Clinical Hemorheology and Microcirculation - Volume 65, issue 1
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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: OBJECTIVE: To determine RDW and MPV levels in Ankylosing Spondylitis (AS) and to investigate their relations with disease activity. MATERIALS AND METHODS: 133 patients with AS (male: 80, female: 53) and age-sex matched 133 controls (male: 79, female: 54) were enrolled. Demographic data, disease activity scores, Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) levels were recorded. RESULTS: The mean ages of patients and controls were 41.9±11.2 and 39.7±14.2 years respectively (p = 0.16). RDW (14.5±1.6% and 13.2±0.8%, p < 0.0001 respectively) and MPV (10.1±0.8fl and 9.9±0.7fl, p = 0.03, respectively) were significantly higher…in patients with AS than in controls. There was a significant difference in RDW between patients with active AS (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) >4) and those with inactive AS (BASDI <4) patients (14.84±1.79fl, 14.24±1.37fl, p = 0.035 respectively). RDW was positively correlated with BASDAI (r = 0.33, P < 0.0001), ESR (r = 0.45, P < 0.0001) and CRP (r = 0.42, P < 0.0001) and PLT levels (r = 0.24, P = 0.004). While MPV was not correlated with BASDAI, it was negatively correlated with ESR (r = –0.19, P = 0.03), CPR (r = –0.26, P = 0.004) and PLT levels (r = –0.39, P = <0.0001). CONCLUSIONS: RDW and MPV were significantly higher in the patients with AS than in the controls. While RDW was correlated with BASDAI and APRs, MPV was only correlated with APRs.
Keywords: Ankylosing Spondylitis, Red Cell Distrubution Width, Mean Platelet Volume, BASDAI
Abstract: OBJECTIVE: This study aimed to examine the influence of oral acetylsalicylic acid on blood fluidity and infusion speed in the cancer patients with Peripherally Inserted Central Catheter (PICC). BACKGROUND: PICC is placed for prolonged chemotherapy of cancer patients. The fibrin sheaths, which consist of cellular substance and non-cellular substance, generate at the place of insertion and grow down all over the catheter. Finally they cover the vent of the catheter and lead to catheter dysfunctions such as the decrease of infusion speed. In addition, the high viscosity status of cancer patients could lead to acute embolization, which…adds to the high risk of death. DESIGN: Randomized controlled trial. METHODS: This research was carried out between April 2013 and January 2014 in the second hospital of Xiangya, Central South University in Changsha, China. Initially 96 cancer participants with PICC were chosen and randomly allocated to experimental and control group. The participants of the experimental group were conducted route PICC maintain technique and took acetylsalicylic acid 100 mg per day after dinner, while the control group received route PICC maintain technique only. The infusion speed and hemorheology indexes of the two groups were tested before our study and at the end of the 2nd and 4th months with several instruments. RESULTS: Repeated measures analysis of variance indicated that taking acetylsalicylic acid orally had significant main effect on high shear blood viscosity and red blood cell deformability index (P < 0.05), and it also had significant main effect as well as time effect on plasma viscosity (P < 0.05); and time had significant main effect as well as interaction effect with oral acetylsalicylic acid on low shear blood viscosity and red blood cell aggregation index (P < 0.05). Repeated measures ANOVA also showed that taking acetylsalicylic acid orally had significant main effect, time effect and interaction effect on infusion speed (P < 0.01). CONCLUSION: Oral acetylsalicylic acid could improve hemorheology condition and the infusion speed related to fibrin sheath in the cancer patients.
Keywords: Acetylsalicylic acid, hemorheology, infusion speed, fibrin sheaths, cancer patients, Peripherally Inserted Central Catheter (PICC)
Abstract: Raynaud’s phenomenon is an episodic, painful attack of the acral parts caused by local diminished blood supply. The aim of our study was to examine hemorheological parameters, cold agglutinins, cryoglobulins and their relationship in patients suffering from Raynaud’s phenomenon. Blood was taken from 74 patients (mean age: 48 years, female/male: 56/18). Cold agglutinins and cryoglobulins were determined. Hemorheological parameters were also measured such as hematocrit, plasma and whole blood viscosity, red blood cell aggregation and deformability. Results were compared to a group of 58 healthy controls (mean age: 31.5 years, female/male: 24/34). Cold agglutinins were positive in 70%,…cryoglobulins in 43% of patients. When compared to healthy controls, increased red blood cell aggregation (64.54 ± 8.93 vs. 61.11 ± 7.05) and decreased red blood cell deformability (0.669 ± 0.002 vs. 0.681 ± 0.001) was observed in Raynaud’s patients (p < 0.05), but there were no differences in hematocrit (43.27% ± 3.85 vs. 44.10% ± 3.70), plasma (1.27 mPas ± 0.08 vs. 1.24 mPas ± 0.09) and whole blood viscosity (4.12 mPas ± 0.52 vs. 4.26 mPas ± 0.46). No differences were found between the hemorheological profile of cold agglutinin/cryoglobulin positive and negative patients. Also primary and secondary Raynaud’s patients had similar rheological profile. Erythrocyte aggregation and deformability seems to be unfavorable in Raynaud’s patients that can play a role in the disturbance of the microcirculation.
Abstract: It is widely known that the β-adrenergic receptor (AR) blocker (propranolol) inhibits human endothelial cell (EC) angiogenesis in vitro , but how the α -AR antagonist (phentolamine) affects human EC angiogenesis has not yet been studied. Here, we show for the first time that both human dermal microvascular ECs (HDMECs) and human brain microvascular ECs (HBMECs) express α -ARs. Moreover, our results indicate that phentolamine inhibits the proliferation, migration, and tubulogenesis of HDMECs and HBMECs. Finally, VEGFR-2 and Ang1/2 expression of HDMECs was suppressed by phentolamine. Together, these results indicate that phentolamine impairs several critical events of neovascularization, and α…-ARs, as well as the VEGF/VEGFR-2 and Ang/Tie-2 signaling pathways, may be involved in these processes. Our results suggest a novel therapeutic strategy for the use of α -blockers in the treatment of human angiogenesis-dependent diseases.
Abstract: Lymphangiomas are a rare condition, which are characterized by multiple cystic lesions of a single or multiple organs that are thought to originate from intrauterine atypically distended and connected lymphatic tissue. We describe a case of a 56 years old woman with the final diagnosis of a perinephric lymphangioma. With the use of contrast-enhanced ultrasound (CEUS) it was possible to add valuable diagnostic information regarding the extent of the lymphangioma to surrounding tissue without the necessity to use additional ionizing radiation or nephrotoxic contrast agents.
Abstract: Single-walled carbon nanotubes (SWNTs) have been increasingly used in a variety of biomedical applications, such as in vivo delivery of drugs and tumor imaging. Potential exposure of SWNTs to human red blood cells (RBCs) may cause serious toxicity including alteration of mechanical properties of cells. The present study investigated the cellular response to exposure of SWNTs with measuring rheological characteristics of RBCs, including hemolysis, deformability, aggregation, and morphological changes. RBCs were exposed to two different dispersion-state samples (i.e. individual SWNTs and bundled SWNTs) in chitosan hydroxyphenyl acetamide (CHPA) solutions. The concentrations of SWNTs were carefully chosen to avoid any…hemorheological alterations due to hemolysis. Rheological characteristics were measured using microfluidic-laser diffractometry and aggregometry. Our results show that the bundled SWNTs had higher hemolytic activity than did the individual SWNTs. RBC aggregation apparently decreased as the concentration of SWNTs or incubation time increased. Additionally, bundled SWNTs caused significant alterations in the shape and fusion of RBCs. In conclusion, bundled SWNTs were found to be more toxic than individual SWNTs. These results provide important insights into the interactions between RBCs and SWNTs and will facilitate assessment of the risk of nanomaterial toxicity of blood.
Abstract: The aim of this study was to investigate the venoarteriolar reflex (VAR) responses in type 1 (T1DM) and type 2 (T2DM) diabetes mellitus (DM) with polyneuropathy and to estimate their relationship with age, DM duration, initial cutaneous temperature and body mass index. Four groups of subjects were investigated: 1st group –20 patients with T1DM; 2nd group –50 patients with T2DM; 3rd group of 20 healthy subjects with similar age and body mass index (BMI) to the T1DM group; 4th group (Control2) of 24 healthy subjects adjusted by age and BMI to the T2DM group. The cutaneous perfusions of the big…toe pulp were monitored as baseline perfusions at a temperature of 32°C in supine and sitting position with hanging legs and back in supine position. Loss of venoarteriolar reflex responses was established in 75% of T1DM patients, 78% of T2DM patients and in none of the investigated healthy controls. Reduced venoarteriolar perfusion responses were established in both T1DM and T2DM patients with polyneuropathy compared with healthy subjects. Reliable positive associations between VAR responses and the age, DM duration and initial cutaneous temperature were found.
Abstract: The study aimed to investigate local thermally induced microvascular reactivity in patients with type 1 (T1DM) or type 2 diabetes mellitus (T2DM) and polyneuropathy and to compare it with healthy controls. A hundred and fourteen subjects were investigated divided into 3 groups: 1st group –20 patients with T1DM; 2nd group –50 patients with T2DM; 3rd group –44 healthy controls. The skin perfusions of the first tiptoe were monitored by laser Doppler flowmetry during thermal test. The initial (PUi) and basal perfusions at 32°C (PUb) tended to be higher in the DM groups and the PUb of T1DM group was higher…compared with the healthy subjects. The perfusion responses to heating were attenuated in the patients compared with the controls. The calculated vasodilator heat-induced indices were significantly lower and the vasoconstrictor indices during relative cooling in the recovery period were significantly higher in DM patients related to the healthy subjects. The reduced cutaneous microvascular responses to local thermal stimulation in the plantar sides of the toes of both T1DM and T2DM patients with polyneuropathy were similar to those found by previous studies in other investigated sites of glabrous and nonglabrous skin of patients with DM.
Keywords: Diabetes mellitus, laser Doppler flowmetry, microcirculation, thermal test
Abstract: OBJECTIVE: To evaluate the relationship between systemic inflammation and skin microcirculation in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). METHODS: We assessed skin microcirculation flux (laser Doppler flowmetry), classical cardiovascular risk factors, inflammatory markers and disease activity (Disease Activity Score 28, Bath Ankylosing Spondylitis Disease Activity Index) in 75 patients with arthritis with a median disease duration of 4 years, and in 26 healthy subjects. RESULTS: In patients with arthritis inflammatory markers (C-reactive protein, interleukin 6, fibrinogen) were increased, peak flux velocity after the occlusion at the temperature of 36.6°C and maximal heat flux…velocity after the heating were significantly lower. These findings were accompanied by the slower increase in the flux rate during local heating. There were positive correlations between inflammatory markers and microcirculation parameters in patients with RA and AS, but only for RA patients between peak flux velocity and disease activity. There were no significant intergroup differences when the classical cardiovascular risk factors were compared except for the lower HDL cholesterol in arthritis patients. CONCLUSIONS: Patients with chronic systemic inflammatory arthritis presented altered microvascular function and reduced vasodilator capacity of the forearm skin microcirculation.
Abstract: The impact of macromolecules on RBC aggregation continues to be of interest, nevertheless present measurements still have limitations and need improvement. We applied flow cytometry to measure RBC aggregation in dextran T500 (Dx500) solution. The samples were fixed in the aggregated state by glutaraldehyde. Fixed RBC exhibit auto fluorescence, which can be detected by flow cytometry. Single cells, doublets, triplets and larger aggregates can be distinguished quantitatively and quickly due to the correlation between auto fluorescence intensity and number of RBC per measured event. With the increase in concentration of Dx500, percentages of all aggregates and bigger aggregates increased significantly…at concentration of 2%, 4% and 6%, while decreased when the concentration reached 8% and 10%. The percentage of bigger aggregates in concentration of 4% was higher than that in 2% and 6%. The data of flow cytometry was confirmed by microscopic observation and are in good agreement with the literature. The method provide additional advantages to the conventional measurement of RBC aggregation. It gets the distribution of single cells and aggregates as derived from the microscopic observation with hematocrit of physiological level. It uses sample volume as 1/5∼1/10 as needed in sendimentation and photometricmethods.