Clinical Hemorheology and Microcirculation - Volume 11, issue 1-2
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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.
The following professionals and institutions will benefit most from subscribing to
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: In a group of 19 type 2 diabetics complicated by non-proliferative retinopathy, we evaluated, at baseline and after oral administration of 1 g. of calcium dobesilate, whole-blood filterability, red cell membrane fluidity (using pyrene as probe) and fluidity gradient (employing fluorescent fatty acids as probes). From the data obtained after administration of calcium dobesilate, we observed an increase in whole-blood filterability and in red cell membrane fluidity. No variation instead was evident for the fluidity gradient. These findings, even if preliminary, may be indicative of the microrheological action of this molecule.
Abstract: Whole blood viscosity (WBV) at the shear rates of 0.471 sec−1 and 63.9 sec−1 , plasma viscosity, hematocrit, fibrinogen, plasma total cholesterol, HDL- and LDL-cholesterol, and Cerebral Blood Flow (CBF) - by the 133 Xenon inhalation method - were measured before and soon after LDL-apheresis in four patients affected with familial heterozygous hypercholesterolemia. Heart Rate (HR), Blood Pressure, pC02, p02, and pH in capillary blood, and the anxiety level of patients (by the State-Trait Anxiety Inventory) were also measured at the beginning of each CBF examination. WBV at the shear rate of 0.471 sec−1 (p<0.05), fibrinogen…(p<0.01), plasma viscosity (p<0.05), total cholesterol (p<0.01) and LDL-cholesterol (p<0.01) significantly (paired t-test) decreased after LDL-apheresis, as compared with baseline measurements. No significant differences were found for hematocrit, HDL-cholesterol, WBV at the shear rate of 63.9 sec−1 , HR, MABP, pC02, p02, pH, anxiety, and CBF measured before and after LDL-apheresis. These results show that, despite the significant drop in plasma and low shear WBV induced by LDL-apheresis, CBF remains constant, and this is probably because of its autoregulatory property.
Abstract: Erythrocyte deformability indexes and packed cell viscosities of reticulocyte-rich blood samples of guinea pigs were compared with the values obtained from the same animals at the beginning of the experiments. Both of these parameters were increased in reticulocyte rich samples. Erythrocyte deformability indexes correlated with the reticulocyte ratio of the blood samples, but there was no significant correlation between the packed cell viscosities and reticulocyte ratios.
Abstract: In order to study the role of hemorheology in pathogenesis of acute hemorrhagic necrotizing pancreatitis (AHNP), forty four adult hybrid dogs were used and divided into 5 groups. Groups I and II were operation control (8 dogs) and acute interstitial pancreatitis group (8 dogs) respectively. Groups III–V suffered from AHNP by injection of sodium taurocholate in major pancreatic duct. Furthermore, groups IV and V were treated with Dextran 40 solution and Salvia Miltiorrhizae intravenous injection respectively. Arterial blood pressure and central venous pressure in all 5 groups did not exhibit significant changes before and after operation. Serum amylase and lipase…level of groups III–V increased obviously after AHNP, but they decreased more rapidly in groups IV and V after treatment with drug than those in group III. Hemorheologic changes were measured with Low Shear 30 sinus. Plasma viscosity of all 5 groups had no evident changes before and after operation. There were no significant changes in hematocrit (HCT), apparent viscosities of whole blood at 0.512 sec−1 (η 0.512) and 51.2 sec−1 (η 51.2), aggregation index of RBC (AI), viscous component (η′) and elastic component (η″) of complex viscosity; and elastic modulus (G′) of whole blood in groups I and II had no significant alteration before and after operation. However, the parameters mentioned above in groups III–V increased significantly after AHNP had been induced by experiment. They decreased continuously after treatment with drug in groups IV and V. However, Salvia Miltiorrhizae injection in group V had better improvement in hemorheological alteration than DX40 in group IV did. The results suggested that abnormality of hemorheology was an important factor to introduce the disturbance of microcirculation of pancreas during AHNP and correction of hemorheological abnormality could improve symptoms of pancreatitis.
Keywords: Hemorheology, blood viscosity, viscoelasticity of blood, pancreatitis
Abstract: In this study we further elucidate our previous hypothesis of a different pathogenesis for carotid territory transient ischemic attack (TIA) and minor stroke. Blood parameters involved in atherosclerotic complications or in rheological disorders were studied in 100 consecutive male patients, 47 with carotid territory minor strokes and 53 with carotid TIA. Whole blood viscosity was significantly higher in the patients with minor stroke than in the patients with TIA, mean 7.0 versus 6.4 cpoise (after correction for hematocrit, p<0.025), whereas we found no difference in plasma viscosity. The values of glycosylated hemoglobin, 5.05 vs 4.40 % of total Hb (p<0.0001)…were higher in the minor stroke group and the platelet count, 250 vs 192×109 /l (p<0.0001) was significantly lower in the TIA group than in the minor stroke group. These findings strengthen our former hypothesis that the pathogenesis of carotid TIA and minor stroke may frequently be different.
Keywords: TIA, minor stroke, viscosity, platelet count, glucose
Abstract: In order to evaluate changes in the rheological properties of whole blood during the first days of extrauterine life, determinations of flow rate were carried out in 22 healthy full term newborn infants with weight appropriate for gestational age. At birth and on 4th day of life, flow rate was measured by the method of Reid et al. along with Ht, MCV, MCH, MCHC, Hb content, WBC, RBC and platelet count, plasma fibrinogen and the activities of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), catalase (CAT) and glutathione-reductase (GR), the main erythrocyte oxygen radical scavenger enzymes. Erythrocyte flow rate was significantly…lower on 4th day than in cord blood. Fibrinogen plasma content significantly increased from birth to the 4th day and no significant differences were detected in the other data with the exception of MCV, which was higher in cord blood. GSH-Px values in cord and 4th day blood correlated positively with flow rate. A multiple regression analysis between flow rate in cord blood as dependent variable and other parameters evaluated in both cord and 4th day blood revealed two significant correlations: with GSH-Px (positively in both cord and 4th day blood), with GR (negatively in cord blood). The data suggest that the red cell antioxidant system could account for the rheological properties of whole blood during the first days of life.
Abstract: In a group of stable CRF subjects, we evaluated the red cell membrane transverse fluidity gradient (obtained marking intact red blood cells with fatty acid fluorescent probes) and the total erythrocyte Ca2+ content. From the obtained results, it is evident that both these parameters discriminate the CRF subjects from normal controls. These data suggest an impairment of the erythrocyte rheology and metabolism in this disease.
Abstract: Red blood cell (RBC) deformability in chronic alcoholism has been studied, using the Cell Transit Analyzer (CTA) which provides transit times of 5000 individual RBC passing via cylindrical micropores of 5.0 μm in diameter and 15 μm in length. Blood from chronic alcoholic patients without cirrhosis was studied before and after 8 days alcohol withdrawal. The results indicate: 1) the mean transit time of the RBC population from alcoholic patients is greater than those of the control population, 2) these changes affect the entire cell population and not only a sub-population, 3) alcohol withdrawal for 8 days improved the deformability…of the most rigid cells of alcoholic patients (i.e., a slight but significant decrease of the highest percentile values of the transit time distribution).
Keywords: RBC, Deformability, Alcohol, Transit Time Analysis
Abstract: In 89 patients with acute myocardial infarction, the time course and extent of changes in whole-blood viscosity at 115 sec−1 and 5.75 sec−1 , plasma viscosity, erythrocyte aggregation and fibrinogen concentration were measured during the first week. 71 patients received thrombolytic therapy: 1.5 MU of streptokinase (n=20), 2 MU of urokinase (n=25), 30 mg of APSAC (n=26). The remaining 18 patients received placebo. Thrombolytic treatment led to a reduction in viscosity parameters beginning after 3 h and lasting for 24 to 48 hours. A comparison of the different drugs revealed that the effects of APSAC are most pronounced and…last longer (up to 72 h), whereas viscosity changes induced by urokinase - most probably dose-dependent - are only moderate. In contrast, with placebo, blood viscosity and fibrinogen increase continuously until day 7. We conclude that reduced blood viscosity may improve microcirculation in the infarcted area and thus play a protective role in acute myocardial infarction. It seems to be necessary to include blood rheology in the assessment of thrombolytic agents, since differences in the efficacy of the different drugs with respect to blood rheology may be of importance.
Abstract: The transit time of adult leukocytes through 5 μm Nuclepore membranes has been calculated for subpopulations both in isolation and in co-suspensions. The results agree with previous findings that granulocytes and lymphocytes have similar properties. In suspensions of unfractionated leukocytes these subpopulations can not be distinguished and have a mean transit time of 1.17±0.11 s at 5 cm H2 O pressure. In all cases the number of pore-blocking cells corresponds approximately to the number of monocytes, being 1.1%, 11.8% and 4.8% respectively in the granulocyte, mononuclear and unfractionated suspensions. The transit time of purified red cells and the mean transit…time for the majority of leukocytes, calculated for diluted but unfractionated blood, are 1.21±0.08 ms and 0.85±0.06 s respectively at a pressure of 10 cm H2 O. Under the same conditions, the mean transit time for isolated but unfractionated leukocytes is 0.51±0.06 s. Density centrifugation therefore seems to be an acceptable, but not essential, prerequisite to studying the filterability of human leukocytes.
Abstract: Effect of contrast media (CM) on red blood cell (RBC) filterability was studied using a newly developed nickel mesh filtration method. The impact of CM osmolality, viscosity and iodine content on RBC filterability in this system was analyzed. Under isotonic conditions, iothalamate (48 mgI/ml, 1.3 cp) and low osmolality CM, iohexol (101 mgI/ml, 1.8 cp) did not cause any changes in RBC morphology. The RBC suspension of iothalamate was more filterable than that of iohexol because of low viscosity. However, under equal viscosity (iodine content) conditions, iothalamate caused shape change and marked decreases in RBC filterability with a small increase…in viscosity (iodine content) from 1.3 cp to 1.7 cp (48 mgI/ml to 98 mgI/ml). This change in viscosity (iodine content) corresponded to a remarkable increase in osmolality from 300 mOsm/kgH2 O to 588 mOsm/kgH2 O. Under similar conditions, iohexol did not induce any discernible shape changes and resulted in a small decrease in filterability. The present study clearly showed that the osmotic effect of CM on RBC filterability is more predominant than the effects of viscosity and iodine content.
Keywords: contrast media, red cell filterability, osmolality, viscosity, iodine, iohexol
Abstract: Fourty four patients with cholesterol levels above 250 mg/dl were randomized into two groups receiving either n-3 fatty acids (3*2 capsules daily) or placebo for 24 days. Hematocrit, blood and plasma viscosity were taken at baseline, after 12 and 24 days. The results show that blood viscosity falls in both groups. The decline is faster and stronger in the n-3 supplemented group. There is no change in plasma viscosity in either group. Hematocrit falls slightly in the n-3 group. The findings confirm earlier data but are obtained with a more rigorous study design. In conclusion we feel that n-3 fatty…acids have a strong potential for normalizing blood rheology and should be tested clinically under this aspect.
Keywords: n-3 fatty acids, fish oil, blood viscosity, diet, hemorheology
Abstract: An erythrocyte control preparation for quality assurance purposes would be of considerable value in rheological studies of erythrocyte filterability (deformability). Normal human erythrocytes stored at 4°C in citrate-phosphate-dextrose or saline-adenine-glucose-mannitol appeared to be rheologically stable for 4 weeks when tested using the Hemorheometre or Cell Transit Analyser but, after 2–3 weeks' storage, an increasing sub-population of pore clogging erythrocytes was detected by the St. George's Filtrometer. In contrast, a commercial preparation of stabilised human red blood cells (Coulter SH-RBC) was found to be more stable rheologically, as tested by all three instruments, for up to 6 weeks and thus has…potential as a rheological control preparation.
Abstract: Coronary resistances of dogs with normal coronaries were measured before and after the hematocrit values were increased by exchange transfusion of packed red blood cell suspensions. Coronary resistances increased about 9% in this group. In a second group of dogs, experiments were performed after the coronary arteries were critically stenosed. The changes in coronary resistances were more prominent in the critical stenosis group. Blood viscosity measured at a hematocrit of 45% and erythrocyte deformability indexes were also increased in the coronary sinus blood after the exchange transfusion of packed cells. These findings imply that there is a close relationship between…the rheologic properties of blood and coronary circulation. This relationship may include a positive feed-back, which will result in detrimental etTects on blood rheologic parameters.