Clinical Hemorheology and Microcirculation - Volume 56, issue 2

Authors: Rabai, M. | Detterich, J.A. | Wenby, R.B. | Toth, K. | Meiselman, H.J.

Article Type: Research Article

Abstract: Consumption of red wine is associated with a decreased risk of several cardiovascular diseases (e.g., coronary artery disease, stroke), but unfortunately literature reports regarding ethanol's effects on hemorheological parameters are not concordant. In the present study, red blood cell (RBC) deformability was tested via laser ektacytometry (LORCA, 0.3–30 Pa) using two approaches: 1) addition of ethanol to whole blood at 0.25%–2% followed by incubation and testing in ethanol-free LORCA medium; 2) addition of ethanol to the LORCA medium at 0.25%–6% then testing untreated native RBC in these media. The effects of ethanol on deformability for oxidatively stressed RBC were investigated …as were changes of RBC aggregation (Myrenne Aggregometer) for cells in autologous plasma or 3% 70 kDa dextran. Significant dose-related increases of RBC deformability were observed at 0.25% (p < 0.05) and higher concentrations only if ethanol was in the LORCA medium; no changes occurred for cells previously incubated with ethanol then tested in ethanol-free medium. The impaired deformability of cells pre-exposed to oxidative stress was improved only if ethanol was in the LORCA medium. RBC aggregation decreased with concentration at 0.25% and higher for cells in both autologous plasma and dextran 70. Our results indicate that ethanol reversibly improves erythrocyte deformability and irreversibly decreases erythrocyte aggregation; the relevance of these results to the health benefits of moderate wine consumption require further investigation. Show more

Keywords: Alcohol, erythrocyte aggregation, erythrocyte deformability, oxidative stress

DOI: 10.3233/CH-2012-1632

Citation: Clinical Hemorheology and Microcirculation, vol. 56, no. 2, pp. 87-99, 2014

Authors: Wiewiora, Maciej | Slowinska-Lozynska, Ludmila | Glück, Marek | Piecuch, Jerzy | Sosada, Krystyn | Monkos, Karol

Article Type: Research Article

Abstract: This study presents the association between metabolic syndrome and hemorheological parameters among obese patients qualified for bariatric surgery. We studied 73 morbidly obese patients who were qualified for bariatric surgery. Blood and plasma viscosity measurements were performed using a cone-plate viscometer (Brookfield DV-II). RBC aggregation was measured using the Laser-assisted Optical Rotational Cell Analyser (LORCA). The following parameters for the aggregation process were estimated: aggregation index (AI), amplitude (AMP), aggregation half-time (t1/2 ), threshold shear rate (γthr ), the fast (Tfast ) and the slow (Tslow ) component. Metabolic syndrome was defined according to the Adult Treatment Panel III and …International Diabetes Federation criteria. The obese presented differences in all rheological properties compared to control, regardless of clinical diagnosis of metabolic syndrome, except that whole blood viscosity was higher only in the obese metabolic syndrome group. No differences among the obese with and without metabolic syndrome were observed except in hematocrit. Whole blood viscosity and corrected blood viscosity correlated positively with WHR and BMI. AI, γthr , Tslow correlated positively with BMI, WHR, total cholesterol level and low-density lipoproteins. Negative correlation presented t1/2 with BMI, WHR, fibrinogen, total cholesterol level and low-density lipoproteins. The study showed that morbid obesity is associated with hemorheological disturbances independently of clinical diagnosis of metabolic syndrome. Show more

Keywords: Obesity, blood rheology, metabolic syndrome

DOI: 10.3233/CH-2012-1642

Citation: Clinical Hemorheology and Microcirculation, vol. 56, no. 2, pp. 101-109, 2014

Authors: Romagnoli, Marco | Alis, Rafael | Martinez-Bello, Vladimir | Sanchis-Gomar, Fabian | Aranda, Rafael | Gómez-Cabrera, Mari-Carmen

Article Type: Research Article

Abstract: Nowadays cardiac and metabolic diseases are a matter of concern. Exercise is a valid treatment and method of prevention for not only adults, but also young subjects. Physical activity causes transient blood rheology impairment in adults. However little is known about the effects of exercise on blood flow characteristics in young subjects. The aim of the study was to assess the effects of a light aerobic exercise session on blood rheology in young subjects. Ten young subjects (aged 12–16 years) performed 1 hour of submaximal aerobic exercise (70% HRmax ). Blood samples were drawn just before and after exercise. We …determined blood and plasma viscosity, fibrinogen, erythrocyte deformability and aggregability. No changes in blood viscosity (p > 0.05), erythrocyte aggregation (p > 0.05) and fibrinogen (p > 0.05) were observed. Hematocrit (p = 0.025) and plasma viscosity (p = 0.018) rose with exercise, while erythrocyte elongation index lowered (p < 0.001). Plasma volume slightly reduced which may explain the lack of changes in blood viscosity. The results of the present study indicate a similar hemorheological response to submaximal exercise in both young people and adults. Show more

Keywords: Hemorheology, youth, submaximal exercise

DOI: 10.3233/CH-121657

Citation: Clinical Hemorheology and Microcirculation, vol. 56, no. 2, pp. 111-117, 2014

Authors: Wester, Torjus | Awan, Zaheer Ahmed | Kvernebo, Tobias Skylstad | Salerud, Göran | Kvernebo, Knut

Article Type: Research Article

Abstract: Objectives: To explore the potentials of microcirculatory assessments for predicting outcome of patients treated with extra corporeal membrane oxygenation for cardiogenic shock. Methods: Eight patients with acute cardiogenic shock treated with ECMO and eight healthy controls were examined with skin vital microscopy and laser Doppler perfusion measurements. Results: Three patients died on ECMO (group 1). Five patients were successfully weaned off ECMO (group 2). Four patients were discharged from hospital and one died after successful weaning from bleeding complications. Patients surviving ECMO (group 2) had microcirculatory findings comparable with healthy controls. Patients in group 1 showed major skin microvascular pathology: …pericapillary bleedings (n = 1), pericapillary dark haloes (n = 2) and capillary micro thrombi (n = 1). As compared with survivors they had lower functional capillary density (FCD) (n = 3), higher heterogeneity of functional capillary density (n = 3) and significantly reduced capillary mean flow-categorical velocity (n = 2). Laser Doppler measurements in group 1 had non-significant lower laser Doppler flux values as compared with survivors and controls. Conclusion: Skin microvascular pathology as detected with video microscopy (pericapillary bleedings or haloes, micro-thrombi/capillaries with “no flow”, low FCD with high spatial distribution heterogeneity or low mean flow-categorial velocity) seems to be associated with poor prognosis. Show more

Keywords: Capillary flow heterogeneity, capillary pathology, cardiogenic shock, extra-corporeal life support, extra-corporeal membrane oxygenation, microvascular hemodynamics, microvascular monitoring, vital microscopy

DOI: 10.3233/CH-131670

Citation: Clinical Hemorheology and Microcirculation, vol. 56, no. 2, pp. 119-131, 2014

Authors: Sallisalmi, Marko | Tenhunen, Jyrki | Kultti, Anne | Tammi, Markku | Pettilä, Ville

Article Type: Research Article

Abstract: BACKGROUND: Total plasma hyaluronan concentration is increased in septic shock. High-molecular-weight hyaluronan has a high intrinsic viscosity. Excessive release of high-molecular-weight hyaluronan in sepsis may induce hyperviscosity. METHODS: Plasma viscosity and the molecular size of plasma hyaluronan were determined in 20 patients with septic shock and in 20 healthy controls. Ex vivo, the effects of 0.4% and 0.047% high-molecular-weight hyaluronan 1560 kDa, 0.9% saline, and 6% hydroxy-ethyl-starch 130 kDa were compared to plasma and whole blood viscosity and red blood cell aggregation at a systemic hematocrit of 0.4, and at a microcirculatory hematocrit of 0.2. RESULTS: Plasma viscosity and total …plasma protein content were low in septic shock patients on days one and four of treatment. Hyaluronan concentration was 10-fold higher in sepsis on day 1. Molecular weight of hyaluronan was relatively low, mostly 50–500 kDa, and did not change significantly in sepsis. Ex vivo, 0.4% high-molecular-weight hyaluronan 1560 kDa increased blood viscosity but did not promote red blood cell aggregation. Dilutions of 6% hydroxyl-ethyl-starch 130 kDa and 0.047% high-molecular-weight hyaluronan 1560 kDa had comparable effects on blood viscosity and red blood cell aggregation. CONCLUSIONS: Plasma viscosity of the septic patients remained low for four days despite markedly elevated concentration of relatively small-molecular-weight hyaluronan. Show more

Keywords: High-molecular-weight hyaluronan, viscosity, aggregation, rheology, intensive care

DOI: 10.3233/CH-131677

Citation: Clinical Hemorheology and Microcirculation, vol. 56, no. 2, pp. 133-144, 2014

Authors: Brandt, Moritz | Schönfelder, Tanja | Schwenk, Melanie | Becker, Christian | Jäckel, Sven | Reinhardt, Christoph | Stark, Konstantin | Massberg, Steffen | Münzel, Thomas | von Brühl, Marie-Luise | Wenzel, Philip

Article Type: Research Article

Abstract: BACKGROUND: Interaction between vascular wall abnormalities, inflammatory leukocytes, platelets, coagulation factors and hemorheology in the pathogenesis of deep vein thrombosis (DVT) is incompletely understood, requiring well defined animal models of human disease. METHODS AND RESULTS: We subjected male C57BL/6 mice to ligation of the inferior vena cava (IVC) as a flow reduction model to induce DVT. Thrombus size and weight were analyzed macroscopically and sonographically by B-mode, pulse wave (pw) Doppler and power Doppler imaging (PDI) using high frequency ultrasound. Thrombus size varied substantially between individual procedures and mice, irrespective of the flow reduction achieved by the ligature. Interestingly, PDI …accurately predicted thrombus size in a very robust fashion (r2 = 0.9734, p < 0.0001). Distance of the insertion of side branches from the ligature significantly determines thrombus weight (r2 = 0.5597, p < 0.0001) and length (r2 = 0.5441, p < 0.0001) in the IVC, regardless of the flow measured by pw-Doppler with distances <1.5 mm drastically impairing thrombus formation. Occlusion of side branches prior to ligation of IVC did not increase thrombus size, probably due to patent side branches inaccessible to surgery. CONCLUSION: Venous side branches influence thrombus size in experimental DVT and might therefore prevent thrombus formation. This renders vessel anatomy and hemorheology important determinants in mouse models of DVT, which should be controlled for. Show more

Keywords: Deep vein thrombosis, mouse model, high frequency ultrasound, side branches

DOI: 10.3233/CH-131680

Citation: Clinical Hemorheology and Microcirculation, vol. 56, no. 2, pp. 145-152, 2014

Authors: Vayá, Amparo | Sánchez, Fernando | Todolí, Jose | Calvo, Javier | Alis, Rafael | Collado, Susana | Ricart, Jose M.

Article Type: Research Article

Abstract: The association between hyperhomocysteinemia (HHcy) and Raynaud's phenomenon (RP) remains a matter of debate. In 18 primary RP, 23 secondary RP and 41 controls, we investigated homocysteine (Hcy) levels along with biochemical and inflammatory parameters. The Hcy levels in both primary and secondary RP were elevated when compared with controls (p < 0.05 and p < 0.01, respectively). As age was higher in secondary RP as compared with controls (p < 0.01), both primary and secondary RP were age-matched with a corresponding control group, and with Hcy maintaining its statistical significance (p < 0.05). No differences in creatinine, B12 vitamin …or folic acid were observed between groups (p > 0.05), or in the prevalence of cardiovascular risk factors (p > 0.05). When patients were classified according to presence or absence of digital ulcers, as a sign of microangiopathy severity, the former showed higher Hcy levels than the latter (p = 0.035). Our results indicate that both primary and secondary RP patients show a mild increase in Hcy levels, which is not related to age, vitamin deficiencies or impaired renal function, but is related to microangiopathy severity. Therefore the association of HHcy and RP suggest that Hcy may contribute to endothelial dysregulation, which characterizes this disease. Specific studies should be designed to elucidate the pathogenesis of HHcy in these patients. Show more

Keywords: Raynaud's phenomenon, homocysteine, microangiopathy

DOI: 10.3233/CH-131681

Citation: Clinical Hemorheology and Microcirculation, vol. 56, no. 2, pp. 153-159, 2014

Authors: Reinhart, S.A. | Schulzki, T. | Bonetti, P.O. | Reinhart, W.H.

Article Type: Research Article

Abstract: Erythrocytes kept outside the blood circulation undergo progressive changes in metabolism, shape and function, which was the topic of this study. For that purpose, blood anticoagulated with either heparin, citrate or EDTA was incubated at temperatures of 5°C, 22°C or 37°C for 0 h, 24 h and 48 h, respectively. A temperature- and time-dependent decrease of glucose and ATP and increase of lactate and LDH were observed. An erythrocyte swelling and echinocytic shape transformation, which was also time- and temperature-dependent, was seen. Density-separated young and old erythrocytes behaved similarly. The degree of echinocytic shape transformation correlated with the increase in …blood viscosity at high shear rate. Echinocytosis was partially reversible when erythrocytes were suspended in buffer containing 0.2% albumin. This phenomenon is specific for albumin, since molecules with a similar molecular weight (dextran 70, heat shock protein, protein C) had no effect. These finding may have an impact on blood banking and transfusion medicine. Show more

Keywords: Anticoagulant, ATP, erythrocyte, morphology, viscosity

DOI: 10.3233/CH-131682

Citation: Clinical Hemorheology and Microcirculation, vol. 56, no. 2, pp. 161-173, 2014

Authors: Oliveira, Rita | Napoleão, Patricia | Banha, João | Paixão, Eleonora | Bettencourt, Andreia | da Silva, Berta Martins | Pereira, Dina | Barcelos, Filipe | Teixeira, Ana | Patto, José Vaz | Viegas-Crespo, Ana Maria | Costa, Luciana

Article Type: Research Article

Abstract: Behçet's disease (BD) is a rare chronic vasculitis of unclear etiology. It has been suggested that inflammatory response has an important role in BD pathophysiology. Herein, we aimed to study the interplay between inflammation, iron metabolism and endothelial function in BD and search for its putative association with disease activity. Twenty five patients clinically diagnosed with BD were selected and twenty four healthy age-sex matched individuals participated as controls. Results showed an increase of total number of circulating white blood cells and neutrophils, serum transferrin, total iron binding capacity, mieloperoxidase (MPO), ceruloplasmin (Cp), C reactive protein, β2 microglobulin and Cp …surface expression in peripheral blood monocytes in BD patients comparatively to healthy individuals (p < 0,05). Of notice, the alterations observed were associated to disease activity status. No significant differences between the two groups were found in serum nitric oxide concentration. The results obtained suggest an important contribution from innate immunity in the pathogenesis of this disease. In particular, surface expression of leukocyte-derived Cp may constitute a new and relevant biomarker to understand BD etiology. Show more

Keywords: Behçet's disease, inflammation, iron metabolism, endothelial function, disease activity

DOI: 10.3233/CH-131725

Citation: Clinical Hemorheology and Microcirculation, vol. 56, no. 2, pp. 175-185, 2014