Clinical Hemorheology and Microcirculation - Volume 87, issue 2

Authors: Zhang, Qiubing | Gou, Fang | Shi, Ping | Xu, Zhe | Yan, Zhitao | He, Mingfang | Yin, Xiaohong | He, Yuanjun | Zhang, Jun

Article Type: Research Article

Abstract: BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) were reported to protect from hypoxia-induced oxidative stress in coronary endothelial cells (CECs) after acute myocardial infarction (AMI). Nrf2 shows a protective effect in hypoxia-induced CECs after AMI. Plasmalemma vesicle-associated protein (PLVAP) plays a pivotal role in angiogenesis after AMI. AIM: To explore the protective effect of ACEIs and the involved mechanisms under hypoxia challenge. METHODS: Human coronary endothelial cells (HCAECs) were used to establish hypoxia-induced oxidative stress injury in vitro . Flow cytometry was used to evaluate the protective effect of ACEI on hypoxia conditions.ET-1, NO, ROS, and VEGF were …detected by ELISA. HO-1, Nrf2, and Keap-1, the pivotal member in the Nrf2 signaling pathway, eNOS and PLVAP were detected in HEAECs treated with ACEI by immunofluorescence, qPCR, and western blotting. RESULTS: The hypoxia ACEI or Nrf2 agonist groups showed higher cell viability compared with the hypoxia control group at 24 (61.75±1.16 or 61.23±0.59 vs. 44.24±0.58, both P  < 0.05) and 48 h (41.85±1.19 or 59.64±1.13 vs. 22.98±0.25, both P  < 0.05). ACEI decreased the levels of ET-1 and ROS under hypoxia challenge at 24 and 48 h (all P  < 0.05); ACEI increased the VEGF and NO levels (all P  < 0.05). ACEI promoted the expression level of eNOS, HO-1, Nrf2 and PLVAP but inhibited Keap-1 expression at the mRNA and protein levels (all P  < 0.05). Blockade of the Nrf2 signaling pathway significantly decreased the expression level of PLVAP. CONCLUSION: ACEI protects hypoxia-treated HEAECs by activating the Nrf2 signaling pathway and upregulating the expression of PLVAP. Show more

Keywords: Acute myocardial infarction, angiotensin-converting enzyme inhibitor, nuclear factor erythroid 2 signaling pathway, human coronary endothelial cells, plasmalemma vesicle-associated protein

DOI: 10.3233/CH-232007

Citation: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 141-170, 2024

Authors: Zhang, Ao-Yi | Dong, Ya-Xin | Tan, Yan-Di | Dian-Shen, | Heng-Sun, | Nie, Shu-Ting | Shao, Yuan-Yuan | Feng-Xian, | Hu, Wen-Shu | Li, Xin-YI | Tao-Xu, | Li, An-Ni | Liang-Xu, | Chang-Zhou,

Article Type: Research Article

Abstract: OBJECTIVE: To investigate predictors of anticoagulation efficacy in deep venous thrombosis (DVT) by ultrasound elastography (UE). METHODS: The basic clinical, laboratory and ultrasound treatment data of fifty-eight patients with DVT were collected and analyzed. Then the results of ultrasound after 3-month anticoagulation treatment were compared among different groups. Multiple logistic regression analysis was used to identify independent risk factors that affected anticoagulation efficacy. The predictive efficacy of each independent risk factor was accessed by drawing operating characteristic (ROC) curves. RESULTS: According to the regression analysis, the elastic modulus (OR = 0.631, P  = 0.001) and strain …rate ratio (OR = 0.332, P  = 0.006) were identified as independent risk factors for the effectiveness of anticoagulation therapy in patients with DVT. According to the ROC curves, elastic modulus and strain rate ratio could predict effective anticoagulation therapy for DVT, and the optimal threshold values were 22.10 kPa and 1.80 respectively. The corresponding AUC values were 0.879 and 0.854, with a sensitivity of 71.4% and 59.5%, a specificity of 93.7%, and a Youden index of 65.1% and 62.7%, respectively. CONCLUSIONS: The elastic modulus (≤22.10 kPa) or strain rate ratio (≤1.80) of the thrombus were independent predictors for the effectiveness of anticoagulation therapy. Show more

Keywords: Elastography, deep vein thrombosis, anticoagulation

DOI: 10.3233/CH-232031

Citation: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 171-185, 2024

Authors: Qiao, Qi | Wang, Bingshuang | Xu, Minzhe | Qi, Zhengqin

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate plaque vulnerability by carotid contrast-enhanced ultrasound (CEUS) and to analyze the correlation between plaque vulnerability and peripheral blood leukocyte classification. MATERIALS AND METHODS: 135 patients with carotid plaque were examined by contrast-enhanced ultrasound. Plaque vulnerability was assessed by semiquantitative visual classification. Baseline clinical data and peripheral leukocyte classification were collected. Ordered logistic regression was used to analyze the correlation between plaque neovascularization grade and peripheral leukocyte classification count. RESULTS: There were significant differences in leukocyte, monocyte, neutrophil, mean platelet volume, lymphocyte, and neutrophil counts between different neovascular plaque grades and …peripheral blood (P  < 0.05). Correlation analysis showed that leukocyte, monocyte, and neutrophil counts were significantly positively correlated. CONCLUSION: The increase in plaque neovascularization is associated with an increase in circulating leukocytes, monocytes, and neutrophils. Therefore, CEUS combined with peripheral blood leukocytes may serve as an early warning of plaque vulnerability and provide a theoretical basis for clinical treatment. Show more

Keywords: Contrast-enhanced ultrasound, carotid plaque, leukocyte, inflammation

DOI: 10.3233/CH-232034

Citation: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 187-197, 2024

Authors: Tzirakis, Konstantinos | Kontopodis, Nikolaos | Ioannou, Christos V.

Article Type: Research Article

Abstract: PURPOSE: To compare the hemodynamic performance of three (Bottom Up non-ballet, Top-Down non-ballet, Top Down ballet) idealized stent graft configurations used during endovascular repair of abdominal aortic aneurysms, under the influence of various rheological models. METHODS: Ten rheological models are assumed and a commercial finite volume solver is employed for the simulation of blood flow under realistic boundary conditions. An appropriate mesh convergence study is performed and five hemodynamic variables are computed: the time average wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), endothelial cell activation potential (ECAP) and displacement force (DF) for all …three configurations. RESULTS: The choice of blood flow model may affect results, but does not constitute a significant determinant on the overall performance of the assumed stent grafts. On the contrary, stent graft geometry has a major effect. Specifically, the Bottom Up non-ballet type is characterized by the least favorable performance presenting the lowest TAWSS and the highest OSI, RRT and ECAP values. On the other hand, the Top Down ballet type presents hemodynamic advantages yielding the highest TAWSS and lowest OSI, RRT and ECAP average values. Furthermore, the ballet type is characterized by the lowest DF, although differences observed are small and their clinical relevance uncertain. CONCLUSIONS: The effect of the assumed rheological model on the overall performance of the grafts is not significant. It is thus relatively safe to claim that it is the type of stent graft that determines its overall performance rather than the adopted blood flow model. Show more

Keywords: Non-Newtonian blood flow, idealized stent graft, computational fluid dynamics, finite volume method, hemodynamic parameters

DOI: 10.3233/CH-232058

Citation: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 199-219, 2024

Authors: Hammer, Simone | Nunes, Danilo Weber | Hammer, Michael | Zeman, Florian | Akers, Michael | Götz, Andrea | Balla, Annika | Doppler, Michael Christian | Fellner, Claudia | Platz Batista da Silva, Natascha | Thurn, Sylvia | Verloh, Niklas | Stroszczynski, Christian | Wohlgemuth, Walter Alexander | Palm, Christoph | Uller, Wibke

Article Type: Research Article

Abstract: BACKGROUND: Differentiation of high-flow from low-flow vascular malformations (VMs) is crucial for therapeutic management of this orphan disease. OBJECTIVE: A convolutional neural network (CNN) was evaluated for differentiation of peripheral vascular malformations (VMs) on T2-weighted short tau inversion recovery (STIR) MRI. METHODS: 527 MRIs (386 low-flow and 141 high-flow VMs) were randomly divided into training, validation and test set for this single-center study. 1) Results of the CNN’s diagnostic performance were compared with that of two expert and four junior radiologists. 2) The influence of CNN’s prediction on the radiologists’ performance and diagnostic …certainty was evaluated. 3) Junior radiologists’ performance after self-training was compared with that of the CNN. RESULTS: Compared with the expert radiologists the CNN achieved similar accuracy (92% vs. 97%, p  = 0.11), sensitivity (80% vs. 93%, p  = 0.16) and specificity (97% vs. 100%, p  = 0.50). In comparison to the junior radiologists, the CNN had a higher specificity and accuracy (97% vs. 80%, p  < 0.001; 92% vs. 77%, p  < 0.001). CNN assistance had no significant influence on their diagnostic performance and certainty. After self-training, the junior radiologists’ specificity and accuracy improved and were comparable to that of the CNN. CONCLUSIONS: Diagnostic performance of the CNN for differentiating high-flow from low-flow VM was comparable to that of expert radiologists. CNN did not significantly improve the simulated daily practice of junior radiologists, self-training was more effective. Show more

Keywords: Vascular malformation, deep learning, magnetic resonance imaging

DOI: 10.3233/CH-232071

Citation: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 221-235, 2024

Authors: Inoue, Masataka | Ohwada, Masahiro | Watanabe, Nobuo

Article Type: Research Article

Abstract: BACKGROUND: Several conventional studies focused on platelet pinocytosis for possible utilization as drug delivery systems. Although platelet pinocytosis is important in such utilization, the impact of the shear rate on pinocytosis is unclear. OBJECTIVE: Our objective was to investigate the relationship between shear rate and platelet pinocytosis in vitro . In addition, this study addressed the change in platelet aggregation reactivity with adenosine diphosphate (ADP) stimulation after pinocytosis. METHOD: Porcine platelet-rich plasma was mixed with fluorescein isothiocyanate (FITC)-conjugated dextran and incubated for 15 min under shear conditions of 0, 500, and 1500 s-1 . After incubation, confocal …microscopic scanning and three-dimensional rendering were performed to confirm the internalization of FITC-dextran into platelets. The amount of FITC-dextran accumulated via platelet pinocytosis was compared using flow cytometry at each shear rate. In addition, light transmission aggregometry by ADP stimulation was applied to platelets after pinocytosis. RESULTS: The amount of intracellular FITC-dextran increased with higher shear rates. Platelets with increased amounts of intracellular FITC-dextran did not show changes in the aggregation reactivity to ADP. CONCLUSIONS: A higher shear rate promotes platelet pinocytosis, but enhanced pinocytosis does not affect aggregation sensitivity, which is stimulated by ADP. Show more

Keywords: Platelet, pinocytosis, dextran, shear rate, aggregation

DOI: 10.3233/CH-232075

Citation: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 237-247, 2024

Authors: Zhang, Yi-ming | Wang, Guo-hua | Xu, Miao-jun | Jin, Gan

Article Type: Research Article

Abstract: OBJECTIVE: This study was designed to investigate the role of 8-oxoguanine DNA glycosylase 1 (OGG1) in preventing atherosclerosis-induced vascular EC injury, thereby providing a theoretical basis for the exploration of drug targets and treatment methods for atherosclerosis. METHODS: Human umbilical vein cell line (EA.hy926) was treated with ox-LDL to construct an in vitro atherosclerotic cell model. pcDNA3.1-OGG1 was transfected into EA.hy926 cells to overexpress OGG1. qRT-PCR, CCK-8 assay, flow cytometry, oil red O staining, ELISA, comet assay and western blot were used to evaluate the OGG1 expression, viability, apoptosis level, lipid droplet content, 8-OHdG level …and DNA damage of cells in each group. RESULTS: Compared with the Control group, ox-LDL stimulation of endothelial cells significantly decreased cell viability, promoted apoptosis and DNA damage, and increased intracellular levels of 8-OHdG and γH2AX, while decreasing protein levels of PPARγ, FASN, FABP4, RAD51 and POLB. However, overexpression of OGG1 can significantly inhibit ox-LDL damage to endothelial cells, promote lipid metabolism, decrease lipid droplet content, and improve DNA repair function. CONCLUSION: Over-expression of OGG1 improves DNA repair. Briefly, OGG1 over-expression enhances the DNA damage repair of ECs by regulating the expression levels of γH2AX, RAD51 and POLB, thereby enhancing cell viability and reducing apoptosis. Show more

Keywords: 8-oxoguanine DNA glycosylase 1 (OGG1), atherosclerosis, apoptosis, DNA damage repair

DOI: 10.3233/CH-232082

Citation: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 249-261, 2024

Authors: Chen, Keke | Wang, Feihang | Deng, Minying | Yuan, Kai | Wang, Xi | Zhao, Qiannan | Dong, Yi | Wang, Wenping

Article Type: Case Report

Abstract: BACKGROUND: Hepatic reactive lymphoid hyperplasia (RLH) is a rare benign lymphoproliferative lesion and a poorly understood disease. It is usually asymptomatic and incidental, but it is difficult to distinguish from hepatocellular carcinoma and metastatic liver tumor on imaging, and percutaneous biopsy is not sufficient to distinguish from low-grade malignant lymphoma and extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), making diagnosis difficult. CASE SUMMARY: A 69-year-old woman came to our hospital for reexamination of pulmonary nodules followed by liver occupation. The lesions showed “wash-in and wash-out” on contrast-enhanced ultrasonography and magnetic resonance imaging. Enhanced …magnetic resonance also showed annular envelope enhancement and limited diffusion on the ADC map during the delay period. Imaging revealed metastatic liver cancer, and the patient underwent a partial hepatectomy. However, the final histopathological diagnosis was RLH. CONCLUSION: If small isolated nodules are found in the liver of middle-aged and elderly female patients with no risk factors for liver malignancy, when the enhanced imaging suggests “wash-in and wash-out”, further focus should be placed on whether the enhanced imaging shows perinodular enhancement and whether the DWI shows limited diffusion in MRI, in order to emphasize the possibility of liver RLH diagnosis. Show more

Keywords: Reactive lymphoid hyperplasia, pseudo lymphoma, ultrasound, MRI, CT, pathology, case report

DOI: 10.3233/CH-232087

Citation: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 263-269, 2024

Authors: Mantskava, M. | Chkhitauri, L. | Shekiladze, E. | Tskhvediani, N. | Kalmakhelidze, S. | Momtselidze, N. | Prantl, L. | Jung, F. | Machaliński, B. | Wojciech, P. | Sanikidze, T.

Article Type: Research Article

Abstract: BACKGROUND: The triad “insulin resistance, prediabetes, diabetes” is three independent neologies with characteristic features and development. In addition, each are characterized by progression and the possibility of transition from one form to other. Due to the fact that diabetes is one of the common diseases associated with high rates of disability, it is necessary to improve diagnostic methods and educational regimens for successful prevention and treatment of the disease. OBJECTIVE: We investigated Band 3 protein (B3p) level, osmotic resistance of erythrocytes, the total antioxidant activity (TAA) of blood serum, level of HbA1 in group patients with insulin resistance …(IR), prediabetes, and Type 2 Diabetes Mellitus (T2DM) and comparative with health control group. METHODS: We used original, accurate research methods that measure the essence of the studied quantities. RESULTS: Disruptions of glucose and insulin homeostasis ay lead to the initiation of oxidative stress (in our study demonstrated by a decrease of TAA of blood serum) increased redox-sensitive PTP activity and aberrant band 3 phosphorylation, potentially leading to reduced erythrocyte deformability. At the same time glycation of Hb during T2DM may affect its cross-link with membrane proteins, in particular with B3p, and although appears to limit its cross-linking and decrease its clusterization ability, induces alterations in the cytoskeletal matrix, and thereby decrease erythrocytes’ osmotic resistance making them more susceptible to hemolysis. CONCLUSIONS: The osmotic resistance of the erythrocytes can be used as a sensitive marker for the detection of the early stages of hyperglycemia (prediabetes). This set of clinical trials will make it possible to identify diseases that make up the triad at an early stage. Early detection of disorders and continued research in this direction will help in the development of a diagnostic scheme for the prevention of such patients. Based on our data, research into anti-oxidation drugs is very important. With the help of the array of studies described in the article and antioxidant treatment, the likelihood of successful treatment will increase. Show more

Keywords: Hyperglycemia, erythrocyte, band 3 protein, oxidative stress, osmotic resistance

DOI: 10.3233/CH-239104

Citation: Clinical Hemorheology and Microcirculation, vol. 87, no. 2, pp. 271-281, 2024