Clinical Hemorheology and Microcirculation - Volume 16, 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.
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: Differences in filtration between RBC's from diabetics and normal subjects were readily detected with nickel filters but not using polycarbonate filters. Parallel measurements using the CTTA demonstrated that although the mean transit time of diabetic and normal cells was similar the more rigid cells within the samples from diabetics were significantly less deformable. This suggests that the abnormalities detected by nickel filters were due to a sub-population of less deformable cells rather than an abnormality of diabetic cells as a whole. In a further study where increasing numbers of glutaraldehyde hardened cells were added to normal red cell samples the…CTTA instrument showed that 10% of hardened cells could be detected without any change being shown in the mean transit time. At this level the nickel filter was much more sensitive than the Nucleopore filter at detecting the sub-population of hardened cells. Taken together these data support the hypothesis that diabetics have a small circulating sub-population of rigid red cells that can be readily detected using nickel filters.
Abstract: Patients suffering from one or more of the cardiovascular occlusive diseases have an increased risk of intraoperative thromboembolic or ischemic complication. Hemorheological factors may influence the risk of occurence of these complications. We tested in a prospective study the impact of preoperative mental stress on hemorheological parameters of 22 patients undergoing surgery without cardiovascular disease, compared to a group of 10 healthy probands without imminent operation. We measured endocrinological stress parameters, hematocrit, plasma viscosity, and plasma protein composition the evening before the observed night and the morning before the operation took place. The overnight reduction in stress parameters seen in…the probands was not present in the patients. Consequences of this different stress response include a statistically significant increase in hematocrit and plasma viscosity in the patients mainly resulting from a shift of fluids out of the intravascular space. We conclude that the rheological parameters might deteriorate during the preoperative period in patients with increased risk of cardiovascular problems.
Abstract: We measured the platelet activation and the rate of erythrocyte aggregation simultaneously employing venous blood from 31 patients with cerebral infarction during the acute phase (less than 7 days after onset) and 73 patients with cerebral infarction during the chronic phase (more than 1 month after onset.). The degree of platelet activation was estimated from the levels of plasma beta-thromboglobulin (BTG), platelet factor 4 (PF4), and thrombospondin (TSP). The erythrocyte aggregation rate was examined using the whole-blood erythrocyte aggregometer developed by us (Am. J. Physiol. 251, H1205-H1210, 1986) with concomitant measurement of the fibrinogen concentration. The mean values of the…erythrocyte aggregation rate, plasma BTG, PF4, TSP and fibrinogen concentration at the acute phase of cerebral infarction were statistically significantly (P<0.05) higher than those at the chronic phase of cerebral infarction or in the control group. Multiple regression analysis revealed that fibrinogen, BTG and TSP were main factors contributing to the enhanced erythrocyte aggregation rate at the acute phase of cerebral infarction, but fibrinogen was the sole contributing factor at the chronic phase of cerebral infarction. We conclude that the platelet activation, erythrocyte aggregation rate and fibrinogen concentration were closely correlated with each other in patients with cerebral infarction during the acute phase.
Abstract: Erythrocyte membrane lipids, ATPase activities, blood cell parameters and hemorheological changes were measured in 51 patients with acute cerebral infarction, 12 patients with arteriosclerosis and 51 normal controls. A decrease in erythrocyte deformability, ATPase activities and an increase in CHO/PL ratio and viscosity at high shear rate were observed in stroke patients in which a significant difference was found compared with that of the control group. Multivariate regression analysis indicated that membrane lipids, ATPase activities, CHO/PL ratio viscosity at high shear rate had linear correlation with erythrocyte deformability. The coefficient of multiple correlation was 0.8937. These findings suggested that…the erythrocyte membrane lipid composition and ATPase activities change significantly in stroke patients. These may be the cause of hemorheological disturbance. These changes existed before the occurrence of the stroke. So it is important to treat the circulation disorder in arteriosclerosis patients to prevent the cerebral infarction. The adoption of treatment with drugs for improving microcirculation and ion transport may be of benefit in the recovery from a stroke. We concluded from our study that CHO/PL could be a feature of arteriosclerosis or strokes, and ATPase activities may serve as an early indication of the patient's state.
Abstract: Erythrocyte deformability was determined in 21 adult patients (13 males and 8 females) suffering from familial hypercholesterolemia (FH) and in a well matched control group by means of the erythrocyte elongation index (EEI) in a Rheodyn SSD (Myrenne, Roetgen Germany) shear stress diffractometer at eight different shear stresses ranging from 0.30 to 60 Pa. The results show that at high shear stress forces of 6, 12, 30 and 60 Pa, FH patients had lower EEI values than the control group: 41.05 ± 2.97 % vs 43.46 ± 2.31 %; 48.21 ± 3.06 % vs 50.48 ± 1.71 %; 52.95 ±…2.60 % vs 55.51 ± 2.04 %; 54.73 ± 2.45 % vs 57.46 ± 2.71 %; all these differences were statistically significant (p<0.01). No statistical differences were observed between the two groups at low shear stresses. No correlation was found between EEI and hematimetric or lipidic parameters. This finding is in agreement with our previous data on decreased red cell deformability in hypercholesterolemic patients determined by filtrometric techniques. The decreased elongation index of erythrocytes could cause a deterioration in blood flow conditions and thus favor ischemic events in these patients.
Abstract: In a group of subjects with vascular atherosclerotic disease (VAD) and in a group of normal controls we evaluated, at baseline and after in vitro chemotactic activation (prolonged for 5 and 15 min) with two stimulating agents (PMA and fMLP), the polymorphonuclear (PMN) filtration parameters, PMN membrane fluidity and PMN cytosolic Ca2+ content. We determined the PMN filtration parameters using the St. George's Filtrometer and considering respectively the initial relative flow rate (IRFR) and the clogging particles (CP), the PMN membrane fluidity, employing the fluorescent probe TMA-DPH, and the PMN cytosolic Ca2+ content adopting the fluorescent probe Fura…2-AM. In normals and in VAD subjects, after PMN activation with PMA and fMLP, a significant variation was evident in all filtration parameters at 5 and 15 min; no important variation was present in PMN membrane fluidity and in PMN cytosolic Ca2+ content. Between normals and VAD subjects no difference was evident regarding the trend of PMN filtration parameters, PMN membrane fluidity and PMN cytosolic Ca2+ content.
Abstract: The microcirculation within and oxygen availability to peripheral tissues are of importance during anesthesia. Hemorheology, the study of the flow behaviour of blood, is an inherent component of this subject. The objective of this study was to investigate the effects of propofol on hemorheological parameters including hematocrit, blood viscosity, plasma viscosity and erythrocyte deformability. In vitro, propofol, nor Intralipid 10%, which closely resembles its vehicle, exhibited any statistically significant effect on erythrocyte deformability. In the in vivo comparison between two groups of ASA I patients undergoing minor orthopedic surgery, anesthetized with either propofol or nitrous oxide/isoflurane, both showed a decreased…hematocrit and whole blood viscosity. A trend of increased erythrocyte deformability was observed in the propofol group only, which however was not statistically significant. In conclusion, the hemorheological effect of propofol appears to be largely comparable to nitrous oxide/Isoflurane in young healthy patients undergoing minor orthopedic surgery.
Keywords: hemorheology, blood viscosity, erythrocyte deformability, anesthesia, surgery
Abstract: Authors studied modifications of the red blood cells arteriolar velocity (RBcAV) in the conjunctival capillary network in diabetic subjects with alterations of red blood cell (RBc) aggregation and of whole blood viscosity (WBV). WBV, RBc aggregation and RBcAV were studied in diabetics with foot ulceration, with healed ulcer, and in controls. RBcAV, RBc aggregation and WBV resulted statistically different between diabetics with and without plantar perforation, and between diabetics and controls. A significant reduction (p<0.05) of RBcAV was found in patients with foot perforation compared to diabetic subjects with recovered foot ulcer, and in the group of diabetic patients as…a whole (p<0.05) compared with controls. In a similar way we found a significant increase (p<0.05) of the erythrocyte aggregation, fibrinogen, and WBV in diabetics with ulcer compared with those without this complication and in diabetic patients (p<0.05) considered altogether compared with controls. A reduction of RBcAV was found associated with an increase of Rbc aggregation and WBV in diabetic patients. A decreased arteriolar diameter was found in diabetic patients in comparison with control subjects.We conclude that modifications of RBC aggregation, fibrinogen, and WBV occur in diabetic ulcer patients.These modifications are associated in diabetic patients with arteriolar flow modifications, and can be documented in the conjuctival microcirculation.
Abstract: In order to find out whether hemorheological alterations precede the atherosclerotic lesions in familial hypercholesterolemia (FH), we studied the lipidic and hemorheological profile of 40 children (18 males and 22 females) with heterozygous FH but without vascular atherosclerotic lesions demonstrable on a carotid ultrasound doppler-duplex, and in a well-matched control group. When compared with the control group FH children showed increased erythrocyte aggregation both at stasis (EAM0 ) (4.9 ± 1.1 vs 3.6 ± 1.0) and at low shear rate (EAM1 ) (8.1 ± 1.4 vs 6.9 ± 1.4; p<0.001), and increased plasma viscosity (PV) (1.20 ± 0.07 vs 1.16…± 0.04; p<0.01). Other rheological parameters determined, fibrinogen (Fbg) and blood viscosity (BV), did not show any statistical differences. The fact that erythrocyte aggregation and plasma viscosity are increased in FH children, even without any concomitant statistical increase in fibrinogen, suggests that the dyslipemia itself can contribute to the rheological alterations. On the other hand, the fact that the above mentioned alterations appear prior to the development of the vascular lesion suggests that they could favour the development of the atherosclerotic process.
Abstract: Attention has been paid to the relationship between hypertension and hemorheology by several authors and their results showed that hypertension was associated with altered blood viscosity. The previous reports were empirically from one or several points of blood viscosity under different shear rates. Can we consider the pathogenesis from the whole curve of blood viscosity versus shear rate? Our aims are to use new concepts to reveal hemorheological properties and to analyze the pathological changes for essential hypertension by a Casson equation which summarize the whole curve of blood viscosity versus various shear rate. We use two parameters which are…derived from Casson equation and regressed from all the data of shear stress and shear rate, i. e. Casson yield stress and Casson viscosity, to describe the hemorheological changes for 139 cases of hypertension patients. Our results showed that: 1) The total patients show increase of the two Casson parameters, especially for female patients; 2) Essential hypertension in the early stage may be not closely connected to Casson parameters; 3) When essential hypertension begins to complicate with cerebral and coronary heart diseases, or some other diseases, the patients show remarked changes in the two Casson parameters, especially for Casson yield stress; 4) Yield stress may be the best parameter to show abnormality in hemorheology, and Casson viscosity is also good to show the abnormality in hemorheology; 5) Yield stress and Casson viscosity are proportionally correlated to hematocrit and plasma viscosity, especially for the yield stress.