Clinical Hemorheology and Microcirculation - Volume 21, issue 3-4

Authors: Izzo, P. | Manicone, A. | Spagnuolo, A. | Lauta, V.M. | Di Pasquale, A. | Di Monte, D.

Article Type: Research Article

Abstract: The erythrocytes deformability of three blood samples coming from healthy donors has been evaluated by Laser‐assisted Optical Rotational Cell Analyzer (LORCA). Blood samples were stored in CPD SAG‐mannitol. The study of progressive reduction in the Elongation Index (EI) during the preservation may be used as way of evaluation of erythrocyte vitality in stored blood samples.

Keywords: Erythrocytes deformability, LORCA, storage of red cells, CPD SAG‐mannitol

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 335-339, 1999

Authors: Ciccone, M. | Pestrichella, V. | Rossi, O. | Maiorano, A. | Modugno, M. | De Pergola, G. | Giorgino, R. | Rizzon, P.

Article Type: Research Article

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 341-342, 1999

Authors: Cicco, G. | Dolce, E. | Vicenti, P. | Stingi, G.D. | Tarallo, M.S. | Pirrelli, A.

Article Type: Research Article

Abstract: In postmenopausal hypertensive women (PostMHW) the erythrocyte deformability (ED) is reduced if compared with premenopausal hypertensive women (PreMHW). This might partially explain the increased incidence of cardiovascular diseases (CD) in hypertensive women after menopause. Moreover a positive correlation exists between estradiol and rheological patterns in women. If PostMHW smoke cigarettes, there is an important decrease in hemorheological parameters. On the other hand if PostMHW are submitted to an hormonal replacement therapy (HRT) they can show controversial results with an impairment if hemorheological parameters. The aim of this study was to evaluate the influence of smoking and HRT on PostMHW. …We studied four groups of subjects: Group 1: PreMHW (10 F aged 35{}\pm{} 3 years) non smokers; Group 2: PostMHW (8 F aged 45{}\pm{} 2 years) non smokers; Group 3: PostMHW (14 F aged 48{}\pm{} 4 years) smokers (20 cigarettes per day); Group 4: PostMHW (16 F aged 50{}\pm{} 2 years) smokers (20 cigarettes per day) submitted to HRT. We evaluated Elongation Index of erythrocytes under torsion force of 30 pascals (EI – 30 Pa) using a new computerized instrument Laser assisted Optical rotational Red Cell Analyzer (LORCA) (Mechatronics, Hoorn, NL) acc. to Hardeman (1994) and, also with the same LORCA, Aggregation Index (AI), t. We measured the transcutaneous oxygen partial pressure (TcpO_{2} ) in subclavicular standard area using a Transcutaneous Oximeter (Microgas 7650 Kontron Instruments with Combi Sensor) and total cholesterolaemia. In PostMHW our data showed a significant (p<{} 0.01) impairment of hemorheological patterns and tissue oxygenation if compared with PreMHW (Group 1). In Group 3 there is a significant (p<{} 0.01) decrease in EI, a significant (p<{} 0.01) increase in AI, a significant (p<{} 0.01) decrease in t and TcpO_{2} if compared with Control Group 1 and Group 2. Finally a further significant (p<{} 0.01) impairment in hemorheology and tissue oxygenation showed Group 4. In conclusion, it seems necessary, that many studies will be performed to understand really protective action of HRT on cardiovascular diseases in PostMHW and it is necessary to suppress cigarette smoking to prevent cardiovascular complications in these patients. Show more

Keywords: Hemorheology, menopause, hormonal replacement therapy, LORCA

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 343-347, 1999

Authors: Vetrugno, Michele | Gigante, Gaetano | Cardia, Luigi

Article Type: Research Article

Abstract: Purpose: to assess the effects on choroidal perfusion of scleral buckling and vitrectomy procedures for retinal detachment. Methods: 17 patients were included in the study: 7 underwent scleral buckling and 10 vitrectomy, for rhegmatogenous retinal detachment. pOBF Langham system evaluation was performed before and after surgery (the fellow eye served as control). Statistical analysis was based on paired t ‐test. Results: in the scleral buckling group was found a mean change (SD) of 470 (355.32) \mu l/min; in the vitrectomy group the mean difference (SD) was 254.2 (132.53) \mu l/min. In both groups a statistically …significant difference with the control was found. Conclusions: our results show that both surgical procedures affect choroidal perfusion and could impair optic nerve head feeding. Show more

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 349-352, 1999

Authors: Pollari, G. | Antonini, V. | Izzo, A. | Moreschini, G. | Serraino, M. | Tonelli, V. | D’Angiolino, A. | Migliaccio, M.

Article Type: Research Article

Abstract: In chronic respiratory insufficiency secondary erythrocytosis (SPC), causing pulmonary hypertension and dx ventricular insufficiency, is often noticed. An alternative therapy to phlebotomy for SPC is isovolemic large volume erythrocytapheresis performed with cell separator (CSE) in order to quickly remove a large volume of red blood cells (RBC) while saving plasma proteins and clotting factors. In order to evaluate the efficiency and safety of CSE in SPC we reported a retrospective analysis of our experience with 61 SPC patients: from April 1996 to May 1998 we performed 208 CSE using Haemonetics MCS3P (TAE protocol). Before every apheresis procedure we verified Hb …(in median 18.8 g/dl), Ht (in median 58.4%), viscometry, coagulation test, EGA, PFR and ECG. 11 patients were treated with 1 CSE, 12 with 3, 29 with 4 and 9 with 5. The mean volume of RBC removed was 576 ml (range 426–800); Hb post CSE averaged 14.4 g/dl and Ht post CSE averaged 42.7%; hematic viscosity post CSE was significantly reduced while tissue oxygen tension increased: the improvement of symptomatology and hematochemical parameters was maintained on the average for 6.5 months. All the procedures were well tolerated and light side effects (paresthesias citrate‐depending in 27 apheresis) were easily controlled. CSE, compared to phlebotomy, has the advantage of selectively removing RBC without loss of clotting factors, platelets and plasma proteins. Although CSE has relatively high costs we noticed a decrease of hospital recurrence (about 50–65%) in SPC patients treated with apheresis. Show more

Keywords: Erythrocytapheresis, polycythemia, chronic obstructive pulmonary disease, viscometry

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 353-355, 1999

Authors: Kameneva, M.V. | Watach, M.J. | Borovetz, H.S.

Article Type: Research Article

Abstract: According to official statistical data there is a significant difference between pre‐menopausal women and age‐matched men in morbidity and mortality from cardiac diseases and especially from myocardial infarction. There are several speculations regarding the nature of this phenomenon which have both supporting and refuting evidence. Our hypothesis was that due to regular physiologic bleeding, rheological properties of blood of pre‐menopausal women are superior to those of men, and place such women at a lower risk of cardiovascular diseases than men in any age group. We believe that this difference in hemorheological properties is due to the reduced concentration of …red blood cells (RBCs) and due to greater population of younger and less population of older RBCs in female blood. We studied mechanical properties of blood from 47 pre‐menopausal women and 50 age‐matched men. Compared to female blood, male blood had higher viscosity and RBC aggregation and lower RBC deformability. Oxygen Delivery Index, calculated as a ratio of hematocrit to blood viscosity, was found to be significantly lower in male blood. Decreased oxygen delivery along with increased RBC aggregation and decreased RBC deformability may contribute to the higher risk for the development of cardiovascular diseases. Regular blood donation may reduce hematocrit and blood viscosity, improve rheological properties of blood, and increase oxygen delivery in men. Show more

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 357-363, 1999

Authors: Ciccone, M. | Maiorano, A. | De Pergola, G. | Minenna, A. | Giorgino, R. | Rizzon, P.

Article Type: Research Article

Abstract: The objective of the present study was to determine whether the intima‐media thickness (IMT) is independently related with obesity, and central fat accumulation in healthy subjects. Common carotid artery IMT, parameters of body fat accumulation and distribution (body mass index, waist circumference, waist‐to‐hip ratio), blood pressure levels, and circulating fasting insulin, glucose, and lipid (cholesterol, HDL‐cholesterol, triglycerides, LDL‐cholesterol) levels were determined in a population of non‐diabetic normal weight and obese subjects. Smoking habits (packs‐years) were also taken into account. 239 healthy subjects (143 women and 96 men), with age ranging between 18 and 45 years, were enrolled into the study. …They were divided indo two groups according to the body mass index (BMI), obese (132 subjects, 77 woman and 55 men, with BMI greater than 27.0) and controls (107 subjects: 66 women and 41 men, with BMI lower than 27.0). Common carotid artery intima‐media thickness was measured by B‐mode ultrasound imaging. Fasting plasma metabolic parameters (glucose and lipids) and insulin levels were determined by enzymatic and radioimmunological assays, respectively. Insulin sensitivity was estimated by insulin tolerance test (ITT) and the rate constant for plasma glucose disappearance (KITT) during the 3‐ to 15‐min period following the regular insulin injection was taken as a measure of in vivo insulin action. Obese patients showed higher IMT than controls, and IMT was significantly associated with BMI in the whole population (r={} 0.316, p<{} 0.001). Age (r={} 0.327, p<{} 0.001), KITT (r=-0.201 , p<{} 0.01), fasting blood glucose (r={} 0.187, p<{} 0.01), LDL‐chol (r={} 0.201, p<{} 0.01), smoking (r={} 0.147, p<{} 0.05), MBP levels (r={} 0.154, p<{} 0.05), cholesterol (r={} 0.152, p<{} 0.05) and HDL‐chol (r=-0.159 , p<{} 0.05) were also significantly associated with IMT. Age (r={} 0.330, p<{} 0.05), BMI (r={} 0.299, p<{} 0.01),waist (r={} 0.312, p<{} 0.001), WHR (r={} 0.266, p<{} 0.001) and KITT (r=-0.259 , p<{} 0.01) were the parameters most strongly correlated with IMT in women, and age (r={} 0.324, p<{} 0.001), BMI (r={} 0.338, p<{} 0.001) waist (r={} 0.325, p<{} 0.001) and LDL‐chol (r={} 0.283, p<{} 0.01) where the parameters most strongly correlated with IMT in men. When a stepwise multiple regression analysis was performed for the whole population, only age (p<{} 0.001) and BMI (p<{} 0.001) maintained a significant positive relationship with IMT. When a stepwise multiple regression analysis was performed separately for men and women, BMI or waist circumference or WHR were alternatively entered into the model; interestingly, only age, BMI and waist were still significantly correlated with IMT, whereas WHR did not maintain a significant correlation with IMT. In conclusion, BMI and waist circumference, but not WHR, are strongly and independently associated with the IMT of common carotid artery. These results suggests that central fat accumulation may accelerate the development of earlier clinically silent stages of atherosclerosis, thus possibly explaining the higher prevalence of cardiovascular diseases in patients with abdominal obesity. Show more

Keywords: Obesity, central fat, intima‐media thickness, atherosclerosis, cardiovascular risk

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 365-374, 1999

Authors: Labrador, V. | Legrand, S. | Muller, S. | Carl, P. | Senger, B. | Voegel, J.‐C. | Latger‐Cannard, V. | Stoltz, J.‐F.

Article Type: Research Article

Abstract: The adhesion of polymorphonuclear leukocytes (PMNs) on the vascular endothelium is a complex process that occurs during biological and pathological events and involves a large family of molecules. This phenomenom could be approached by a modelisation study of the adhesion of PMNs on a biological substrate, fibrinogen. Two different physiological conditions were tested such as the activated state of PMNs with a synthetic pro‐inflammatory activator (N‐Formyl‐Methionyl‐Leucyl‐Phenylalanin, FMLP). The activated state of PMNs was both quantified by flow cytometry and controlled by fluorescence microscopy. The results suggest that quiescent PMNs deposit in accordance with the ballistic deposition model. The preliminary …results obtained with FMLP‐stimulated PMNs show a different deposit process compared to quiescent PMNs but do not allow to determine exactly a deposition model. Show more

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 375-382, 1999

Authors: Alexandratou, E. | Yova, D. | Cokkinos, D.V.

Article Type: Research Article

Abstract: Digital imaging microscopy plays an important role in computer aided cytological and histological diagnosis. In this study, digital imaging microscopy was used to measure Red Blood Cells (RBCs) morphometric characteristics such as area, perimeter, major and minor axis length, elongation, compactness and roughness in both groups: healthy individuals and Coronary Artery Disease (CAD) patients. All the measured characteristics, except elongation, showed a statistically significant difference between the two groups. In particular, patients with CAD presented greater values than healthy ones. Finally multivariate analysis was used in order to take into account the whole measured profile of each patient. Compactness, perimeter …and elongation improved the diagnostic ability, whereas all the others did not show any significant improvement. These three characteristics correctly classify the 84.5% of the patients. In conclusion, RBCs morphometric characteristics could be considered as diagnostic factors for CAD. Show more

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 383-388, 1999

Authors: Casavola, C. | Paunescu, L.A. | Fantini, S. | Franceschini, M.A. | Lugarà, P.M. | Gratton, E.

Article Type: Research Article

Abstract: Near‐infrared spectroscopy (NIRS) is a noninvasive technique to measure the tissue oxygenation in real time. This optical method has many advantages over the invasive analysis currently used for clinical tests. Among the possible applications of near‐infrared oxymetry, we report three protocols (exercise, venous occlusion and tilting table) in conjunction with NIRS, and discuss their applicability in the diagnosis of peripheral vascular disease (PVD).

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 389-393, 1999

Authors: Pascazio, L. | Regina, G. | Perilli, F. | Caputo, G. | Gigli, A. | Lamberti, P.

Article Type: Research Article

Abstract: 100 patients (pts) receiving CEA (carotid endarterectomy) were evaluated in this study. In some of them postoperative complications were observed, characterized by TIA (transient ischemic attack) and, mostly, by cerebral hyperperfusion. In only two of the pts investigated CEA needed the implantation of a shunt, due to the emergence of intolerance signs at carotid Clamping (C) evaluated by TCD (transcranial Doppler); the preoperative cerebral angiography in the two subjects in question did not show malformations of the circle of Willis. The hyperperfusive phenomenon and the absence of intracranial compensation flows during CEA seemed to be ascribed to a more or …less severe impairment of cerebral reserve. Such impairment of the autoregulatory capacity seems to be crucial to the pathogenesis of hemodynamic stroke. Thus the indication to CEA, in pts with severe carotid disease, should take into account also the cerebral reserve (CR) impairment to prevent both thromboembolic and hemodynamic stroke. The predictive and diagnostic role of TCD turns out to be crucial in assessing and selecting pts candidate to CEA. Show more

Keywords: Carotid endarterectomy, transcranial Doppler, cerebral reserve, hyperperfusion syndrome, carotid disease, hemodynamic stroke

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 395-403, 1999

Authors: Antonova, Nadia | Velcheva, Irena

Article Type: Research Article

Abstract: Whole blood and plasma viscosity were measured of 90 patients with chronic cerebrovascular disease (CVD) and 56 healthy individuals by Couette rotational viscometer Contraves Low Shear 30 at a steady flow. Plasma viscosity was measured with capillary viscometer of Ubbelohde type. Two subgroups of patients were investigated: 23 patients with transient ischemic attacks (TIAs) and 67 patients with chronic cerebral infarctions (CCI). They were compared with two control groups: 56 healthy individuals without risk factors for stroke and 37 randomly selected subjects with risk factors for stroke. It is established significant elevation of plasma viscosity in the patients with cerebral …ischemia. The elevation of blood viscosity was most pronounced at shear rate of 94.5 s^{-1} . This comparison is confirmed by the criterion, using blood rigidity number h defined by the formula of Whittington and Harkness. Conclusion is drawn from our study that chronic ischemic cerebrovascular disorders are characterized with chronic hyperviscosity. Show more

Keywords: Cerebrovascular disease, blood and plasma viscosity, blood rigidity number

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 405-408, 1999

Authors: Battistelli, Sandra | Manasse, Giacomo | Gubbolini, Michele | Landini, Tommaso | Coratti, Andrea

Article Type: Research Article

Abstract: The aim of this study was to investigate the behaviour of circulating ET‐1 in patients with carotid atherosclerosis, before and after carotid thromboendarterectomy (TEA), to test the hypothesis that plasma ET‐1 decreases after removal of atherosclerotic lesion. Plasma immunoreactive ET‐1 levels were determined in 17 patients with symptomatic and/or hemodynamically significant carotid atherosclerosis on the day before TEA, 48 h and 72 h after surgery and, in 11 of them, also after 8 h and 24 h. Compared to controls, ET‐1 levels were significantly higher both before and after TEA; after carotid revascularisation (8 h) ET‐1 increased; then, from the …24th h, ET‐1 gradually decreased and at the 48th h and 72th h the decrease was significant in front of basal values. The increase of plasma ET‐1 in the acute postoperative phase may reflect the degree of surgical stress and manipulation in diseased blood vessels; the following decrease may indicate the improvement of vascular dysfunction in the involved carotid site; the persistence of high ET‐1 levels 72 h after surgery could suggest the presence of residual ischemia in the involved district and/or the involvement of other sites in ET‐1 production. Show more

Keywords: Endothelins, atherosclerosis, carotid endarterectomy

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 409-414, 1999

Authors: Aigbe, A. | Famodu, A.A.

Article Type: Research Article

Abstract: Hypertension is the most significant cardiovascular risk factor to emerge in developing countries. 64 hypertensives (40 old hypertensives and 18 newly diagnosed hypertensives) and 40 age and sex matched normotensives controls were studied. Plasma fibrinogen concentration (PFC), euglobulin lysis time (ELT) and relative plasma viscosity (RPV) and relative whole blood viscosity (RWBV) were estimated. The PFC, RPV, RWBV and ELT were significantly higher in new and old hypertensives (P<{} 0.005), respectively, compared with controls. while the RPV was significantly higher (P<{} 0.005) in new hypertensives than old hypertensives. The significantly higher PFC, RPV and ELT in new hypertensives …correspond to higher BP in the new hypertensives than old hypertensives. There were consistence significance levels in PFC, RPV and ELT in both female hypertensives and controls (P<{} 0.005), respectively, with higher BP in male than female. Though there were no significant mean differences between the hypertensive patients in the first two years of the disease, there were cumulative consistent increase in fibrinogen levels and euglobulin lysis time from two years; while RPV shows inconsistence variation until the 5th year. We conclude that a defective rheology and fibrin‐clearing mechanism may contribute to aetiology of vascular complications in hypertensive patients especially in the long term. Show more

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 415-420, 1999

Authors: Passavanti, G. | Cicco, G. | Baldassarre, G. | Vicenti, P. | Soleti, F. | Stingi, G.D. | Carbonara, M.C. | Coratelli, P. | Pirrelli, A.

Article Type: Research Article

Abstract: We studied the effect of some dialytic membrane on tissular oxygenation (TO) and erythrocyte deformability (ED). Sixteen patients (10 M and 6 F, aged 59 \pm 12 years) have been submitted to bicarbonate dialysis (BD) and subdivided into four groups (GR) of 4 patients each: GR 1 (hemophan membrane, 35 BD), GR 2 (polyacrylonitrile, PAN AN 69, 42 BD), GR 3 (polysulphone, 38 BD) and GR 4 (polycarbonate, 37 BD). The TO has been detected with the transcutaneous oxygen pressure (Tc pO_{2 } ) using a transcutaneous oxymeter and the ED has been evaluated with the EMI …(Erythrocyte Morphometric Index), which results from the ratio between deformable erythrocytes (bowl shape) and rigid erythrocytes (discocyte shape), for every 100 red cells fixed in vitro with 0.3% glutaraldehyde. The ED was also evaluated using a laser instrument: Laser Optical Rotational Cell Analyser. During BD was observed a significant decrease of Tc pO_{2 } in the 1st hour only in the 1st and 2nd GR and, in contrast with results obtained in the 3rd and 4th GR, in the same GRs the EMI showed a significant reduction of ED at the end of BD. Finally the LORCA results, showing a significant decrease of ED only in the 1st and 2nd GR, confirmed the data obtained with EMI. In conclusion, our study has suggested that hemophan and PAN AN 69 are less biocompatible than polysulphone and polycarbonate membranes according to effects on ED and TO. Show more

Keywords: Dialysis membranes, biocompatibility, oxymetry, transcutaneous oxymetry, erythrocyte deformability

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 421-424, 1999

Authors: Izzo, P. | Spagnuolo, A. | Manicone, A. | Nazzaro, P. | Lauta, V.M.

Article Type: Research Article

Abstract: In this study we report results regarding erythrocytes deformability in congenital dyserythropoietic anemia type II (HEMPAS) by the use of LORCA (Laser‐assisted Optical Rotational Cell Analyzer). The reduced erythrocytes deformability observed in seven case of CDA II is caused by changes in the structure of glycoproteins due to the incomplete glycosylation of erythrocytic and erythroblastic membrane. Erythrocytes deformbility (EI) was shown to be inversely related with mean corpuscular volume (MCV) and mean haemoglobin concentration (MCH).

Keywords: Dyserythropioietic anaemia, LORCA, erythrocytes deformability

Citation: Clinical Hemorheology and Microcirculation, vol. 21, no. 3-4, pp. 425-430, 1999