Clinical Hemorheology and Microcirculation - Volume 18, issue 2,3

Authors: Firsov, N.N. | Bjelle, A. | Korotaeva, T.V. | Priezzhev, A.V. | Ryaboshapka, O.M.

Article Type: Research Article

Abstract: Aggregation and disaggregation kinetics of erythrocytes in samples of whole blood were studied using a backscattering nephelometry technique. Blood was drawn from normal subjects and from patients suffering from different diseases: chronic glomerulonephritis, systemic lupus erythematosus, hereditary hypercholesterolemia, pulmonary hypertension, intestinal tumors preoperatively (age > 60 years), psoriasis, psoriatic arthritis, ischemia and ischemia with diabetes. Blood samples of healthy donors were used as controls. The backscattering signal in the erythroaggregometer was processed according to algorithms yielding quantitative data on the full amplitude of aggregation, characteristic times of spontaneous aggregation, average hydrodynamic strength of all aggregates and, whenever possible, additionally, …strength of the largest aggregates. The obtained results confirm that the complexity of erythrocyte aggregation kinetics requires multiparametric description which, when applied to clinical material, enables the differentiation of aggregation characteristics between diseases. Show more

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 87-97, 1998

Authors: Mangalani, M. | Lokeshwar, M.R. | Banerjee, R. | Nageswari, K. | Puniyani, R.R.

Article Type: Research Article

Abstract: Beta thalassemia major is an inherited impairment of haemoglobin structure, in which there is partial or complete failure to synthesize a specific type of globin chain. The study was undertaken to assess the hemorheological changes in beta thalassemic major patients. We studied hemorheological parameters in thalassemic patients (n=37 ) immediately after blood transfusion. The parameters studied were whole blood viscosity (WBV), plasma viscosity (PV), red cell rigidity (RCR) and hematocrit (Hct). Blood samples from age‐ and sex‐matched normal controls were also analysed for comparison. Statistical analysis was done using Student’s t ‐test and p values were …recorded. The results showed a significant decrease in level of WBV and Hct in patients when compared to normal controls. However, the red cell rigidity was higher when compared to normal controls. Increase in RCR should show an increase in WBV. But in our study cases there was a significant decrease in WBV which was probably due to the significant decrease in level of hematocrit. Show more

Keywords: Thalassemia, blood viscosity, red cell rigidity

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 99-102, 1998

Authors: Langer, R. | Jordan, U. | Wölfle, A. | Henrich, H.A.

Article Type: Research Article

Abstract: Studies were carried out on the effects of different doses of hydroxyethyl starch 200/0.5 (HES) on plasma clotting factors in dogs, as an animal model for the human clotting system. In 8 German shepherd dogs 15% of the total blood was isovolemically substituted either by Ringer’s solution with lactate alone (controls) or with 0.6, 1.3, 1.9, 2.5 g HES/kg b.w. Immediately after the infusion, the HES concentration in the recipients’ plasma amounted to 8 mg/ml up to 38 mg/ml. In the following 6 h, the HES decreased to 25% in each case. It was found that the higher the plasma …HES content was, the lower the haematocrit. Neither the thrombin‐ nor the batroxobin‐time showed any significant change, irrespective of the plasma HES concentration. The prothrombin‐time was decreased directly after the infusion in parallel to the haematocrit. The single clotting factors FI, FII, FV, FVII, FVIII, FX, and FXII behaved approximately in the same way: their activities directly after infusion, but also 6 h later, were lowered in proportion to the amount of HES infused. The loss of factor activity correlated with the volume‐expanding effect of HES shortly after the infusion, but not 6 h later. It is concluded that there are two different modes of HES action on clotting factors: the dilution by plasma volume expansion and a non‐dilutional action. Cautious handling might be required in patients with clotting disturbances as well as in long‐term treatment. Show more

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 103-116, 1998

Authors: Peng, Jian | Liao, Fu‐long | Yin, Xiao‐jie

Article Type: Research Article

Abstract: According to Hanss’s initial‐flow rate method, F. Liao designed a new cell filtrometer in the early 1990s. The parameters, cell initial transit time (T_{\rm c} ) and membrane clogging rate (CR), can be determined by a single measurement with timing accuracy of 1 ms. The new cell filtrometer has two valuable features: a button‐pushing operation to control electromagnetic valves; and an autocirculation of fluid in the cell filtrometer resulting in the same volume of leading fluid. A series of comparisons of the new filtrometry with viscometry or ektacytometry shows that the instrument seems to be more sensitive in detecting …subpopulations of glutaraldehyde‐hardened cells and the shift of deformability for all the cells. The reproducibility of the filtrometer for different membranes made in China and the USA is reasonable ({\rm CV}<5 % for T_{\rm c} ). Preliminary application of the filtrometer indicates that it might be useful for trial study and routine clinical application. Show more

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 117-124, 1998

Authors: Cai, Shaoxi | Wu, Zezhi | Zhou, Jihong | Yin, Zhiyong

Article Type: Research Article

Abstract: Considering the Fåhraeus effect and the blood volume regulation role of the microcirculation, we used a new method for calculating the blood volume change in microcirculation, macrocirculation as well as the whole circulation (\Delta V_{{\rm mic}} , \Delta V_{{\rm mac}} , \Delta V_{{\rm b}} ), to compare fluid therapy effects of hypertonic saline dextran solution (HSD) and lactic Ringer’s solution at the early stage after burn–blast combined injury (BBI). The measurement of plasma viscosity was used in this calculation. The results showed that, with calculation of the blood volume change in microcirculation and macrocirculation, this method could …more exactly and distinctly display the change and distribution of blood volume during the therapy. It confirms that HSD treatment can increase blood pressure and attenuate tissue edema, by significantly increasing total blood volume, recouping \Delta V_{{\rm mac}} . The study suggests that a desirable and practical clinical method for blood volume change can be developed based on the present study. Show more

Keywords: Blood volume, microcirculation, burn–blast combined injury, macrocirculation, plasma viscosity, Fåhraeus effect

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 125-133, 1998

Authors: Sargento, L. | Zabala, L. | Saldanha, C. | Souza‐Ramalho, P. | Martins e Silva, J.

Article Type: Research Article

Abstract: Sodium fluorescein angiography is a widely used routine ophthalmological diagnostic procedure which enables the study of chorioretinal microcirculation and consists of the injection of sodium fluorescein into the systemic bloodstream. The aim of the present study was to evaluate whether or not fluorescein interferes with erythrocyte properties during the angiographic procedure. In a group of 37 patients, 26 with non‐insulin‐dependent diabetes mellitus (DM) with and without retinopathy, and 11 without diabetes mellitus (non‐DM) although affected by other ophthalmological diseases, all undergoing routine angiography, blood samples were drawn before (T_0 ) and 30 min (T_{30} ) after …fluorescein injection. The erythrocyte aggregation index (EAI), membrane lipid fluidity and erythrocyte acetylcholinesterase activity were determined in both groups. After fluorescein injection there was no statistical change in EAI and erythrocyte membrane fluidity in either group. Erythrocyte acetylcholinesterase activity, a marker of membrane protein integrity, decreased significantly (p<0.01 ) in the DM group. Membrane lipid fluidity did not change with fluorescein injection, however, (i) in the DM group erythrocyte membranes became more rigid than in the non‐DM (DPH: p<0.01 ); (ii) EAI and membrane lipid fluidity became significantly correlated (r= 0.6263 , p<0.05 ) in non‐DM patients at T_{30} . In conclusion, fluorescein administration for angiographic procedures seems to interact with erythrocyte membrane, namely, in diabetic patients, which may interfere with the blood flow in the microcirculation. Show more

Keywords: Sodium fluorescein angiography, erythrocyte acetylcholinesterase, erythrocyte membrane fluidity, erythrocyte aggregation, diabetes mellitus

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 135-139, 1998

Authors: Turchetti, Vera | Leoncini, Francesca | De Matteis, Caterina | Trabalzini, Luca | Guerrini, Maurizio | Forconi, Sandro

Article Type: Research Article

Abstract: The aim of our study was to evaluate the erythrocytic morphology in vascular patients, with or without diabetes, showing cell alterations correlated to blood viscosity and intra‐erythrocytic calcium. We studied 108 subjects: 20 normal subjects, 58 vascular patients (25 suffering from CHD, 19 from CVD, 14 from POAD) and 30 non‐insulin‐dependent diabetes patients with vascular disease in metabolic compensation (13 CHD, 9 CVD, 8 POAD). Erythrocytic morphology, blood viscosity and intra‐erythrocytic calcium were evaluated. Our results show that bowls, the most deformable red cells, decreased significantly in vascular patients and in POAD diabetics, while the discocytes, having a stiffer form, …greatly increased in subjects suffering from ischemic disease and in POAD diabetics. The altered red cells (echinocytes and knizocytes) reached a statistical significance in CVD and POAD diabetics. Comparing the percentage of discocytes to intra‐erythrocytic calcium content in vasculopathic subjects, we obtained a significant correlation. No evidence of a relationship between discocytes and blood viscosity was found, even if blood viscosity significantly increased in patients affected by ischemic disease. These results suggest that ischemia decreases the deformability of red cells which is supported by the study of red cell morphology, by the erythrocytic morphology index (EMI), which becomes < 1, and by the evaluation of cytosolic calcium content. Show more

Keywords: Vascular disease, diabetes, erythrocytic morphology, intra‐erythrocytic calcium, blood viscosity

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 141-149, 1998

Authors: Tozzi‐Ciancarelli, M.G. | Di Massimo, C. | Ascani, G. | Corbacelli, A.

Article Type: Research Article

Abstract: A short‐term in vitro experimental study was performed to analyze the effects of metallic miniplates used in maxillo‐facial rigid internal fixation on some functional features of human erythrocytes that represent a pivotal rheological component for correct blood flow in the tissular area surrounding metallic implants. In our working conditions, no interference on osmotic fragility, intracellular ATP content and spontaneous hemolysis was observed. Conversely, a statistically significant increase of rigidity in the deeper lipid region of erythrocyte membrane was verified. On the basis of our results, the in vitro erythrocyte modifications after 18 h of whole blood/metallic device contact are relatively …small and negligible. Show more

Keywords: Metallic miniplates, erythrocyte membrane fluidity, oxidative process

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 151-156, 1998

Authors: Li, Xiulian | Wang, Li Juan | Tang, Ning | Yue, Hesheng | Huang, Youtian | Lu, Jiesheng | Wang, Baisheng

Article Type: Research Article

Abstract: The isovolumetric hemodilution treatment reduces ischemic injury and anti‐radical interventions may reduce reperfusion injury. However, the effects of the treatment with both interventions have never been investigated. In the present study, anesthetized rabbits underwent 45 min of coronary artery ligation, which was followed by 180 min of reperfusion. Ten animals in each group received: (i) normal saline only; (ii) isovolumetric hemodilution with Dextran 40 during ischemia; (iii) superoxide dismutase (SOD) 1 min before and during reperfusion; and (iv) combined treatment with hemodilution and SOD. Results: (1) compared with those of the control group, left ventricular peak pressure (LVP) and \pm …{\rm d}p/{\rm d}t ‐max improved significantly in the animals which received hemodilution or SOD alone, and left ventricular systolic function of the animals with the combination therapy improved further; (2) infarct size averaged 54.4\pm 2.6 % of the risk region in controls and was significantly smaller in the rabbits that were treated with hemodilution (32.8\pm 1.8 %) (p<0.05 ), with SOD (42.1\pm 3.2 %) (p<0.05 ) and with the combination therapy (23.4\pm 1.5 %) (p<0.01 ). Therefore, (1) in groups where either hemodilution during ischemia or removal of oxygen radicals during reperfusion was done left ventricular systolic function and salvaged ischemic reperfused myocardium improved significantly; (2) in this acute model, SOD improved left ventricular systolic and diastolic functions and reduced infarct size further when given to the animals that had been treated with hemodilution. Show more

Keywords: Myocardial reperfusion injury, hemodilution, Dextran 40, superoxide dismutase

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 157-163, 1998

Authors: Bilto, Yousif Y. | Abdalla, Shtaywy S.

Article Type: Research Article

Abstract: The effects of 8 selected flavonoids on deformability, osmotic fragility and dextran‐induced aggregation of human erythrocytes were studied. The following flavonoids were found to protect against loss of filterability (deformability) through 5 \mu m diameter pores of erythrocytes dehydrated with calcium ionophore A23187 (1.9 \mu mol/l): apigenin\,>\, quercetin\,>\, cirsimaritin\,>\, rutin\,>\, luteolin\,>\, chrysoeriol‐4' ‐O‐glucoside\,>\, 3,5,7‐trihydroxy 4' ‐methoxy flavone 7‐rutinoside, whereas \beta ‐naphtho flavone enhanced the loss of filterability. When the potassium ionophore valinomycin (18 \mu mol/l) was used to induce cell dehydration, the order of potency of the flavonoids …in protecting against loss of filterability was apigenin > cirsimaritin = chrysoeriol‐4' ‐O‐glucoside\,>\, 3,5,7‐trihydroxy 4' ‐methoxy flavone 7‐rutinoside\,>\, luteolin{}={} rutin\,>\, quercetin, whereas \beta ‐naphtho flavone again enhanced the loss of filterability. All flavonoids reduced ESR measured over 1 h except for 3,5,7‐trihydroxy 4' ‐methoxy flavone 7‐rutinoside which showed no effect, and for quercetin which significantly enhanced ESR. All flavonoids also improved erythrocyte osmotic fragility except for apigenin which significantly increased osmotic fragility. These effects were explained in terms of the number and location of hydroxyl groups on the basic skeleton of flavone. The results suggest that the presence of an OH on C5 is essential for the described rheological effects of these flavonoids. Show more

Keywords: Erythrocyte deformability, erythrocyte osmotic fragility, ESR, flavonoids

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 165-173, 1998

Authors: Mellinghoff, Achim C. | Reininger, Armin J. | Wurzinger, Laurenz J. | Landgraf, Rüdiger | Hepp, K. Dietrich

Article Type: Research Article

Abstract: Simultaneous pancreas and kidney transplantation (PKT) is associated with a deterioration of hemorheology. We investigated the determinants of plasma and blood viscosity (hct. 35%) after PKT (n=49 ), in type 1 diabetes (n=26 ) and in healthy controls (n= 24). Patients after PKT were subdivided due to their graft function (intact pancreas and kidney graft, n=26 ; pancreas rejected, intact kidney graft, n=23 ). We examined the correlations of total serum protein, albumin, fibrinogen, \alpha _2 ‐macroglobulin, total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides with plasma and blood viscosity (hct. 35%) measured at …a continuous shear range of 600–0.2 s^{-1} with a rotational viscometer (Haake, Germany). Total protein was strongly associated with plasma viscosity in all examined groups (r>0.5 , p<0.03 ), it determined blood viscosity over the whole shear range in type 1 diabetic patients, but only at high shear rates after PKT (\scriptstyle \geqslant 100 s^{-1} ). The strong association of albumin and blood viscosity in type 1 diabetes and in healthy controls (shear rates \scriptstyle \geqslant 10 s^{-1} ) was not found after PKT. Fibrinogen correlated with plasma and blood viscosity (\scriptstyle \geqslant 25 s^{-1} ) after PKT (p<0.03 ) but not in type 1 diabetic patients or healthy controls. \alpha _{2} ‐macroglobulin correlated with plasma and high shear blood viscosity after PKT only after pancreas rejection, no correlation was found after successful PKT. It also correlated with plasma and blood viscosity at low and high shear rates in type 1 diabetes. Total cholesterol and low shear blood viscosity correlated positively in successfully transplanted patients (r>0.44 ), but negatively after pancreas rejection (r> - 0.44 ). No correlation was found in type 1 diabetic patients, a positive association was found in healthy controls for plasma and low shear blood viscosity. LDL cholesterol correlated negatively (after pancreas rejection) or positively (healthy controls) with low shear blood viscosity (p<0.03 ) and positively with plasma viscosity. HDL cholesterol was negatively associated with high shear blood viscosity in all groups (p<0.05 ), except after successful PKT, where no association was found. It did not correlate with plasma viscosity in any group. Triglycerides did not contribute significantly to blood viscosity in the examined groups. The metabolic alterations after PKT influence plasma proteins, lipids and corpuscular elements of blood with regard to their effect on rheology. Show more

Keywords: Simultaneous pancreas and kidney transplantation, viscosity

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 175-184, 1998

Authors: Muravyov, A.V. | Zaitsev, L.G. | Muravyov, A.A. | Yakusevich, V.V. | Sirotkina, A.M.

Article Type: Research Article

Abstract: In this study, the effect of the angiotensin‐converting‐enzyme inhibitor (ACE inhibitor) Ramipril (5 mg/day) and calcium antagonist Isradipin (5 mg/day) treatment of two groups of hypertensive patients (n=22 in each of group) was evaluated. The parameters of the hemorheological profile (blood and plasma viscosity, red blood cell aggregation and deformation, plasma protein concentration and its osmolality, hematocrit and ratio of Hct/blood viscosity) were measured in basal conditions (before treatment) and after 3 weeks of treatment. The patients showed some increased blood, plasma viscosity, RBC aggregability and fibrinogen concentration in basal conditions. In both groups of patients, three main …parameters of the hemorheological profile (plasma viscosity, Hct and RBC aggregation) decreased after treatment. No significant changes in red cell deformability was found. In conclusion, ACE inhibition with Ramipril and calcium channel blocking with Isradipin lead to a moderate improvement of blood rheology in patients with hypertension. This may be explained by the pronounced vasodilatatory effect of ACE inhibitor and calcium antagonist, though their acting mechanism is different. Show more

Keywords: Arterial hypertension, hemorheological profile, angiotensin‐converting‐enzyme inhibitor, calcium antagonists

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 185-190, 1998

Authors: Rosenson, Robert S. | Tangney, Christine C.

Article Type: Research Article

Abstract: Reliable plasma viscosity measurements are required for cardiovascular risk factor assessment. This study was designed to examine the influence of tourniquet pressure and duration on plasma viscosity measurement with a coaxial cylinder at 37{}^\circ C. Plasma viscosity was evaluated at low (40 mm Hg) and high (mean arterial blood pressure plus 10 mm Hg) tourniquet pressure and at two time intervals following (0–1 and 4–5 min) of tourniquet application in 38 healthy adults. Longer duration of tourniquet application was accompanied by a significant increase in plasma viscosity at both low (1.356{}\pm{} 0.067 mPa s versus 1.393{}\pm{} …0.067 mPa s (p= 0.0001 )) and high (1.321{}\pm{} 0.071 mPa s versus 1.430{}\pm{} 0.086 mPa s (p= 0.0002 )) tourniquet pressures. Plasma viscosity values were not influenced by the magnitude of tourniquet pressure. The accuracy of plasma viscosity measurements can be improved by sample acquisition within 1 min following tourniquet application. Show more

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 191-194, 1998

Authors: Caimi, G. | Canino, B. | Montana, M. | Lo Presti, R.

Article Type: Research Letter

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 195-197, 1998

Article Type: Abstract

Citation: Clinical Hemorheology and Microcirculation, vol. 18, no. 2,3, pp. 199-234, 1998