The redox state of VWF TIL’-TIL3 disulfides are changed by mechanical shearing in vitro and in patients with heart failure subjected to ECMO. (A) Redox states of the 13 TIL’-TIL3 VWF disulfides from a single healthy donor plasma (32 year-old male) sheared at rates of 2000 or 10 000 s⁻¹ for 5 minutes. Shearing at 10 000 s⁻¹ results in reduction of all 13 VWF disulfides. (B) Redox states of the 13 TIL’-TIL3 VWF disulfides in 5 patients with heart failure and 5 patients with heart failure subjected to ECMO. The bars and errors are mean ± SD. Significant differences (P < .01) in the redox state of VWF disulfides are indicated by stars. Parametric unpaired t test was used to evaluate differences between groups.