MECHANISMS OF DVT VEIN WALL REMODELING

这个子项目是众多研究子项目之一

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. DVT (Deep Vein Thrombosis) affects close to one million people annually. DVT's are sometimes difficult to diagnosis and can be associated with many long-term complications such as post-phlebetic syndrome. Accurate diagnosis and methods to better predict a patient's risk of developing post-phlebetic syndrome may help reduce the morbidities often associated with this disease. The target population for this study will be patients over 18 years of age, presenting with a first time diagnosis of acute DVT (Deep Vein Thrombosis) in one leg only. Potential study subjects will be identified in the Vascular Diagnostic Unit after a duplex ultrasound has confirmed an acute DVT. Approximately 150 patients will be recruited for the study. This study will be a combination of two projects. 1. Vein Wall remodeling after DVT- PI: Dr. Peter Henke. 2. Microparticles:Novel Markers to predict Deep Venous Thrombosis-PI: Dr. Thomas Wakefield. This study currently is IRB approved (HUM 2460). Recruitment for HUM 2460 has not yet begun. One arm of HUM 2460 has the same inclusion criteria as needed for Dr. Peter Henke's study. (The other arm: clinically symptomatic but negative by duplex ultrasound will be addressed in an IRB revision of HUM 2460.) It is the intent of the investigators that since both studies involve similar patient population and procedures (blood analysis) that study procedures and consent forms for both projects be combined. Two different aspects of DVT will be examined in this study. One portion of the study will examine 1. The way the vein wall responds to a DVT 2. The correlation between vein wall changes and particular blood markers. This information will be used to evaluate if there is a correlation between particular blood markers and damage to the vein wall, and whether these changes may be used to predict a patient's risk of developing post-phlebitic syndrome. (this portion will be referred to as Vein Wall Remodeling -DVT in remainder of application) The second portion of the study will examine blood samples for biomarkers( including procoagulant microparticles, soluble P-selectin and other markers) to determine if a panel of markers could be utilized in the diagnosis of DVT and subsequent clinical decision making. Currently there are no blood tests that can be used to diagnose DVT in isolation, especially when ultrasound is not available. This portion of the study is addressed in the protocol of study HUM2460 and will be referred to as microparticle study-DVT in remainder of application. In order to accomplish this study subjects will undergo blood draws, duplex ultrasound of the legs and patient questionaires. Study coordinators will maintain responsibility for obtaining informed consent, tracking patients, and assuring all study related procedures are performed in accordance with both protocols.'