Clinical Hemorheology and Microcirculation - Volume 62, issue 1

Authors: Hu, Feng | Wang, Yali | Gong, Kaizheng | Ge, Gaoyuan | Cao, Mingqiang | Zhao, Pei | Sun, Xiaoning | Zhang, Zhengang

Article Type: Research Article

Abstract: Drag-reducing polymers (DRPs) are blood-soluble macromolecules that can increase blood flow and reduce vascular resistance. The purpose of the present study was to observe the effect of DRPs on ischemic reperfusion (I/R) injury of isolated rat hearts. Experiments were performed on isolated rat hearts subjected to 30 min of ischemia followed by 90 min of reperfusion in Langendorff preparations. Adult Wistar rats were divided into the following five groups: control group, I/R group, group III (I/R and 2×10−7  g/ml PEO reperfusion), group IV (I/R and 1×10−6  g/ml PEO reperfusion), and group V (I/R and 5×10−6  g/ml PEO reperfusion). Left ventricular end-diastolic pressure …(LVEDP), left ventricular systolic pressure (LVSP), maximum rate of ventricular pressure increase and decrease ( ± dp/dtmax ), heart rate (HR) and coronary flow were measured. Lactate dehydrogenase (LDH) and creatine kinase (CK) activity and coronary flow, myocardial infarction size and cardiomyocytes apoptosis were also assayed. Our results showed that PEO decreased LVEDP and increased LVSP, ± dP/dtmax in group IV and group V compared with the I/R group (all P  <  0.05). The coronary flow significantly increased and the activities of LDH and CK in the coronary flow significantly decreased in group IV and group V compared with those in the I/R group (all P  <  0.05). Cell apoptosis and myocardial infarction size were reduced in group IV and group V compared with the I/R group (all P  <  0.05). Collectively, these results suggested that DRPs had a protective effect on cardiac I/R injury of isolated rat hearts and it may offer a new potential approach for the treatment of acute ischemic heart diseases. Show more

Keywords: Drag-reducing polymers, ischemic reperfusion injury, polyethylene oxide

DOI: 10.3233/CH-151925

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 1-11, 2016

Authors: Kim, Hee Jung | Yoo, Sung Mook | Chung, Jae Ho | Kim, Tae Sik | Lee, Sung Ho | Son, Ho Sung

Article Type: Research Article

Abstract: PURPOSE: A newly developed fluid warmer (ThermoSens® ) has a direct blood warming plate, which can result in hemolysis or red blood cell injury during heating. Therefore, to evaluate the safety of heating blood products with a fluid warmer, we conducted laboratory tests to study hemolysis and erythrocyte rheology. METHODS: We used outdated human blood taken from a Korean blood bank. Packed red blood cells mixed with 100 mL isotonic saline was passed through the fluid warmer. Blood flow was achieved by either gravity or 300 mmHg pressure. Blood samples were analyzed before and after heating for hemolysis marker …and erythrocyte rheology parameters. RESULTS: The temperatures at the outlet were higher than 38°C at gravity and 300 mmHg pressure, respectively. There were no significant differences in hemolysis markers (hemoglobin, hematocrit, lactate dehydrogenase, and plasma free hemoglobin) or erythrocyte rheology (deformability, disaggregating shear stress, and aggregation index) between before and after heating (p  >  0.05) except LDH at gravity (p  = 0.0001). CONCLUSION: The ThermoSens® fluid warmer caused no erythrocyte injury or negative effects on rheology during heating. Regarding medical device development, hemorheologic analysis can be useful for safety evaluation of medical devices that directly contact blood for temperature modulation. Show more

Keywords: Fluid warmer, heating, transfusion, hemolysis, hemorheology, hypothermia

DOI: 10.3233/CH-151926

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 13-17, 2016

Authors: Perry, Maria | Simon, Jena | Gareau, Daniel | Glassberg, Jeffrey

Article Type: Research Article

Abstract: BACKGROUND: Pain is the most common complication of Sickle Cell Disease (SCD). Tissue oximetry properties in SCD during steady state and acute pain are not well described. METHODS: This was a cross sectional study of tissue oximetry properties in individuals with SCD during steady state, acute pain and healthy controls without SCD. A novel tissue oximetry device was used to better account for tissue pigmentation interference. We hypothesized that during acute SCD pain, blood volume to painful areas would be at least 10% less than steady state. Bayesian analyses of the data (with flat piors) were planned a …priori because of the small projected sample size. RESULTS: The sample included 14 individuals (4 during crisis, 5 steady state, and 5 controls). In individuals with SCD, blood volume to the lower back was higher during crisis (0.18% of tissue volume vs. 0.14% ). Bayesian analyses yielded a 3% probability that our hypothesis (that blood volume would decrease by 10% ) was correct. CONCLUSIONS: During acute SCD pain, blood volume to painful areas is not decreased. Bayesian analyses were useful for interpretation of small sample data and may have utility in early phase trials for rare diseases. Show more

Keywords: Sickle cell disease, pain crisis, tissue oximetry

DOI: 10.3233/CH-141927

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 19-26, 2016

Authors: Hopps, Eugenia | Canino, Baldassare | Montana, Maria | Calandrino, Vincenzo | Urso, Caterina | Lo Presti, Rosalia | Caimi, Gregorio

Article Type: Research Article

Abstract: Obstructive sleep apnea syndrome (OSAS) is associated with an elevated risk of cardiovascular events and stroke. Matrix metalloproteinases (MMPs) are endopeptidases involved in extracellular matrix degradation and then in the development and progression of cardiovascular diseases. Our aim was to evaluate plasma levels of gelatinases (MMP-2 and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2) in a group of subjects with OSAS. We enrolled 48 subjects (36 men and 12 women; mean age 49.7 ± 14.68 yrs) with OSAS diagnosed with a 1-night cardiorespiratory study and then we subdivided these subjects into two subgroups according to the apnea/hypopnea index (AHI): …Low (L = 21 subjects with AHI <30) and High (H = 27 subjects with AHI >30). We measured plasma concentration of the gelatinases and their inhibitors using ELISA kits. We observed a significant increase in plasma concentration of MMP-9, MMP-2, TIMP-1 and TIMP-2 in the entire group of OSAS subjects and in the two subgroups, with higher levels in the H in comparison with the L subgroup. In the whole group of OSAS subjects we also noted a significant decrease in MMP-9/TIMP-1 ratio in comparison with normal controls. Only MMP-9 was significantly correlated with the severity of the disease, expressed as AHI, with the oxygen desaturation index and also with the mean oxygen saturation. MMPs pattern is altered in OSAS and significantly influenced by the severity of the disease; it probably contributes to the vascular remodeling that leads to the atherosclerotic disease and cardiovascular complications. Show more

Keywords: MMP-2, MMP-9, TIMP-1, TIMP-2, obstructive sleep apnea

DOI: 10.3233/CH-151928

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 27-34, 2016

Authors: Partovi, Sasan | Kaspar, Mathias | Aschwanden, Markus | Robbin, Mark R. | Bilecen, Deniz | Walker, Ulrich A. | Staub, Daniel

Article Type: Research Article

Abstract: PURPOSE: The purpose was to evaluate skeletal muscle microcirculation by means of quantitative dynamic contrast-enhanced ultrasound (DCEUS) in patients with systemic sclerosis (SSc). METHODS: DCEUS imaging of the gastrocnemius muscle was performed with phospholipid-stabilized microbubbles filled with sulfur hexafluoride in 12 patients with SSc and 12 healthy volunteers. The fitted time intensity curves (TIC) during the first 3 minutes after administration of the contrast agent bolus were analysed. Time course parameters of the TIC were compared between patients and healthy volunteers. RESULTS: Peak enhancement, wash-in area under the curve and was-out area under the curve was …decreased in the patient group versus healthy volunteers (168 versus 248 AU p  = 0.291; 2193 versus 3314 p  = 0.198; 4948 AU x sec versus 8948 AU x sec p  = 0.037). In the SSc patients the mean transit time and wash-in perfusion index were numerically, but not statistically lower than in the healthy volunteers, but rise and fall time were similar. CONCLUSION: On the microvascular level in SSc patients versus their healthy counterpart key parameters related to blood volume were decreased and perfusion parameters showed a slight diminishment in the patient population. These results suggest a component of impaired skeletal muscle microcirculation in SSc patients. Show more

Keywords: Systemic sclerosis, contrast-enhanced ultrasound, skeletal muscle, microcirculation

DOI: 10.3233/CH-151929

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 35-44, 2016

Authors: von Tempelhoff, Georg-Friedrich | Schelkunov, Olga | Demirhan, Attila | Tsikouras, Panagiotis | Rath, Werner | Velten, Eva | Csorba, Roland

Article Type: Research Article

Abstract: OBJECTIVE: Structure and mechanical properties of red blood cells are markedly influenced by pathophysiology of many diseases which in turn potentially impair microcirculatory blood flow. The physiological association between blood rheological parameters and red blood cell indices was investigated in otherwise healthy unselected mid-age women prior to elective gynaecological surgery. METHODS: Red Blood Cell-deformability (RBC 1.2, 3.0; 6.0, 12.0; 30.0, 60.0) during exposure to low (RBC 1.2, 3.0), moderate (RBC 16.0, 12.0) and high shear forces (RBC 30.0, 60.0; Rheodyn; Myrenne), -aggregation (MA1; Myrenne) during low shear (E1; 4−1 S) and in stasis …(E0) and plasma viscosity (Pv; KSV 1; Fresenius) were correlated with red blood cell indices (RBC-I: MCV, MCH and MCHC) and subjects’ characteristics in 286 healthy women the day before undergoing gynaecologic standard surgery. Women with known pregnancy, malign-, infective-, chronic-disease or extreme BMI (<16; >40 Kg/m2 ) were excluded from this trial. RESULTS: From June 2014 to December 2014 a total of 286 healthy women (age: 46.5±17.6 y; BMI: 25.5±5.2 kg/m2 ) were eligible for inclusion into this prospective evaluation. Pv (mean±SD: 1.17±0.12 mPa s) and RBC aggregation (E0:12.6±6.3; E1:17.9±7.3) were not significantly correlated with RBC-I but with age and BMI. In contrast, RBC-deformability correlated significantly with MCV and MCH but significantly inversely correlated with MCHC. Deformability significantly increased with age but was unaffected by BMI of women. The correlation between RBC-I and RBC deformability was most remarkable during moderate shear force exposure. Neither haemoglobin nor haematocrit were correlated with RBC deformability or RBC-I. CONCLUSIONS: Cell volume and haemoglobin content had a strong impact on deformability in apparently healthy mid age women, whereas low MCHC and large MCV were associated with an increase in deformability while high MCHC and small MCV correlated with increased rigidity of RBC. BMI had no impact on deformability while age was associated with an increase in all determinants of blood viscosity. RBC aggregability was not affected by MCV, MCHC or MCH in mid-age women. Show more

Keywords: Plasma viscosity, red blood cell aggregation, red blood cell deformability MCH, MCV, MCHC

DOI: 10.3233/CH-151944

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 45-54, 2016

Authors: Tripolino, Cesare | Irace, Concetta | Carallo, Claudio | De Franceschi, Maria Serena | Scavelli, Faustina | Della Valle, Elisabetta | Gnasso, Agostino

Article Type: Research Article

Abstract: OBJECTIVE: Elastic properties of the vessel wall are associated with atherosclerosis and major cardiovascular events. Several physiological and pathological conditions can affect arterial elasticity, but few studies have considered the role of hemorheological parameters. The present study aimed to investigate the relationship between hemorheological parameters and vascular stiffness in the carotid artery district. METHODS: One hundred and two individuals were enrolled. Blood and plasma viscosity were measured by a cone-plate viscometer (Wells-Brookfield DV-III, Stoughton, U.S.A.). Echo-Doppler evaluation of carotid arteries was performed in order to calculate elastic indexes (strain, β-stiffness index and distensibility). The association between hemorheological parameters …and carotid elasticity indexes was assessed by simple and multiple regression analyses. RESULTS: In simple correlation analysis, only blood viscosity was directly associated with β-stiffness index (r  = 0.20, p  = 0.05) and inversely with strain (r  =−0.26, p  = 0.01) and distensibility (r  =−0.34, p  = 0.001). After adjusting for cardiovascular risk factors, blood viscosity, but not plasma viscosity or hematocrit, was independently associated carotid arterial measures, together with age, obesity, hypertension, and dyslipidemia. CONCLUSIONS: The results of the present study demonstrate a strong association between blood viscosity and common carotid elasticity indexes. Show more

Keywords: Blood viscosity, plasma viscosity, carotid elasticity, ultrasound

DOI: 10.3233/CH-151946

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 55-62, 2016

Authors: Tripolino, Cesare | Irace, Concetta | Carallo, Claudio | De Franceschi, Maria Serena | Scavelli, Faustina Barbara | Gnasso, Agostino

Article Type: Research Article

Abstract: OBJECTIVE: Red blood cell distribution width (RDW) is a numerical measure, reported as part of a standard complete blood count, usually employed for differential diagnosis of anemic state. Some lines of evidence demonstrate that RDW associates with type 2 diabetes incidence and its complications. To further explore the role of RDW as predictor of abnormal glucose metabolism, we have analyzed the relationship between RDW and 2-hours plasma glucose concentration during an oral glucose tolerance test (OGTT). METHODS: Forty-five outpatients were enrolled for the present study. Participants underwent 75 g OGTT and measurements of hematological parameters. Cardiovascular disease risk factors …(blood pressure, blood lipids, cigarette smoking, obesity) were evaluated by routine methods. RESULTS: In simple regression analysis 2-hours post-load glucose was directly associated with age (r  = 0.36, p  = 0.01), fasting glucose levels (r  = 0.40, p  = 0.002) and RDW (r  = 0.31, p  = 0.037). In multiple regression analysis fasting glucose, RDW, triglycerides and age significantly and independently predicted 2-hours plasma glucose (p  <  0.01 for all coefficients). CONCLUSION: The present findings demonstrate that RDW associates with plasma glucose concentration after a 75-g oral glucose tolerance test. Our results highlight the role of RDW as predictor of glucose metabolism disturbance. Show more

Keywords: Red blood distribution width, OGTT, diabetes

DOI: 10.3233/CH-151947

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 63-69, 2016

Authors: Grembiale, Rosa Daniela | Bruno, Caterina | Tripolino, Cesare | Ursini, Francesco | Calabria, Marilena | Naty, Saverio | Gutierrez, Marwin | Mazzuca, Salvatore

Article Type: Research Article

Abstract: AIM: Vascular damage and fibrotic process represent the pathophysiological hallmarks of systemic sclerosis (SSc). Peripheral microangiopathy can be early detected by nailfold videocapillaroscopy (NVC), whereas recent studies suggest that ultrasound real time elastosonography (US-RTE) can be a useful tool to evaluate the reduction of skin elasticity. The aim of our study was to investigate possible correlations between NVC microvascular alterations and finger tissue stiffness evaluated with US-RTE in SSc subjects. METHODS: 20 subjects (16 women and 4 men) who met the ACR criteria for SSc were recruited. All subjects underwent complete clinical examination, NVC and US-RTE evaluation. US-RTE …was carried out on both the hands, at the level of the palmar surface of the distal phalanx of the fingers. RESULTS: 10 subjects showed limited disease subset (LSS) and 10 showed diffuse disease subset (DSS). Eight patients had ‘Early/Active’ NVC pattern and 12 had ‘Late’ NVC pattern. DSS subjects showed highest skin stiffness values when compared to both LSS (p  = 0.03) and healthy subjects (p  = 0.002). Multiple regression analysis shows an independent association between Late NVC pattern and skin stiffness (R2  = 0.24, p  = 0.027). CONCLUSION: This study demonstrates, for the first time, a strong relationship between microvascular alterations and skin stiffness, evaluated with US-RTE, in SSc patients. Show more

Keywords: Systemic sclerosis, nailfold videocapillaroscopy, ultrasound elastosonography

DOI: 10.3233/CH-151948

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 71-78, 2016

Authors: Sinan, Mukaddes | Ertan, Nesrin Zeynep | Mirasoglu, Bengusu | Yalcin, Ozlem | Atac, Nazlı | Toklu, Akin Savas | Basaran-Kucukgergin, Canan | Baskurt, Oguz Kerim

Article Type: Research Article

Abstract: Inhalation of 100% oxygen in a hyperbaric chamber has been accepted as a useful treatment for patients with various pathologies who suffer from hypoxia. The oxidative effects of hyperbaric oxygen (HBO) on RBCs have been investigated in animals but there is not enough data on hemorheological parameters in patients following HBO treatment (HBOT). In this study, we investigated the effect of HBO on hemorheological and haematological parameters during treatment. Red blood cell (RBC) deformability and aggregation, blood and plasma viscosity and superoxide dismutase activity were investigated in patients who underwent HBOT. Hematological parameters were determined by an electronic hematology …analyzer. A Laser-assisted Optical Rotational Cell Analyzer (LORCA) was used to measure RBC deformability. RBC aggregation was measured for cells in autologous plasma and for cells resuspended in PBS containing Dextran70 (3% ) by using a Myrenne Aggregometer. A Wells-Brookfield cone/plate rotational viscometer was used for viscosity measurements. According to our results, a significant decrement of the hematocrit and the RBC count was observed after the 20th session of HBOT compared to the baseline, but none of the hemorheological parameters changed significantly. Our results showed that HBOT did not cause any significant changes in hemorheological parameters, thereby not representing any problems for the patients. Show more

Keywords: HBOT, RBC aggregation, deformability, viscosity, SOD

DOI: 10.3233/CH-151952

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 1, pp. 79-88, 2016