Clinical Hemorheology and Microcirculation - Volume 53, issue 4

Authors: Caimi, Gregorio | Canino, Baldassare | Incalcaterra, Egle | Ferrera, Eleonora | Montana, Maria | Lo Presti, Rosalia

Article Type: Research Article

Abstract: Acute myocardial infarction (AMI) is accompanied by oxidative stress, and protein oxidation is among the consequences of oxidative stress. We examined the plasma concentration of protein carbonyl groups (PC), a marker of protein oxidation, in a group of young subjects with AMI (45 men and 5 women; mean age 40.4 ± 4.8 yrs). We found a significant increase of PC (p < 0.001) in comparison with normal controls. No difference was observed between patients with AMI characterized by elevated ST segment and those without elevation of ST segment. There was no correlation between the ejection fraction and PC in the …whole group nor in the subgroups of STEMI and non-STEMI patients. Subdividing the whole group of AMI patients according to the number of risk factors and the number of stenosed coronary vessels, the difference in PC level was not statistically significant among the subgroups. This study showed an increased protein oxidation in young subjects with recent AMI. Further investigation is needed to ascertain whether this can be a target of therapeutic intervention. Show more

Keywords: Juvenile coronary heart disease, oxidative stress, protein oxidation, cardiovascular risk factors

DOI: 10.3233/CH-2012-1551

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 297-302, 2013

Authors: Lapi, Dominga | Emdin, Michele | Mastantuono, Teresa | Sapio, Daniela | Santillo, Mariarosaria | Colantuoni, Antonio

Article Type: Research Article

Abstract: The aim of the present study was to assess the in vivo effects of aldosterone topically applied on the hamster cheek pouch microcirculation under baseline conditions or during ischemia-reperfusion. Male Syrian hamsters were anesthetized, tracheotomized and intubated. They were studied under baseline conditions or submitted to ischemia-reperfusion. Cheek pouch microvessels were visualized by fluorescence microscopy. Microvascular parameters were determined by computerized methods. Under baseline conditions, aldosterone (0.2, 0.5, 2.4 μM/L/2 min) induced dose-dependent constriction of all arterioles within 2.0 ± 0.5 min of administration. Diameter reduction was in the same range in smaller arterioles: A3 ones constricted by 24 ± …3% of baseline (at the highest dose). Aldosterone applied prior to ischemia and at reperfusion caused arteriolar constriction, marked microvascular permeability (0.66 ± 0.03 Normalized Grey Level), reduction in perfused capillary (−70 ± 4% of baseline) and leukocyte adhesion. All changes were statistically significant compared with ischemic animals. Potassium canrenoate (mineralcorticoid receptor inhibitor) prior to aldosterone did not abolish the aldosterone-induced effects, while valsartan (angiotensin II AT1 receptor inhibitor) prior to aldosterone ameliorated microvascular ischemia-reperfusion injury. In conclusion, aldosterone determined dose-dependent arteriolar constriction likely by angiotensin II type-1 receptor activation (non-genomic mechanism) worsening the effects of ischemia-reperfusion on capillary perfusion, while protecting from free radical formation. Show more

Keywords: Hamster cheek pouch microcirculation, ischemia-reperfusion, aldosterone, mineral corticoid receptor, angiotensin II AT\(_{\rm{1}}\) receptor

DOI: 10.3233/CH-2012-1552

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 303-315, 2013

Authors: Bilgi, Muhammet | Güllü, Hakan | Kozanoğlu, İlknur | Özdoğu, Hakan | Sezgin, Nurzen | Sezgin, Alpay Turan | Altay, Hakan | Erol, Tansel | Müderrisoğlu, Haldun

Article Type: Research Article

Abstract: Coronary slow flow (CSF) has been documented in 25% of patients evaluated for angina or angina-like chest pain, despite the presence of normal epicardial coronary arteries on angiography. The risk for the development of clinical events in patients with non-obstructive coronary artery disease (NOCAD) is higher than in patients with completely normal coronary arteries. The object of this study was to evaluate changes in blood and plasma viscosity in patients with CSF or NOCAD. The study included 147 subjects (CSF, n = 42, NOCAD, n = 42 and controls, n = 63). Blood and plasma viscosity, complete blood counts, fibrinogen, …and high sensitivity C-reactive protein (hs CRP) levels were measured. There was no significant difference between the groups with respect to blood and plasma viscosity (p > 0.05). Hemoglobin, hematocrit, and erythrocyte counts were significantly higher in the CSF group compared to the NOCAD group (p = 0.017, p = 0.023 and p = 0.023 respectively) and the control group (p = 0.026, p = 0.02 and p = 0.02, respectively). High sensitivity CRP levels in the NOCAD group were higher than the CSF group and the control group (p = 0.001 and p = 0.018, respectively). In conclusion, no significant difference was observed in the blood and plasma viscosity in patients with CSF or NOCAD. Increases in hemoglobin and hematocrit values without an increase in viscosity may play a role in the pathophysiology of CSF. Show more

Keywords: Blood viscosity, coronary slow flow, non-obstructive coronary artery disease

DOI: 10.3233/CH-2012-1553

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 317-326, 2013

Authors: Rossi, Marco | Casani, Augusto Pietro | Pesce, Margherita | Cerchiai, Niccolò | Santoro, Gino | Franceschini, Stefano Sellari

Article Type: Research Article

Abstract: Abnormalities in labyrinth vasculature, resulting in labyrinth ischemia may be responsible for acute unilateral vestibular syndrome (AVS). However, since no tools for the study of the labyrinth microvasculature are available in clinical settings, labyrinth microvascular abnormalities in AVS patients (AVS-pts) can only be hypothesized on the basis of the their cardiovascular risk profile. Considering that skin microcirculation may mirror vascular function in other body districts, we examined skin endothelial function in 20AVS-pts and in 20 healthy control subjects (CS), with the aim of predicting labyrinth microvascular abnormalities in the same AVS-pts, potentially involved in the pathogenesis of their AVS. AVS-pts …and CS underwent laser-Doppler flowmetry measurement of the skin forearm vasodilator response (SVR) to iontophoresis of the endothelial-dependent vasodilator acetylcholine (ACh) and to the endothelial-independent vasodilator sodium nitroprusside (SNP). SVR to ACh was significantly lower than to SNP in AVS patients (p < 0.005, ANOVA for repeated measures), consistent with skin endothelial dysfunction, while no significant differences in SVR between ACh and SNP were observed in CS. Accordingly with an arbitrary cut-off of 30% or greater reduction in SVR to ACh compared to SNP, endothelial dysfunction was found in 4 (20%) of CS, and in 14 (70%) of AVS-pts (6 with associated co-morbidities potentially responsible for endothelial dysfunction, and 8 without these co-morbodities). This study shows that the investigation of skin endothelial function in AVS-pts may be helpful in identifying AVS-pts in whom an ischemic origin of AVS might be more probable, in spite of their low cardiovascular risk profile. Show more

Keywords: Vertigo, acute vestibular syndrome, skin microcirculation, laser-Doppler flowmetry, endothelial dysfunction, iontophoresis, acetylcholine, sodium nitroprusside

DOI: 10.3233/CH-2012-1554

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 327-335, 2013

Authors: Wiggermann, P. | Wohlgemuth, W.A. | Heibl, M. | Vasilj, A. | Loss, M. | Schreyer, A.G. | Stroszczynski, C. | Jung, E.M.

Article Type: Research Article

Abstract: PURPOSE: To evaluate the time dependent changes of microcirculation in hepatocellular carcinoma (HCC) lesions during degradable starch microsphere (DSM)-TACE using contrast enhanced ultrasound (CEUS). MATERIALS AND METHODS: A total of 48 CEUS examinations were performed (1–5 MHz, convex probe) in 6 selected patients who underwent DSM-TACE with EmboCept® S for the treatment of HCC lesions. I.v. application of ultrasound contrast media was performed before and 24 hours post embolization. In addition i.a. contrast application was performed via the angiographic catheter right before and after the embolization and during a follow up time of 2 hours every 30 minutes. The capillary …circulation of the treated HCC lesions was analyzed and quantitative perfusion analysis was performed using a perfusion software by two experienced radiologists in consensus. RESULTS: A significantly reduced microvascularization was seen right after DSM-TACE in all cases using CEUS. The reduction of PEAK, RBV (regional blood volume) and RBF (regional blood flow) compared to preembolization values was highly significant. Mean PEAK was 34.3 ± 13.1 prior to embolization and 9.4 ± 9.1 post embolization (p < 0.001). Mean RBV was 446.5 ± 122.4 prior to embolization and 70.9 ± 23.8 post embolization (p < 0.001). The corresponding figures for RBF were 34.7 ± 13.4 prior- and 4.8 ± 3.4 post embolization (p < 0.001). During follow up a stepwise revascularization of the lesions was documented: 90 minutes post embolization perfusion parameters were not significantly different from prae-embolization values. CONCLUSION: In this feasibility study, capillary perfusion quantification of HCC lesions after DSM-TACE could be demonstrated using CEUS. Using quantitative perfusion analysis it was possible to quantify the transient embolizing effect of DSM-TACE. Show more

DOI: 10.3233/CH-2012-1555

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 337-348, 2013

Authors: Saavedra, Arturo P. | Warth, James A. | Burke, John F. | Norton, Kathryn J. | Gelfand, Jeffrey A.

Article Type: Research Article

Abstract: OBJECTIVE: We have studied dense erythrocytes separated on Arabinogalactan (Stractan) ultracentrifuged gradients in flame-burned patients and in normal individuals. In each case, the percentage of erythrocytes in the densest layers was increased when compared to age and sex matched controls. METHODS AND RESULTS: Using an in vitro system, we showed that as human whole blood is warmed to 48.6°C, the number of dense erythrocytes increases. In addition, the reduced glutathionine (GSH) content of the densest red blood cells is decreased compared to those in lighter fractions on the same gradient or to dense erythrocytes separated from blood incubated at room …temperature. These dense red cells were largely composed of spherocytes and spheroechynocytes, two forms of erythrocytes which have been shown by others to have markedly abnormal flow characteristics in vitro. CONCLUSIONS: We have demonstrated that in vivo dense erythrocytes can be generated in the setting of flame burns. Thus, the underlying reason may be oxidant injury as represented by the reduced level of GSH that we found in association with the generation of dense erythrocytes. Show more

DOI: 10.3233/CH-2012-1556

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 349-356, 2013

Authors: Rossi, Marco | Matteucci, Elena | Pesce, Margherita | Consani, Cristina | Galetta, Fabio | Giampietro, Ottavio | Santoro, Gino

Article Type: Research Article

Abstract: Vascular oscillation (vasomotion) occurs in the microcirculation and is thought to be a significant contributor to tissue perfusion. Our aim was to assess skin vasomotion (SV) of type 1 diabetic patients (T1D-pts) and its relationship with clinical or laboratory variables of the studied T1D-pts. Forearm endothelial-, sympathetic- and myogenic-dependent SV were assessed basally and after 3 min of forearm ischemia in 40 T1D-pts and 50 healthy controls, by spectral analysis of laser-Doppler (LD) signal at the frequency ranges of 0.009–0.02 Hz, 0.021–0.06 Hz and 0.061–0.2 Hz, respectively. Post-ischemic per cent increase (PI%-increase) in power spectral density (PSD) of skin endothelial- …and sympathetic-dependent VS was significantly reduced in T1D-pts compared to controls (p < 0.0005, p < 0.0001, respectively). Linear regression analysis showed a significant positive relationship between PI%-increase of endothelial-dependent SV and heart rate variation during laying-standing test (R = 0.65, p = 0.00001), and a negative relationship between PI%-increase in PSD of skin LD signal 0.009–1.6 Hz spectrum and glycated haemoglobin serum levels (R = 0.44, p = 0.0036) in T1D-pts. These results are consistent with reduced skin endothelial- and sympathetic-dependent stimulated SV and with relationships between some clinical or laboratory variables and SV parameters in the T1D-pts studied. Show more

Keywords: Skin microcirculation, skin vasomotion, type 1 diabetes, microalbuminuria, autonomic dysfunction, laser-Doppler flowmetry, spectral Fourier analysis

DOI: 10.3233/CH-2012-1621

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 357-367, 2013

Authors: Alves, Maria M. | Rocha, Cristina | Gonçalves, Maria P.

Article Type: Research Article

Abstract: The aim of this work was to investigate the rheological behaviour of human blood, in a controlled stress rheometer, using different cone-plate and parallel plate geometries. Steady-shear (flow curves and kinetics) and oscillatory (strain, frequency and time sweeps) tests were performed at 37°C. The results demonstrated that rheological data are significantly influenced by the measuring geometry and the rheological parameters obtained from rheological models must be analysed with great caution. The Cross model provided a better fit of the flow curves and the Power Law model gave a better concordance between the rheological parameters obtained with the different measuring systems. …The oscillatory measurements demonstrated a linear viscoelastic behaviour below a critical frequency and the Friedrich-Braun model described well the frequency sweeps experimental data in that region. The correlation between steady-shear and oscillatory properties (Cox-Merz rule) suggests that the two methods can be complementary and may give important information on red blood cells aggregation and deformability. Results from oscillatory time sweeps confirm a blood aggregation process in two steps. Show more

Keywords: Blood viscosity, controlled stress rheometer, rheological models, viscoelasticity

DOI: 10.3233/CH-121645

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 369-386, 2013

Authors: Piagnerelli, Michael | Njimi, Hassane | Coelho, Tatiana Veloso | Reggiori, Giulia | Castanares Zapatero, Diego | Donadello, Katia | Vincent, Jean-Louis

Article Type: Research Article

Abstract: BACKGROUND: Alterations of the microcirculation are common in critically ill patients and persistence of these alterations is associated with poor outcome. Infusion of high doses of activated protein C can ameliorate the microcirculation. Because red blood cells (RBCs) play an essential role in oxygen transport to the tissues, we studied the effects of activated protein C on RBC deformability in septic patients. METHODS: RBC deformability, assessed by ektacytometry (LORCA system) for shear stresses between 0.30 and 50 Pa, was compared in healthy volunteers and in septic patients before and during activated protein C infusion. RESULTS: RBC deformability was altered in …septic patients compared to healthy volunteers. RBC deformability improved transiently during activated protein C infusion for shear stresses of 4.89 and 7.78 Pa, but the elongation index increased by just 3.4 and 3.2%, respectively. CONCLUSIONS: RBC deformability was altered in sepsis. Activated protein C had no clinically relevant effects on RBC deformability as assessed using ektacytometry. Show more

Keywords: Red blood cell, microcirculation, activated protein C, deformability, sepsis, laser-assisted Optical Rotational Cell Analyzer

DOI: 10.3233/CH-2012-1550

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 387-391, 2013

Article Type: Other

Citation: Clinical Hemorheology and Microcirculation, vol. 53, no. 4, pp. 393-396, 2013