Clinical Hemorheology and Microcirculation - Volume 16, issue 4

Authors: Blombäck, Birger

Article Type: Review Article

Keywords: Fibrin, fibrinogen, evolution, gel formation, proteolysis, thrombin, biosynthesis

DOI: 10.3233/CH-1996-16401

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 383-477, 1996

Authors: Pettit, K.L. | Hunt, W.B. | George, S.J. | Barnes, A.J.

Article Type: Research Article

Abstract: Differences in filtration between RBC's from diabetics and normal subjects were readily detected with nickel filters but not using polycarbonate filters. Parallel measurements using the CTTA demonstrated that although the mean transit time of diabetic and normal cells was similar the more rigid cells within the samples from diabetics were significantly less deformable. This suggests that the abnormalities detected by nickel filters were due to a sub-population of less deformable cells rather than an abnormality of diabetic cells as a whole. In a further study where increasing numbers of glutaraldehyde hardened cells were added to normal red cell samples the …CTTA instrument showed that 10% of hardened cells could be detected without any change being shown in the mean transit time. At this level the nickel filter was much more sensitive than the Nucleopore filter at detecting the sub-population of hardened cells. Taken together these data support the hypothesis that diabetics have a small circulating sub-population of rigid red cells that can be readily detected using nickel filters. Show more

Keywords: Erythrocyte, filterability, diabetes

DOI: 10.3233/CH-1996-16402

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 479-485, 1996

Authors: Klotz, Karl-Friedrich | Weitz, Gunther | Müller, Gerhard | Raasch, Walter | Kuppe, Hermann | Schmucker, Peter

Article Type: Research Article

Abstract: Patients suffering from one or more of the cardiovascular occlusive diseases have an increased risk of intraoperative thromboembolic or ischemic complication. Hemorheological factors may influence the risk of occurence of these complications. We tested in a prospective study the impact of preoperative mental stress on hemorheological parameters of 22 patients undergoing surgery without cardiovascular disease, compared to a group of 10 healthy probands without imminent operation. We measured endocrinological stress parameters, hematocrit, plasma viscosity, and plasma protein composition the evening before the observed night and the morning before the operation took place. The overnight reduction in stress parameters seen in …the probands was not present in the patients. Consequences of this different stress response include a statistically significant increase in hematocrit and plasma viscosity in the patients mainly resulting from a shift of fluids out of the intravascular space. We conclude that the rheological parameters might deteriorate during the preoperative period in patients with increased risk of cardiovascular problems. Show more

Keywords: perioperative stress, rheology, plasma viscosity, serum proteins

DOI: 10.3233/CH-1996-16403

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 487-495, 1996

Authors: Tanahashi, N. | Tomita, M. | Kobari, M. | Takeda, H. | Yokoyama, M. | Takao, M. | Fukuuchi, Y.

Article Type: Research Article

Abstract: We measured the platelet activation and the rate of erythrocyte aggregation simultaneously employing venous blood from 31 patients with cerebral infarction during the acute phase (less than 7 days after onset) and 73 patients with cerebral infarction during the chronic phase (more than 1 month after onset.). The degree of platelet activation was estimated from the levels of plasma beta-thromboglobulin (BTG), platelet factor 4 (PF4), and thrombospondin (TSP). The erythrocyte aggregation rate was examined using the whole-blood erythrocyte aggregometer developed by us (Am. J. Physiol. 251, H1205-H1210, 1986) with concomitant measurement of the fibrinogen concentration. The mean values of the …erythrocyte aggregation rate, plasma BTG, PF4, TSP and fibrinogen concentration at the acute phase of cerebral infarction were statistically significantly (P<0.05) higher than those at the chronic phase of cerebral infarction or in the control group. Multiple regression analysis revealed that fibrinogen, BTG and TSP were main factors contributing to the enhanced erythrocyte aggregation rate at the acute phase of cerebral infarction, but fibrinogen was the sole contributing factor at the chronic phase of cerebral infarction. We conclude that the platelet activation, erythrocyte aggregation rate and fibrinogen concentration were closely correlated with each other in patients with cerebral infarction during the acute phase. Show more

Keywords: cerebral ischemia, platelet aggregation, erythrocyte aggregation, fibrinogen

DOI: 10.3233/CH-1996-16404

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 497-505, 1996

Authors: Qu, Shen | Xu, Wei | Fan, Hong | Guo, Sushu

Article Type: Research Article

Abstract: Erythrocyte membrane lipids, ATPase activities, blood cell parameters and hemorheological changes were measured in 51 patients with acute cerebral infarction, 12 patients with arteriosclerosis and 51 normal controls. A decrease in erythrocyte deformability, ATPase activities and an increase in CHO/PL ratio and viscosity at high shear rate were observed in stroke patients in which a significant difference was found compared with that of the control group. Multivariate regression analysis indicated that membrane lipids, ATPase activities, CHO/PL ratio viscosity at high shear rate had linear correlation with erythrocyte deformability. The coefficient of multiple correlation was 0.8937. These findings suggested that …the erythrocyte membrane lipid composition and ATPase activities change significantly in stroke patients. These may be the cause of hemorheological disturbance. These changes existed before the occurrence of the stroke. So it is important to treat the circulation disorder in arteriosclerosis patients to prevent the cerebral infarction. The adoption of treatment with drugs for improving microcirculation and ion transport may be of benefit in the recovery from a stroke. We concluded from our study that CHO/PL could be a feature of arteriosclerosis or strokes, and ATPase activities may serve as an early indication of the patient's state. Show more

Keywords: stroke, arteriosclerosis, erythrocytes, membrane lipids, ATPase, deformability, viscosity

DOI: 10.3233/CH-1996-16405

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 507-513, 1996

Authors: Vayá, Amparo | Martínez, Marcial | Solves, Pilar | Barberá, José Luis | Aznar, Justo

Article Type: Research Article

Abstract: Erythrocyte deformability was determined in 21 adult patients (13 males and 8 females) suffering from familial hypercholesterolemia (FH) and in a well matched control group by means of the erythrocyte elongation index (EEI) in a Rheodyn SSD (Myrenne, Roetgen Germany) shear stress diffractometer at eight different shear stresses ranging from 0.30 to 60 Pa. The results show that at high shear stress forces of 6, 12, 30 and 60 Pa, FH patients had lower EEI values than the control group: 41.05 ± 2.97 % vs 43.46 ± 2.31 %; 48.21 ± 3.06 % vs 50.48 ± 1.71 %; 52.95 ± …2.60 % vs 55.51 ± 2.04 %; 54.73 ± 2.45 % vs 57.46 ± 2.71 %; all these differences were statistically significant (p<0.01). No statistical differences were observed between the two groups at low shear stresses. No correlation was found between EEI and hematimetric or lipidic parameters. This finding is in agreement with our previous data on decreased red cell deformability in hypercholesterolemic patients determined by filtrometric techniques. The decreased elongation index of erythrocytes could cause a deterioration in blood flow conditions and thus favor ischemic events in these patients. Show more

Keywords: Familial hypercholesterolemia, erythrocyte deformability, Rheodyn SSD

DOI: 10.3233/CH-1996-16406

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 515-522, 1996

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

Article Type: Research Article

Abstract: In a group of subjects with vascular atherosclerotic disease (VAD) and in a group of normal controls we evaluated, at baseline and after in vitro chemotactic activation (prolonged for 5 and 15 min) with two stimulating agents (PMA and fMLP), the polymorphonuclear (PMN) filtration parameters, PMN membrane fluidity and PMN cytosolic Ca2+ content. We determined the PMN filtration parameters using the St. George's Filtrometer and considering respectively the initial relative flow rate (IRFR) and the clogging particles (CP), the PMN membrane fluidity, employing the fluorescent probe TMA-DPH, and the PMN cytosolic Ca2+ content adopting the fluorescent probe Fura …2-AM. In normals and in VAD subjects, after PMN activation with PMA and fMLP, a significant variation was evident in all filtration parameters at 5 and 15 min; no important variation was present in PMN membrane fluidity and in PMN cytosolic Ca2+ content. Between normals and VAD subjects no difference was evident regarding the trend of PMN filtration parameters, PMN membrane fluidity and PMN cytosolic Ca2+ content. Show more

Keywords: Vascular Atherosclerotic Disease, Polymorphonuclear Leukocyte Rheology, PMN Membrane Fluidity, PMN Cytosolic Ca$^{2+}$, Chemotactic Activation

DOI: 10.3233/CH-1996-16407

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 523-531, 1996

Authors: Mokken, Fleur Ch. | Henny, Pieter | van der Waart, Francina J.M. | Gelb, Adrian W. | Kedaria, Mohan

Article Type: Research Article

Abstract: The microcirculation within and oxygen availability to peripheral tissues are of importance during anesthesia. Hemorheology, the study of the flow behaviour of blood, is an inherent component of this subject. The objective of this study was to investigate the effects of propofol on hemorheological parameters including hematocrit, blood viscosity, plasma viscosity and erythrocyte deformability. In vitro, propofol, nor Intralipid 10%, which closely resembles its vehicle, exhibited any statistically significant effect on erythrocyte deformability. In the in vivo comparison between two groups of ASA I patients undergoing minor orthopedic surgery, anesthetized with either propofol or nitrous oxide/isoflurane, both showed a decreased …hematocrit and whole blood viscosity. A trend of increased erythrocyte deformability was observed in the propofol group only, which however was not statistically significant. In conclusion, the hemorheological effect of propofol appears to be largely comparable to nitrous oxide/Isoflurane in young healthy patients undergoing minor orthopedic surgery. Show more

Keywords: hemorheology, blood viscosity, erythrocyte deformability, anesthesia, surgery

DOI: 10.3233/CH-1996-16408

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 533-541, 1996

Authors: Giansanti, Roberto | Rabini, Rosa Anna | Boemi, Massimo | Fumelli, Paolo

Article Type: Research Article

Abstract: Authors studied modifications of the red blood cells arteriolar velocity (RBcAV) in the conjunctival capillary network in diabetic subjects with alterations of red blood cell (RBc) aggregation and of whole blood viscosity (WBV). WBV, RBc aggregation and RBcAV were studied in diabetics with foot ulceration, with healed ulcer, and in controls. RBcAV, RBc aggregation and WBV resulted statistically different between diabetics with and without plantar perforation, and between diabetics and controls. A significant reduction (p<0.05) of RBcAV was found in patients with foot perforation compared to diabetic subjects with recovered foot ulcer, and in the group of diabetic patients as …a whole (p<0.05) compared with controls. In a similar way we found a significant increase (p<0.05) of the erythrocyte aggregation, fibrinogen, and WBV in diabetics with ulcer compared with those without this complication and in diabetic patients (p<0.05) considered altogether compared with controls. A reduction of RBcAV was found associated with an increase of Rbc aggregation and WBV in diabetic patients. A decreased arteriolar diameter was found in diabetic patients in comparison with control subjects.We conclude that modifications of RBC aggregation, fibrinogen, and WBV occur in diabetic ulcer patients.These modifications are associated in diabetic patients with arteriolar flow modifications, and can be documented in the conjuctival microcirculation. Show more

Keywords: Microcirculation, Arteriolar velocity, Hemorheology, Diabetes

DOI: 10.3233/CH-1996-16409

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 543-548, 1996

Authors: Vayá, Amparo | Martínez, Marcial | Dalmau, Jaime | Velert, Ma Mar | Aznar, Justo

Article Type: Research Article

Abstract: In order to find out whether hemorheological alterations precede the atherosclerotic lesions in familial hypercholesterolemia (FH), we studied the lipidic and hemorheological profile of 40 children (18 males and 22 females) with heterozygous FH but without vascular atherosclerotic lesions demonstrable on a carotid ultrasound doppler-duplex, and in a well-matched control group. When compared with the control group FH children showed increased erythrocyte aggregation both at stasis (EAM0 ) (4.9 ± 1.1 vs 3.6 ± 1.0) and at low shear rate (EAM1 ) (8.1 ± 1.4 vs 6.9 ± 1.4; p<0.001), and increased plasma viscosity (PV) (1.20 ± 0.07 vs 1.16 …± 0.04; p<0.01). Other rheological parameters determined, fibrinogen (Fbg) and blood viscosity (BV), did not show any statistical differences. The fact that erythrocyte aggregation and plasma viscosity are increased in FH children, even without any concomitant statistical increase in fibrinogen, suggests that the dyslipemia itself can contribute to the rheological alterations. On the other hand, the fact that the above mentioned alterations appear prior to the development of the vascular lesion suggests that they could favour the development of the atherosclerotic process. Show more

Keywords: Familial hypercholesterolemia, children, rheology, plasma viscosity, erythrocyte aggregation, fibrinogen

DOI: 10.3233/CH-1996-16410

Citation: Clinical Hemorheology and Microcirculation, vol. 16, no. 4, pp. 549-557, 1996