Clinical Hemorheology and Microcirculation - Volume 42, 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: The main functions of the blood are the transport, and delivery of oxygen and nutrients, removal of carbon dioxide and waste products of metabolism, distribution of heat and signals of immune system. They are provided by circulation due to the driving force of the heart. Circulation of the blood depends on its rheological properties of the blood as well as on characteristics of the vessels through which the blood passes. The blood flow resistance is influenced by the complicated architecture of the vascular network and flow behaviour of blood components – blood cells and plasma. The obtained data based on…analysis of influences on blood flow are differentiated in the dependence on place and level of investigation. At a macroscopic level the blood appears to be a liquid material, but at a microscopic level the blood appears to be a material with microscopic solid particles of varying size – various blood cells. From this point of view, we have to consider the blood flow in large vessels, and also on the level of microvessels. This division of facts of hemorheology is somewhat simplistic, but is very useful from the point of view of explanation and comprehension.
Keywords: Red blood cells, deformability, blood flow, red blood cells aggregation, circulation, vessel
Abstract: Objective: No data are presently available about changes in capillary density in the skeletal muscle and in the brain of spontaneously hypertensive rats (SHR) in relation to the development of hypertension. Design and methods: We have investigated 4 week-old and 12 week-old SHR and age-matched normotensive Wistar–Kyoto controls (WKY). Microvessel density (MVD) in the cerebral cortex and in a skeletal muscle were evaluated in sections stained for CD31. We also evaluated MVD in the dermal tissue of normotensive subjects and essential hypertensive patients. Subcutaneous small resistance arteries were dissected and mounted in a micromyograph and the media to lumen…ratio (M/L) was measured. Results: A significant reduction in MVD in the skeletal muscle and in the brain of SHR was clearly observed at 12 weeks of age, after the development of hypertension, but not at 4 weeks of age (pre-hypertensive condition). In hypertensive patients a significant reduction in the dermal MVD and an inverse correlation between M/L and MVD was observed. Conclusions: Our results suggest that, in the brain and skeletal muscle of adult SHR after the development of hypertension, and in the derma of adult essential hypertensive patients microvascular rarefaction may occur.
Keywords: Hypertension, microvascular rarefaction, microcirculation, capillaries, small vessels
Abstract: The antifibrinolytic agents aprotinin and tranexamic acid have both been proven to be efficient in reducing postoperative blood loss and transfusion requirements in patients in cardiac surgery. In light of recent safety issues regarding aprotinin, this single-centre study compared efficacy and safety of low dose aprotinin (2 million KIU, pump-prime volume only) and low dose tranexamic acid (1 g, pump-prime volume) in 708 consecutive patients from two prospective registers undergoing elective cardiac procedures with cardiopulmonary bypass (CPB). Incidences of postoperative complications showed no significant differences between groups. Postoperative blood loss and transfusion requirements were significantly lower in aprotinin compared to…tranexamic acid patients. Overall, both antifibrinolytic low dose regimens are safe components of perioperative patient management in elective cardiac surgery with CPB. Cardiac procedures requiring longer CPB times might benefit from the administration of low dose aprotinin.
Abstract: Background: In chronic liver diseases, liver function is adversely affected and the consequent alterations in blood constituents are known to affect vascular and rheological parameters. The aim of the study was to analyze the rheological profile in chronic liver disease (CLD) patients in Nigeria. Patients and methods: Seventy consecutive CLD patients attending the Gastroenterology Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria were studied prospectively over an 8 month period (May–December, 2007). Fifty apparently healthy age-and-sex matched individuals who were prescreened and found serologically negative to HIV 1 and 2, HBsAg and HCV were used as…controls. Diagnosis of CLD was based upon histological findings of chronic parenchymal liver disease in the presence of stigmata of CLD. Plasma fibrinogen level was determined by the clot-weight technique. Plasma viscosity, erythrocyte sedimentation rate, haematocrit and platelet count were analysed. Clinico-demographic features, treatment modalities and the complications were analyzed. Results: A total of 120 subjects comprising 70 CLD patients (50 males (71.4%) and 20 females (28.6%)) and 50 controls were studied. Alcoholic cirrhosis (44.3%) was the main risk factor closely followed by viral hepatitis (41.4%). Haematocrit and platelet count of CLD patients were significantly lower than the controls (p<0.001). Plasma fibrinogen concentration and plasma viscosity in CLD patients were significantly lower compared to the controls (p<0.001). Conclusion: CLD patients had low blood viscosity and low fibrinogen level (hypofibrinogenamia) when compared to controls. This may have contributed to the hypocoagulable state and therefore the bleeding tendency encountered in these patients.
Keywords: Rheological factors, chronic liver disease, hypocoagulable state
Abstract: We hypothesize that real-time in vivo microvascular abnormalities should correlate with biochemical markers of inflammation/endothelial dysfunction in T1DM. Real-time quantification of T1DM and healthy non-diabetic control microcirculation was conducted utilizing computer-assisted intravital microscopy. Selected biochemical markers (high sensitivity C-reactive protein (hsCRP), soluble vascular cell adhesion molecules (sVCAM), soluble intercellular adhesion molecules (sICAM), soluble E-selectin (sE-selectin), nitrotyrosine, superoxide anion (O2 − ), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α)) were used for correlation. The severity of microvascular abnormalities, as reflected by the arithmetic severity index (SI), was significantly increased in T1DM vs. controls (5.89 ± 1.47 vs. 2.34 ± 1.48; P<0.001).…In addition several of the specific microvascular abnormalities (related to flow and morphometry) were significantly more prevalent in the T1DM patients. Finally, the following significant positive correlations existed between the inflammatory/endothelial dysfunction markers and specific microvascular abnormalities: sVCAM and abnormal vessel diameter (P=0.004, OR =1.033, 95% CI for OR =(1.01, 1.056)), superoxide (O2 − ) release and abnormal vessel distribution (P=0.032, OR =1.798, 95% CI for OR =(1.051, 3.075)), and sE-selectin and abnormal vessel distribution (P=0.036, OR =1.118, 95% CI for OR =(1.007, 1.241)). In view of such significant correlations, we conclude that these specific microvascular abnormalities can serve as unique physiologic markers of endothelial dysfunction to correlate with the biochemical markers of inflammatory/endothelial dysfunction in disease progression and therapeutic efficacy studies.
Abstract: We have recently demonstrated that the use of a tourniquet to locate the vein prior to blood sampling may affect red blood cell (RBC) deformability and aggregation, even if the tourniquet is quickly removed after insertion of the needle into the vein. However, in clinical practice, the tourniquet is usually kept in place until blood sampling is completed. The present study tested the effects of tourniquet application during the blood sampling period on RBC deformability and aggregation. We compared blood samples obtained at 5, 30, 60 and 90 seconds following the tourniquet application; a control blood sample was obtained without…applying a tourniquet. RBC deformability was slightly increased at 5 seconds (7.6% mean, 1–5 Pa) and at 60 seconds (5.9% mean, 1–30 Pa) but not at 30 or 90 seconds, with the increase inversely related to shear stress. The RBC aggregation index was slightly but significantly decreased at 5, 30 and 60 seconds, with no changes observed for either amplitude or half-time of aggregation. These very modest yet significant effects of tourniquet application on hemorheological parameters may not be meaningful in terms of pathophysiology, but may become important in data interpretation or for specific subjects.
Keywords: Red blood cell deformability, red blood cell aggregation, methodology, venipuncture procedures, blood sampling