Clinical Hemorheology and Microcirculation - Volume 44, issue 4
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Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research.
The endeavour of the Editors-in-Chief and publishers of
Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of
Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process.
Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.
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Clinical Hemorheology and Microcirculation: medical practitioners in all fields including hematology, cardiology, geriatrics, angiology, surgery, obstetrics and gynecology, ophthalmology, otology, and neurology. Pharmacologists, clinical laboratories, blood transfusion centres, manufacturing firms producing diagnostic instruments, and the pharmaceutical industry will also benefit.
Important new topics will increasingly claim more pages of
Clinical Hemorheology and Microcirculation: the role of hemorheological and microcirculatory disturbances for epidemiology and prognosis, in particular regarding cardiovascular disorders, as well as its significance in the field of geriatrics. Authors and readers are invited to contact the editors for specific information or to make suggestions.
Abstract: Bioelectrical impedancemetry has been used to evaluate hemorheological parameters in vitro but whole body impedance measurements are also correlated to some hemorheologic factors, due to their close relationship with determinants of electric properties of blood. In previous studies, we have determined a set of predictive equations for hematocrit, whole blood viscosity and plasma viscosity in both sedentary and trained individuals. In this study we aimed at verifying those findings and investigating for other equations in a sample of 62 subjects whose body composition was assessed with a multifrequency bioelectrical impedancemeter using low intensity at the following frequencies: 1, 5, 10,…50 and 100kHz. Viscometric measurements were done with a falling ball viscometer. Hematocrit was measured with microcentrifuge. We confirm that hematocrit was correlated with impedance measurements at 50 kHz (r=−0.671, p < 0.01), and describe a new predictive equation for RBC rigidity index «k» calculated with the equation of Quemada, (“k” index = 0.0003 Z50 + 1.2815; mean difference: −0.0506; 95% confidence interval of −0.0134 to 0.00324) that is also correlated with impedance measurements at 50 kHz (r = 0.526, p < 0.01). Although the precision of these formulae is not sufficient for allowing true «predictions» of hematocrit and red cell deformability, these findings confirm that factors of viscosity are to some extent reflected by whole body electric properties.
Abstract: The study was conducted to investigate the effect of Salvianolic acid B (Sal B) on TNF-α-stimulated adhesion molecule expression i.e. vascular adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and E-selectin in human aortic endothelial cells (HAECs) under laminar shear stress (LSS) condition. Exposure of HAECs to LSS (12 dynes/cm2 for 6 h decreased the TNF-α-induced protein expression of adhesion molecules i.e. VCAM-1, ICAM-1 and E-selectin. Pre-treatment of HAECs with Sal B (10 μg/ml) then exposed to LSS (12 dynes/cm2 ) for 6 h significantly inhibited VCAM-1, ICAM-1 and E-selectin expression stimulated by TNF-α. Moreover, combined Sal B and LSS…treatment inhibited the adhesiveness of monocytic U937 cells to TNF-α-stimulated HAECs. We further examined the molecular mechanisms and found that the combination of Sal B and LSS treatment dramatically inhibited TNF-α-induced NF-κB activation evidenced by IκBα degradation and p65 nuclear translocation in HAECs. This study provides the first biomechanopharmacological evidence that Sal B has a combination effect with LSS to reduce the expression of three adhesion molecules, leading to reduced monocyte adhesion to HAECs, at least in part, by inhibiting the NF-κB signaling pathway. Data from this study thus support the potential clinical application of Sal B in vascular inflammatory diseases.
Abstract: Some studies indicate that obesity is associated with rheological disturbances. Because there are usually sex differences in the type of obesity we decided to evaluate rheological differences between male and female obese patients. We studied 18 morbidly obese men, mean age 43.66 ± 11.32 years, mean body mass index (BMI) 49.82 ± 6.03 kg/m2 and 20 obese females, mean age 40.6 ± 11.86 years, mean BMI 47.41 ± 8.81 kg/m2 . Blood and plasma viscosity measurements were performed using a cone-plate viscometer (Brookfield DV-II). Erythrocyte elongation and red blood cell (RBC) aggregation were measured using the Laser-assisted Optical Rotational…Cell Analyser (LORCA). Whole blood viscosity and RBC deformability expressed by the elongation index were significantly higher in obese men. We did not observe differences in plasma viscosity, corrected blood viscosity and aggregation parameters among the obese population. Blood viscosity correlated with selected RBC aggregation indices. We conclude that morbidly obese patients presented sex-dependent differences in some rheological properties. This study indicates a relation between erythrocyte aggregation indices and blood viscosity in obese populations.
Keywords: Obesity, red cell aggregation and deformability, blood and plasma viscosity
Abstract: Introduction: Bleeding during liver surgery is often routinely controlled by the Pringle maneuver consisting in the temporary clamping of hepatic artery, portal vein, and bile duct. This study aimed at investigating a possible influence of the Pringle maneuver on tissue hypoxia during liver resection. Methods: Twenty-five consecutive patients undergoing elective liver resection were prospectively randomized either to be treated with the Pringle maneuver (Pringle group, n = 14) or without clamping (Controls, n = 11). Blood lactate levels, pyruvate levels, and hepatic vein oxygen saturation were monitored perioperatively. Results: Patients were comparable with respect to resection time, intraoperative blood loss,…and duration of surgery. The Pringle maneuver induced a significant increase in arterial lactate levels during liver resection when compared to Controls (2.6 ± 0.3 vs 1.8 ± 0.2 mmol/l; p < 0.05). Further, the Pringle maneuver significantly increased hepatic venous lactate (3.3 ± 0.3 vs 1.6 ± 0.3 mmol/l; p < 0.05) and lactate/pyruvate ratio in hepatic venous blood (43 ± 8 vs 21 ± 5; p < 0.05) during surgery. This was paralleled by a temporal decrease in hepatic venous oxygen saturation in the Pringle group (61 ± 4 vs 73 ± 4%; p < 0.05). Conclusion: Our findings demonstrate that liver metabolism and tissue oxygenation were markedly affected by occlusion of the liver hilus. Restricting the use of the Pringle maneuver to cases with severe bleeding might therefore be beneficial in patients undergoing liver resection.
Abstract: Behçet’s disease (BD) is a chronic, progressive and inflammatory multisystemic disease, that significantly affects the cardiovascular system. Oxidative stress (OS) is a disturbance in oxidant/antioxidant balance in favor of oxidants. The OS that increases acutely and chronically due to the inflammatory process plays an important role in the pathogenesis of the cardiovascular system effects of the disease by causing endothelial dysfunction in vascular structures. The aim of our study was to investigate the relationship between OS and myocardial perfusion, which is based on microvascular dysfunction, in BD. Material and method: Twenty-seven patients with BD (16 M, 11 F, mean age:…38.7 ± 9.4 years) and 22 healthy volunteers (12 M, 10 F, mean age: 35.8 ± 6.5 years) participated in our study. Technetium-99m methoxyisobutylisonitrile single photon emission computed tomography (Tc-99m MIBI SPECT) stress-rest test was performed with two-day protocol. Myocardial perfusion scores (summed stress score, summed rest score, summed difference score, fix defect score) and perfusion defect prevalence (stress, rest, ischemic and fixed) were determined as the percentage of left ventricle. Coronary angiography was performed in patients with abnormal myocardial perfusion scintigraphy. For OS analysis, the blood samples were taken immediately before the first imaging procedure and were studied for malondialdehyde, glutathione, nitrite, nitrate, vitamin C, retinol, and carotene. Results: In the BD group, a total of 9 patients had abnormal findings in their stress and rest electrocardiography. Perfusion defect in myocardial perfusion scintigraphy was observed in 14 patients (51.8%). Twelve patients accepted coronary angiography, and their results were normal. In the comparison of myocardial perfusion scores, perfusion defect prevalence and OS parameters, there was a significant difference between the BD and control groups. In the BD group, no correlation was observed between myocardial perfusion scores, perfusion defect prevalence and OS parameters. Conclusion: Defects in myocardial perfusion and increase in OS were observed in BD; however, there was no correlation between the two findings in the inactive period. In other words, the prevalence and intensity of myocardial perfusion defects can vary at different OS levels.
Abstract: The stiffness of the arteries normally increases with age. Radiofrequency echo-tracking is a non-invasive ultrasound method which is able to detect the stiffness of the arteries, represented by the β stiffness index. The estimation of biological age of vessels is possible on the basis of the normal age-group specific β stiffness values. The β stiffness index becomes higher in early stages of atherosclerosis as well, before any visible morphological changes. Hutchinson–Gilford progeria syndrome (HGPS) is rare genetic disorder resulting in accelerated aging including appearance of progressive atherosclerosis at an early age which determines the quality and term of life of…these patients. Determination of vascular age and early diagnosis of atherosclerosis seems crucial. According to our knowledge, the estimation of vascular age detected with radiofrequency echo-tracking in HGPS patients, in contrast to the normal age-specific β stiffness values, has not been published yet.
Abstract: Aims: Distorted wall shear stress (WSS) in patients with type 2 diabetes mellitus (T2DM) may be partly explained by an altered red blood cell aggregation tendency (RAT) on viscosity at low shear rate (SR). The present study evaluates viscosity modeling by implementation of hematocrit and RAT in patients with and without T2DM (non-T2DM). Methods: A Couette viscometer and LORCA aggregometer provided viscosity and RAT on 6 shear rates in 55 patients (46–78 yrs, 66% male, T2DM: n = 28), following informed consent. Using a K-fold cross-validation, two linear mixed models predicted by SR and Hct and by SR, Hct and…RAT were compared. Results: In non-T2DM modeling was improved in relatively low RATs (48%, p = 1.0 × 10−11 ) and became worse in relatively high RATs (−18%, p = 0.019). In T2DM the opposite was observed, as modeling became worse in relatively low RATs (−16%, p = 0.001) but was improved in relatively high RATs (22%, p = 0.022). Conclusions: In addition to confirming previous research, major differences in modeling improvement between T2DM and non-T2DM were found. Especially patients with T2DM, a high RAT and often high viscosity at low SR benefit from a more accurate viscosity modeling. Further studies should evaluate how these findings affect WSS in these patients.
Keywords: Type 2 diabetes mellitus, red blood cell aggregation tendency, viscosity modeling