. Wide-scale studies are needed to detect the normal levels of different thrombohemorrhagic parameters of these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.hemonc.2017.07.001","type":"journal-article","created":{"date-parts":[[2017,8,26]],"date-time":"2017-08-26T12:31:48Z","timestamp":1503750708000},"page":"123-128","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Thrombo-hemorrhagic liability in children with congenital heart diseases"],"prefix":"10.4103","volume":"11","author":[{"given":"Shebl Said","family":"Shebl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid Ahmed Naguib","family":"El-shehaby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin Shebl","family":"Said","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira Hamed","family":"Darwish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabeh Helal","family":"Elfadaly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Amer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1016\/j.hemonc.2017.07.001_b0005","doi-asserted-by":"crossref","first-page":"F33","DOI":"10.1136\/adc.2007.119032","article-title":"Twenty-year trends in diagnosis of life-threatening neonatal cardiovascular malformations","volume":"93","author":"Wren","year":"2008","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"10.1016\/j.hemonc.2017.07.001_b0010","doi-asserted-by":"crossref","first-page":"2622","DOI":"10.1161\/01.cir.0000436140.77832.7a","volume":"128","author":"Giglia","year":"2013","journal-title":"Circulation"},{"key":"10.1016\/j.hemonc.2017.07.001_b0015","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1111\/j.1538-7836.2011.04584.x","article-title":"Perinatal and Paediatric Haemostasis Subcommittee of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Developmental hemostasis: recommendations for laboratories reporting pediatric samples","volume":"10","author":"Ignjatovic","year":"2012","journal-title":"J Thromb Haemost"},{"key":"10.1016\/j.hemonc.2017.07.001_b0020","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1055\/s-0037-1613757","article-title":"Hemostatic parameters and platelet activation marker expression in cyanotic and acyanotic pediatric patients undergoing cardiac surgery in the presence of tranexamic acid","volume":"83","author":"Levin","year":"2000","journal-title":"Thromb Haemost"},{"key":"10.1016\/j.hemonc.2017.07.001_b0025","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1161\/CIRCRESAHA.110.233056","article-title":"Microparticles in hemostasis and thrombosis","volume":"108","author":"Owens","year":"2011","journal-title":"Circ Res"},{"key":"10.1016\/j.hemonc.2017.07.001_b0030","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1038\/nm899","article-title":"Interaction of P-selectin and PSGL-1 generates microparticles that correct hemostasis in a mouse model of hemophilia A","volume":"9","author":"Hrachovinov\u00e1","year":"2003","journal-title":"Nat Med"},{"key":"10.1016\/j.hemonc.2017.07.001_b0035","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.thromres.2003.12.011","article-title":"Soluble P-selectin and thrombomodulin-protein C-Protein S pathway in cyanotic congenital heart disease with secondary erythrocytosis","volume":"112","author":"Horigome","year":"2003","journal-title":"Thromb Res"},{"key":"10.1016\/j.hemonc.2017.07.001_b0040","series-title":"Essentials of glycobiology","article-title":"Selectins","author":"Cummings","year":"2008"},{"key":"10.1016\/j.hemonc.2017.07.001_b0045","series-title":"Immunobiology: the immune system in health and disease","author":"Janeway","year":"2005"},{"key":"10.1016\/j.hemonc.2017.07.001_b0050","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/S0735-1097(02)02973-X","article-title":"A simple method for non-invasive estimation of pulmonary vascular resistance","volume":"41","author":"Abbas","year":"2003","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hemonc.2017.07.001_b0055","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/S0735-1097(02)01718-7","article-title":"Overproduction of platelet microparticles in cyanotic congenital heart disease with polycythemia","volume":"39","author":"Horigome","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.hemonc.2017.07.001_b0060","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1253\/circj.71.948","article-title":"Increased thrombogenecity in patients with cyanotic congenital heart disease","volume":"71","author":"Kajimoto","year":"2007","journal-title":"Circ J"},{"key":"10.1016\/j.hemonc.2017.07.001_b0065","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1053\/jcan.2002.128436","article-title":"Coagulation abnormalities in patients with cyanotic congenital heart disease","volume":"16","author":"Tempe","year":"2002","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"10.1016\/j.hemonc.2017.07.001_b0070","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1177\/1076029612456733","article-title":"Platelet-derived microparticles and platelet function profile in children with congenital heart","volume":"19","author":"Ismail","year":"2013","journal-title":"Clin Appl Thromb Hemost"},{"key":"10.1016\/j.hemonc.2017.07.001_b0075","doi-asserted-by":"crossref","first-page":"2214","DOI":"10.1161\/01.STR.28.11.2214","article-title":"Soluble adhesion molecules reflect endothelial cell activation in ischaemic stroke and in carotid atherosclerosis","volume":"28","author":"Frijns","year":"1997","journal-title":"Stroke"},{"key":"10.1016\/j.hemonc.2017.07.001_b0080","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1007\/s00246-010-9674-0","article-title":"Comparison of endothelial biomarkers according to reversibility of pulmonary hypertension secondary to congenital heart disease","volume":"31","author":"Smadja","year":"2010","journal-title":"Pediatr Cardiol"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387617300894?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387617300894?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/02275670-201811030-00001","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:49:52Z","timestamp":1787838592000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/02275670-201811030-00001"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1016\/j.hemonc.2017.07.001","relation":{},"ISSN":["1658-3876"],"issn-type":[{"value":"1658-3876","type":"print"}],"subject":[],"published":{"date-parts":[[2018,7]]}}}