Clinical Hemorheology and Microcirculation - Volume 66, issue 3

Authors: Jung, Friedrich | Connes, Philippe | Lehmann, Christian

Article Type: Editorial

DOI: 10.3233/CH-179000

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 3, pp. 185-186, 2017

Authors: Kulis, Aleksandra | Misiorek, Anna | Marchewka, Jakub | Głodzik, Jacek | Teległów, Aneta | Dąbrowski, Zbigniew | Marchewka, Anna

Article Type: Research Article

Abstract: BACKGROUND: Cryotherapy is a physiotherapy method used to treat back pain in older persons. OBJECTIVE: This study aims to evaluate the changes in the rheological parameters of blood in older women with spondyloarthrosis, who underwent whole-body cryotherapy. METHODS: The experimental group comprised 69 older women with lumbar spondyloarthrosis, aged between 65 and 70 years. Due to the methodology of the procedure, the experimental group was randomly divided into three groups. Each group underwent two weeks of different types of physiotherapy: only whole-body cryotherapy (22 women); only kinesitherapy (23 women); and both cryotherapy and kinesitherapy (24 …women). The control group comprised 25 women who did not undergo any form of therapy. The evaluation of the rheological properties of the blood encompassed measurements of the plasma viscosity, the erythrocyte elongation and aggregation indices, and the level of fibrinogen. RESULTS: The conducted rheological tests revealed a significant decrease in the erythrocyte elasticity and aggregation indices only in the group of women who had undergone both whole-body cryotherapy and kinesitherapy. CONCLUSIONS: Applying whole-body cryotherapy to older women with spondyloarthrosis decreases the elasticity of erythrocytes and, despite favourable changes in the aggregation parameters, problems with perfusion may still appear. For this reason, the benefit of using whole-body cryotherapy in these persons is debatable. Show more

Keywords: Cryotherapy, older women, spondyloarthrosis, rheological parameters

DOI: 10.3233/CH-160230

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 3, pp. 187-195, 2017

Authors: Liao, Fuyuan | Jan, Yih-Kuen

Article Type: Research Article

Abstract: BACKGROUND: Diabetic foot ulcers (DFU) are a major complication in diabetics. Impaired microvascular reactivity is a major contributor to the development of DFU and has been traditionally quantified by time-domain or frequency-domain measures of skin blood flow (SBF). These measures, however, are unable to characterize the changes of nonlinear dynamics of SBF associated with diabetes and peripheral neuropathy. OBJECTIVE: The objective of this study was to investigate altered nonlinear dynamics of skin blood flow in the plantar foot of diabetics with peripheral neuropathy. METHODS: 18 type 2 diabetics with peripheral neuropathy and 8 healthy controls …were recruited. SBF at the first metatarsal head in response to a loading pressure of 300 mmHg and a local heating was measured using laser Doppler flowmetry. A sample entropy approach was used to quantify the degree of regularity of SBF. RESULTS: Our results showed that the regularity degree of SBF in the diabetic foot underwent only small changes during post-occlusive reactive hyperemia and thermally induced biphasic response compared to non-diabetics. SBF of the diabetic foot has higher degree of irregularity during reactive hyperemia because of attenuated myogenic activity, and demonstrated higher regularity during the biphasic response largely due to significantly enhanced cardiac activities. CONCLUSIONS: This study suggests that the regularity degree of SBF at the first metatarsal head could be used to assess impaired microvascular reactivity and thus may be used to assess the risk for DFU in diabetics with peripheralneuropathy. Show more

Keywords: Blood flow oscillations, diabetic foot ulcers, nonlinearity, regularity, sample entropy

DOI: 10.3233/CH-160239

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 3, pp. 197-210, 2017

Authors: Hadimeri, Ursula | Wärme, Anna | Stegmayr, Bernd

Article Type: Research Article

Abstract: BACKGROUND: A native arteriovenous fistula (AVF) is recommended for angio access in patients on chronic hemodialysis (HD). Fistula patency has been improved by exposure to Far Infrared light (FIR). OBJECTIVE: To investigate whether a single FIR treatment could alter blood velocity, AVF diameter or inflammatory markers. METHODS: Thirty patients with a native AVF in the forearm were included. Each patient was his/her own control. Ultrasound (US) examinations were performed before and after a single FIR treatment. RESULTS: A single FIR treatment resulted in a significant increase in blood velocity over the AV fistula …from a mean of 2.1 ± 1.0 m/s to 2.3 ± 1.0 m/s (p  = 0.02). The diameter of the arterialized vein became wider; 0,72 cm ± 0.02 to 0,80 cm ± 0.02, (p  = 0.006). The increase in fistula blood velocity correlated positively with base line serum- urate p  = 0.004) and the increase in venous diameter with the base line plasma orosomucoid concentration (p  = 0.005). CONCLUSIONS: This study shows that a single FIR treatment significantly increased AVF blood velocity and vein diameter. Thus, one FIR treatment can help maturation of AVF in the early postoperative course. Show more

Keywords: Ultrasound, vascular access, Far Infrared therapy, hemodialysis

DOI: 10.3233/CH-170254

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 3, pp. 211-217, 2017

Authors: Schiffner, René | Reiche, Juliane | Schmidt, Martin | Jung, Christian | Walther, Sebastian | Irintchev, Andrey | Bischoff, Sabine J.

Article Type: Research Article

Abstract: BACKGROUND: The influence of the recombinant form of human relaxin-2 (serelaxin) on pulmonary hemodynamics under physiologic conditions have not been the subject of studies in an animal model up until now. METHODS: We therefore utilised the large animal model sheep, convenient in its similar cardiovascular physiology, to investigate said influence. All animals underwent right heart catheterization, a safe and reliable invasive procedure for the assessment of pulmonary hemodynamics, and then received either 30μ g/kg serelaxin (n  = 11) or saline (n  = 13). Systolic, diastolic and mean values of both pulmonary artery pressure (respectively, PAPs, PAPd, PAPm) and pulmonary …capillary wedge pressure (respectively, PCWs, PCWd, PCWm) blood gases, heart rate (HR) and both peripheral and pulmonary arterial oxygen saturation were obtained. Cardiac output (CO), pulmonary vascular resistance (PVR), pulmonary arterial compliance (PAcompl) and systemic vascular resistance (SVR) were calculated. RESULTS: The key findings of the current study are that 20 min after serelaxin injection a rapid decrease of the PAPm, PCWPm, SVR and an decrease of the PAcompl was observed (P  < 0.01). CONCLUSION: These findings suggest that serelaxin might be suitable to improve pulmonary hemodynamics in clinically relevant scenarios, like acute heart failure or pulmonary hypertension. Show more

Keywords: Pulmonary hemodynamics, relaxin-2, relaxin receptors, serelaxin, sheep model, right heart catheterisation

DOI: 10.3233/CH-170269

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 3, pp. 219-229, 2017

Authors: Ranieri, M. | Klein, S. | Kotrade, A. | Taeger, C. | Dolderer, J.D. | Prantl, L. | Geis, S.

Article Type: Research Article

Abstract: BACKGROUND: A physiological oxygen transport through a circulatory and microcirculatory system is essential for execution of cellular functions. Several pathological conditions e.g. infections, ischemia, cancer, diabetes, hypertension or chronic wounds show a change of oxygen distribution and oxygen tension in cellular microenvironment. Additionally complex operative procedures in order to reconstruct tissue defects require a reliable monitoring of microcirculation. OBJECTIVE: Target of this study was to evaluate skin oxygenation during an ischemia-reperfusion experiment using transepidermal oxygen flux imaging. METHODS: Twelve patients at the Department of Plastic and Reconstructive surgery of the University hospital of Regensburg underwent …to elective hand operations. During the operation a tourniquet is standardly set on the upper arm to create ischemia in order to facilitate the operative procedure. Measurements were performed at the different time intervals: in rest, under ischemia and after reperfusion. RESULTS: The transepidermal oxygen flux increased during the ischemic condition compared to normal condition and decreased to a lower value during reperfusion (rest: 0.043±0.007, ischemia: 0.063±0.014, reperfusion: 0.030±0.028). CONCULSION: Transepidermal oxygen flux imaging by ratiometric luminescence imaging seems to be a reliable tool to assess skin oxygenation. However dynamic changes seem to be more informative than absolute thresholds. Further investigations are necessary to prove these promising results. Show more

Keywords: Postoperative monitoring, tissue perfusion, tissue oxygenation, microciculation

DOI: 10.3233/CH-170266

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 3, pp. 231-238, 2017

Authors: Kolbenschlag, J. | Sogorski, A. | Timmermann, C. | Harati, K. | Daigeler, A. | Hirsch, T. | Goertz, O. | Lehnhardt, M.

Article Type: Research Article

Abstract: BACKGROUND: Surgical flaps have become reliable tools in the microsurgical armamentarium, but are still faced with tissue loss due to impaired perfusion which can lead to complete flap failure. Remote Ischemic Conditioning (RIC) has been demonstrated to be an effective way to improve microcirculation in surgical flaps in humans. However, little is known about the optimal amount and length of RIC cycles. OBJECTIVE: Determination of a superior protocol for RIC of cutaneous microcirculation in humans. METHODS: 60 healthy volunteers were randomized into different groups and received a RIC protocol, consisting of three cycles of either …1 second, 1, 5, or 10 minutes of ischemia followed by ten minutes of reperfusion. RIC was applied with a inflatable tourniquet placed on the upper arm. Changes in microcirculation were assessed via combined laser doppler/spectroscopy (O2C device) at the anterior lateral thigh. Relative increase at the end of conditioning vs. baseline measurements was calculated and compared between groups. RESULTS: RIC caused significant changes in cutaneous microcirculation (p  < 0.05) which were more pronounced in groups with longer ischemia intervals. The ten minutes group was significantly superior. CONCLUSION: A conditioning protocol containing three cycles of ten minutes of ischemia is superior to protocols with shorter ischemia intervals for RIC of cutaneous microcirculation. Show more

Keywords: Remote ischemic conditioning, ischemia, reperfusion, microsurgery, flap

DOI: 10.3233/CH-170268

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 3, pp. 239-248, 2017

Authors: Tóth, Judit | Debreceni, Ildikó Beke | Berhés, Mariann | Hajdú, Endre | Deák, Ádám | Pető, Katalin | Szabó, Judit | Németh, Norbert | Fülesdi, Béla | Kappelmayer, János

Article Type: Research Article

Abstract: OBJECTIVE: In a fulminant porcine sepsis model, we determined the kinetics of hypoxia induced changes in relation to sepsis parameters and markers of organ damage. METHODS: Female pigs were challenged by live Escherichia coli and samples were analysed up to 4 hours. Bone marrow reactions were determined by analysing immature forms of peripheral blood cells by a hematology analyser and light microscopy. Platelet mitochondrial membrane depolarisation was determined by flow cytometry. RESULTS: Core temperature, modified shock index and lactate levels all became significantly elevated compared to baseline values at 4 hours in septic animals. …At 2 hours already the reticulocyte count, nucleated red blood cell count and the absolute number of dysplastic platelets became significantly elevated. The platelet mitochondrial membrane depolarisation was significantly decreased by 2 hours in septic animals compared to the baseline values and to control animals. No massive organ damage was evident during the 4-hour observation period, but uric acid levels in septic animals became significantly elevated already by 2 hours. CONCLUSIONS: In this Escherichia coli induced porcine model, severe sepsis was evident by conventional criteria at 4 hours while several - mostly hypoxemia induced - biomarkers were already altered by 2 hours. Show more

Keywords: Immature red blood cells and platelets, platelet apoptosis, sepsis

DOI: 10.3233/CH-170271

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 3, pp. 249-259, 2017

Authors: Pintér, Örs | Hardi, Péter | Nagy, Tibor | Gasz, Balázs | Kovács, Viktoria | Arató, Endre | Sínay, László | Lénárd, László | Jancsó, Gábor

Article Type: Research Article

Abstract: BACKGROUND: Patients having coronary artery disease treated by coronary bypass or PCI procedure are exposed to tissue damage because of the phenomenon called reperfusion injury. Reperfusion injury can be characterized/monitored by oxidative stress parameters, inflammatory markers and by post-operative complication rate. OBJECTIVE: Beyond the obvious factors determining its severity (affected myocardial mass, ischaemic time, collateral circulation etc.) we examined the GST enzyme group’s most cardio selective member, GSTP1 and its genetic polymorphism if there is any genetically determined preventive effect on the above-mentioned parameters. MATERIALS AND METHODES: We have performed randomized prospective study in the …Heart Institute of Pecs with 862 patients, treated by coronary bypass or PCI procedure. Blood samples were taken a day before, one hour, one day, one week after the operation. Leucocyte count (WBC), myeloperoxidase (MPO), thiol group (SH); Superoxide dismutase (SOD), malondialdehyde (MDA), reduced Glutathione (GSH) level was checked in different periods of time as a comparison. The onset of myocardial damage and the corresponding necro enzyme level changes were registered in the perioperative period. Our patient’s GSTP1 allele pair combinations (A, B, or C) were determined by real time PCR method. RESULTS: In patients with GSTP1 AA genotype we have found significance level reaching plasma concentration rise in SOD and MDA, and drop in GSH, SH. The CKMB concentration rise in the post-operative 24 hours was significantly higher in the GSTP1 AA group. CONCLUSIONS: According to our results the AA allele combination can be considered as a risk factor. GSTP1-AA allele pair has negative effect on ischemia-reperfusion tolerance of the heart. In case of cardiovascular interventions, the study of GST enzyme polymorphisms can be an independent risk stratification factor in determining the perioperative risk in the future. Show more

Keywords: Oxidative stress, CABG, PTCA, GST

DOI: 10.3233/CH-170270

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 3, pp. 261-272, 2017