Clinical Hemorheology and Microcirculation - Volume 14, issue 3

Authors: Isbister, James P.

Article Type: Review Article

Abstract: There is not only good evidence that hematocrit alterations are intimately related to cardiovascular control, but there is also a wide clinical spectrum of relative anemia and relative polycythemia which are predominantly manifestations of interactions between the cardiovascular system and blood volume. For patients whose hematocrit levels remain within the normal range, even though there may be significantly fluctuating, few questions are usually asked. However, if the changes in plasma volume result in a patient developing relative anemia or relative polycythemia greater attention is taken as the patient has entered the “abnormal” hematocrit range. It is thus important to consider …an individual's hematocrit in relation to cardiovascular and blood volume control. In most circumstances an alteration in hematocrit is an appropriate physiological adaptation. In other circumstances the changes may be maladaptive or if there are conflicted stresses on oxygen transport and/or other defects present (eg arterial, lung or cardiovascular disease) the changes in hematocrit to one stimulus may result in secondary undesirable effects which are not “part of the evolutionary plan”. Lastly, there may be circumstances when the organism is not able to respond appropriately to a stress due to disease (eg marrow failure, shock, cardiorespiratory disease etc) and in these circumstances the clinician should consider what response “nature” would like to achieve, but is unable. Show more

Keywords: Hematocrit, Blood Volume, Plasma Volume, Red Cell Mass, Spleen, Hemorheology

DOI: 10.3233/CH-1994-14301

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 305-319, 1994

Authors: Puniyani, R.R. | Agashe, V.S. | Kudrimoti, H.S. | Fernandez, A. | Rao, S. | Merchant, R. | Phadke, S.

Article Type: Research Article

Abstract: Hemorheological studies were conducted on cases of neonatal polycythemia and cases exhibiting the neonatal hyperviscosity syndrome. It was found that though hematocrit is the major contributing factor towards hyperviscosity, low plasma viscosity and decreased erythrocyte deformability also contribute to the final picture of whole blood viscosity observed in neonatal polycythemia. Hyperviscosity may be present in absence of polycythemia and may be responsible for the clinical hyperviscosity syndrome. This revealed the importance of estimation of whole blood viscosity in cases of newborns at risk, in whom just the estimation of hematocrit may not be enough to diagnose the condition of hyperviscosity. …Measurement of red cell filterability may also be important, as reduced filterability may contribute to the increase in the whole blood viscosity in polycythemia or even otherwise. From this study, it could be seen that neonates exhibiting the hyperviscosity syndrome may not necessarily have polycythemia or for that matter may not have blood hyperviscosity. This makes estimation of whole and red cell deformability to be important parameters to exclude the diagnosis of hyperviscosity in the neonate so that other clinicopathological explanations may be sought by the attending physician to explain the symptoms and signs. Show more

Keywords: Neonatal Polycythemia, Hematocrit, Whole Blood Hyperviscosity, Red Cell Deformability

DOI: 10.3233/CH-1994-14302

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 321-328, 1994

Authors: Toth, K. | Habon, T. | Horvath, I. | Mezey, B. | Juricskay, I. | Mozsik, Gy.

Article Type: Research Article

Abstract: In the regulation of coronary circulation both hemodynamical and hemorheological factors play an important role. Recent studies emphasize the role of hemorheological parameters as primary risk factors in cardiovascular diseases. The data of 377 patients (pts) with ischemic heart disease (IHD) (mean age (ma): 55 yrs) and 59 healthy controls (HC) (ma: 35 yrs) at rest and 32 pts with IHO (ma: 51 yrs) and 20 HC (ma: 23 yrs) during exercise stress test were analysed. Hemodynamical parameters (cardiac output and cardiac index *CI*) by impedance-cardiographic and radio-cardiographic methods and hemorheological parameters (whole blood *WBV* and plasma viscosity and fibrinogen …level) were determined, and a new index – the circulatory index (* CRI = CI/WBV *) – was introduced. The rheological parameters in IHD were in the pathological range and were significantly (p < 0.01) higher than in HC. The CRI both at rest and during exercise was significantly lower in IHD pts than in the controls (p < 0.01). Our data show that hemorheological factors are altered in IHD and CRI is significantly lower than in HC. These findings underline the pathophysiological role of these factors in cardiovascular diseases. Show more

Keywords: Blood rheology, cardiac index, exercise stress test, ischemic heart disease

DOI: 10.3233/CH-1994-14303

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 329-338, 1994

Authors: Oder, W. | Oder, B. | Kollegger, H. | Spatt, J. | Zeiler, K. | Aull, S. | Mraz, M. | Wessely, P.

Article Type: Research Article

Abstract: The aim of the present study was to investigate whether analgesic-induced chronic headache is associated with hemorheologic dysfunction. The viscoelastic properties of whole blood from 28 patients with chronic headache induced by regular use of analgesics were compared to the viscoelastic properties from 28 healthy control subjects matched with respect to age, sex, cigarette smoking, and intake of oral contraceptives. Fifteen of the investigated 28 patients originally suffered from migraine, 13 from tension-type headaches. Prior to analgesic drug-withdrawal, blood viscosity at shear rates 10/s and 50/s, blood elasticity at 50/s (each adjusted to a hematocrit of 45%), and the calculated …shear resistance of erythrocytes in patients, originally suffering from tension-type headaches, were significantly higher than the corresponding values in control subjects. In contrast, most viscoelastic properties in migraine patients with the exception of blood elasticity at 50/s did not differ significantly from controls. A standardized analgesic drug-withdrawal therapy was administered for 10 days during hospitalization. Patients were re-examined 30 days after analgesic withdrawal. There were no relevant differences of viscoelastic properties in migraine and tension-type headache patients in comparison to the viscoelastic properties prior to drug-withdrawal therapy. The results of the present study indicate that hemorheologic dysfunction does not play a major role in the pathogenesis of analgesic-induced chronic headache. Show more

Keywords: headache, blood viscosity, blood elasticity, analgesics, drug-withdrawal therapy

DOI: 10.3233/CH-1994-14304

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 339-346, 1994

Authors: Lipovac, V. | Gavella, M.

Article Type: Research Article

Abstract: Gangliosides at the levels of 5–20 μg/ml were found to inhibit significantly the loss of filterability of human erythrocytes treated in vitro with Ca2+ ionophore A 23187 (0,19 μmol/l), at 25°C, in a concentration-dependent manner. No further rheological effect at 20 μg/ml ganglioside concentration indicates that binding of gangliosides to erythrocytes is saturable and hence specific. On the other hand, the absence of the protective effect of gangliosides against erythrocyte impairment at 4°C suggests the involvement of enzymes in this process. The hypothesis that ganglioside-induced activation of the Ca2+ -extrusion pump regulated by calmodulin may be responsible for the …protective effect of gangliosides against the loss of erythrocyte filterability induced by in vitro calcium cell loading remain to be elucidated. Show more

Keywords: hemorheology, erythrocyte deformability, gangliosides, erythrocyte filtration, calcium

DOI: 10.3233/CH-1994-14305

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 347-353, 1994

Authors: Kiesewetter, H. | Birk, A. | Jung, F. | Radtke, H.

Article Type: Research Article

Abstract: The aim of this investigation was to examine the effect of felodipine on the blood pressure and on the rheological properties of patients who suffer from arterial hypertension without secondary organic changes (WHO stage I) and had not undergone antihypertensive treatment up to that time. 104 patients were included in this randomised, placebo-controlled double-blind study. Felodipine significantly decreased the confirmatory parameters, the systolic and diastolic blood pressures, by 10% from 154 to 140 mmHg and from 94 to 85 mmHg respectively (p<0.001). A significant difference between felodipine and placebo was found for the exploratory parameters except for the haematocrit. Felodipine …decreased the plasma viscosity by 7% (p<0.001), the erythrocyte aggregation by 12% (p<0.01), the spontaneous thrombocyte aggregation by 40% (p<0.001) and leukocyte adhesiveness by 24% (p<0.01). These parameters remained unchanged by placebo. One of the patients in the felodipine group complained of kidney pain and headache and discontinued the treatment. Another patient in the Felodipine group and two of the patients in the placebo group dropped out because of lack of compliance. Five patients in the felodipine group and 4 patients in the placebo group complained of adverse drug reactions such as headache, ankle edema, tiredness, kidney pain, gastrointestinal complaints and one had an attack of gout. Show more

Keywords: arterial Hypertension, WHO stage I, Felodipine, blood fluidity

DOI: 10.3233/CH-1994-14306

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 355-367, 1994

Authors: Yova, D. | Haritou, M. | Koutsouris, D.

Article Type: Research Article

Abstract: It is well known that there is a correlation between cardiovascular diseases and catecholamines release on the one hand and that catecholamines induce changes on the deformability of red blood cells (RBCs) on the other. In addition He-Ne laser low-power irradiation, seems to decrease RBC deformability and to increase their osmotic fragility in vitro. The present work aims to estimate the effects of low-power He-Ne laser irradiation on red blood cells deformability, with and without epinephrine, in order to give some more information about the biophysical mechanisms of interaction of He-Ne laser irradiation with RBCs, through the modification of epinephrine …and RBCs membrane interaction. In this study a low-power He-Ne laser (power output 8.0 mW, 632.8 nm wavelength) was used for the irradiation of red blood cells in the presence or absence of epinephrine. Deformability of individual cells passing through micropores was determined by measuring the change of electrical resistance produced by the erythrocytes travelling via a specific polycarbonate filter containing 30 non-overlapping pores (15 μm in length, 5 μm in diameter) without significant variations of pore size (less than 2%). The data obtained indicate that: 1) The RBCs deformability was increased by 6.2% and 13% in the presence of 10−4 M and 10−3 M epinephrine respectively, as reflected in a significant decrease (p=0.025) in the mean transit time <τ> of RBCs passing through the pores. 2) The RBCs deformability was decreased by 30%, due to low-power He-Ne irradiation, for 5 min. 3) RBCs in the presence of 10−4 M epinephrine after He-Ne irradiation for 5 min under continuous stirring presented a decrease of 21.7% in deformability and in the presence of 10−3 M epinephrine a decrease of 11.8% in deformability. The results indicate that epinephrine and laser irradiation act antagonistically in relation to RBCs deformability. Show more

Keywords: Red blood cells, Helium-Neon laser, Deformability, Catecholamines

DOI: 10.3233/CH-1994-14307

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 369-378, 1994

Authors: Crouch, S.P.M. | Saihan, E.M. | Fletcher, J.

Article Type: Research Article

Abstract: Polymorphonuclear leukocytes (PMN) appear to play a role in the pathogenesis of leg ulceration through tissue damage occurring as a result of these cells being trapped within the capillaries in anoxic tissue. The aim of this study was to determine whether ingestion of a 400mg slow release tablet of pentoxifylline (PTOX) would cause a reduction in the ex vivo responses of PMN isolated from patients with varicose leg ulcers. Superoxide anion production, as measured by lucigenin-enhanced chemiluminescence was significantly reduced at 2 and 4 hours post-ingestion in response to stimulation by formylmethionylleucylphenylalanine (FMLP) and C5a des arg in zymosan activated …serum (ZAS). The response to FMLP was reduced by 39% (p=0.014) at 2 hours and by 32% (p=0.029) at 4 hours. The response to ZAS was reduced by 52% at 2 hours (p=0.007) and 50% at 4 hours (p=0.0104). Upregulation of the adhesion molecule CD11b in response to FMLP and ZAS was also significantly reduced in the patient group at 2 (p=0.010 for both stimuli) and 4 hours after ingestion (FMLP, p=0.0212; ZAS, p=0.0150), although the unstimulated expression of this molecule remained constant. There were no significant differences in the PMN responses observed when data for the patients was compared with the control group. These results suggest that the previous in vitro and ex vivo observations with PTOX on PMN from normal subjects can be reproduced with cells from patients suffering with varicose leg ulcers. PTOX may reduce recruitment and activation of further cells into the inflammatory foci and thus help prevent exacerbations of inflammation. Show more

Keywords: pentoxifylline, polymorphonuclear leukocytes, varicose leg ulcers, superoxide anions, lactoferrin, adhesion molecules

DOI: 10.3233/CH-1994-14308

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 379-392, 1994

Authors: Caimi, G. | Lo Presti, R. | Montana, M. | Canino, B. | Ventimiglia, G. | Catania, A. | Sarno, A.

Article Type: Research Article

Abstract: In a group of subjects with vascular atherosclerotic disease (VAD) we examined the platelet membrane fluidity (obtained marking intact resting platelets with TMA-DPH), the platelet membrane cholesterol/phospholipid ratio (C/PL - using column chromatography), the platelet membrane individual phospholipids (employing the thin layer chromatography) and the platelet cytosolic Ca2+ content (evaluated marking intact resting platelets with Fura 2-AM). From the obtained data, it is evident that platelet membrane fluidity differentiates normals from VAD subjects. Platelet membrane lipid pattern (C/PL and individual phospholipids) and cytosolic Ca2+ content do not discriminate normals from VAD subjects. In normals the polarization degree of …TMA-DPH is significantly correlated to the phosphatidylserine and phosphatidylcholine, while in VAD subjects no relationship is present between the polarization degree of TMA-DPH and the platelet metabolic parameters. Show more

Keywords: Vascular Atherosclerotic Disease, Platelet Membrane Fluidity, Platelet Membrane Lipids, Platelet Cytosolic Ca2+

DOI: 10.3233/CH-1994-14309

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 393-399, 1994

Authors: Chabanel, Anne | Samama, Meyer M.

Article Type: Research Article

Abstract: Several methods are presently used to evaluate plasma viscosity and its variation. The falling ball viscometer, in spite of its cheap running cost, has been only used by a limited number of laboratories. We wish in this article to give our own appraisal of the technique. We studied the influence of the individual glass syringes and stainless steel balls, as well as the temperature dependence on plasma viscosity value. Freezing plasma samples did not appear to affect the value of plasma viscosity, as well as the mode and frequency of thawing, since the variations (0.01 mPa.s or less) were equivalent …to the reliance of the technique (0.01 mPa.s, 1%). A reference range for healthy controls was determined. We could not detect any significant difference between men and women for plasma viscosity values. In spite of the fibrinogen increase with aging or smoking, we could not observe any significant variation for plasma viscosity values in healthy controls. However, in a large range of fibrinogen values, a good correlation was found between plasma viscosity and fibrinogen concentration (r2 = 0.460; p = 0.0001). In 9 patients with IgG myeloma, a significant correlation between serum viscosity and IgG concentration was obtained (r2 = 0.797; P = 0.001). Concomittant measurements of plasma viscosity with a rotational viscometer (Contraves LS30) showed a strong correlation with our values (r2 = 0.980). We conclude that falling ball viscometry is a valid technique to measure plasma viscosity variations in clinical or research studies. Show more

Keywords: plasma viscosity, viscometer, fibrinogen, age, smoking, paraproteinemia

DOI: 10.3233/CH-1994-14310

Citation: Clinical Hemorheology and Microcirculation, vol. 14, no. 3, pp. 401-412, 1994