Clinical Hemorheology and Microcirculation - Volume 43, issue 3
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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: We use continuous wavelet analysis (WA) of Laser Doppler Flux (LDF) time series measured in basal cell carcinomas (BCC) and plaque psoriasis (PP) in order to investigate the rhythmical behavior of blood flow in tumor or inflammatory associated neoangiogenesis. A total of 68 patients with primary BCCs and 40 patients with PP were included in the study. LDF time series were separated in four scaling levels corresponding to the influences of sympathetic activity (SL1), myogenic activity in the vessel wall (SL2), respiration (SL3) and heart beat (SL4). In BCC, SL1 decreased compared to healthy skin. In all other…scaling levels, we found a statistically significant increase of the SLs compared to healthy skin. These increases were not found in PP. Rhythmical behavior of blood flow in malignant tumors is totally different from that in regions with inflammation. In BCCs, thermoregulatory processes, ascribed to sympathetic activity, decrease statistically significant. In contrast, inflammatory processes in PP do not substantially change sympathetic activity. WA of tumor perfusion could open a new noninvasive monitor system for controlling tumor therapy.
Abstract: The relationship between erythrocyte deformability and aggregability with left ventricular mass index has been examined in patients diagnosed with at least one cardiovascular risk factor but without ongoing coronary heart disease. The group consisted of 66 individuals, 30 men and 36 women, of the average age 57.7 years. For each patient, deformability and aggregability of red blood cells (RBCs) as well as end-diastolic left ventricle diameter (LVD), interventricular septum thickness (IVST) and posterior wall thickness (PWT) were measured. On the basis of the echocardiographical parameters and anthropometric data, left ventricular mass index (LVMI) was calculated. The analysis revealed statistically significant…correlation between the LVMI and erythrocyte deformability and aggregability: the LVMI increases with decreasing deformability and is higher in patients with higher aggregability. This finding indicates that the worsening of RBC rheological properties is one of the main factors contributing to alterations of cardiac geometry through the increase of peripheral resistance which, in turn, significantly augments the heart afterload. Given that left ventricular hypertrophy (LVH) is a predictor of cardiovascular morbidity and mortality, the association between hemorheological parameters and left ventricular geometry may be important in clinical practice.
Keywords: Erythrocyte deformability, erythrocyte aggregability, left ventricular geometry, CVD risk
Abstract: Introduction: Carotid artery stenting has become a possible treatment of significant carotid stenosis. The risk of stent occlusion and restenosis might be increased by abnormal rheological conditions amplified platelet aggregation and free radical production during the operation. Aims: The aim of our study was to assess the changes in hemorheological parameters, platelet aggregation, and catalase activity after endovascular treatment of carotid stenosis. Methods: 18 patients (11 men, ages 68 ± 9 years and 7 women, ages 62 ± 8 years) suffering from significant carotid stenosis and treated with carotid endovascular intervention were examined. Alteration in hemorheological parameters as…well as epinephrine-, ADP-, and collagen-induced platelet aggregation were evaluated. Antioxidant reserve was characterized by the determination of catalase activity. The measurements were carried out directly before and after the procedure and 1, 2, 5 days and 1 month following the intervention. Preceding the operation the patients were administered a maximum dose (300 mg) of clopidogrel. Results: Hematocrit, plasma fibrinogen concentration (PFC) and whole blood-, and plasma viscosity values (WBV and PV) significantly decreased immediately after stenting (p<0.001). By the fifth day following the intervention the PFC, WBV, PV, red blood cell (RBC) aggregation and ADP-induced platelet aggregation significantly increased (p<0.0001) compared to values measured postprocedurally. At 1 month follow-up these parameters, except whole blood viscosity, decreased significantly compared to measurements made on the 5th day. On the other hand, catalase activity showed significant elevation by the end of the first month. Conclusion: Hemorheological parameters and platelet aggregation showed specific changes following carotid stenting. Abnormal changes of the rheological conditions and increasing platelet activation are the most pronounced in the first week following stenting, which may lead to early stent occlusion. Oxidative stress production returned to baseline levels only by the end of the first month.
Abstract: Iron deficiency is a systemic disorder, which affects a variety of different cell types and is one of the most frequent diseases throughout the world. The influence of iron deficiency upon erythrocyte deformability is controversial and could be a consequence of membrane peroxidation damage or cross linking of membrane proteins. The aim of this study was to determine the overall elasticity (the deformability of the entire cell is evaluated) of iron deficient red blood cells (RBC) using laser optical tweezers. In this study, the laser trapped the cell and the elasticity was then analyzed measuring cell deformation at six different…drag velocities. Twenty-five RBCs from 11 healthy blood donors (controls) and 7 patients with iron deficiency anemia were analyzed. Iron deficiency subjects were classified into 3 groups based on Hb concentration for statistical analysis (group I: Hb = 7.0–7.9; group II: 8.0–10.2 and group III: 7.0–10.2 g/dl). The results showed an increased rigidity in the iron deficiency of deficient red blood cells when compared to normal control blood cells, and, this impaired deformability seems to be correlated to the hemoglobin concentration. In conclusion, the results obtained by optical tweezers showed that iron deficiency affects the elasticity of whole RBC.
Keywords: Iron deficiency, red cells elasticity, optical tweezers
Abstract: Exposure of red blood cells (RBCs) to catecholamines (epinephrine, phenylephrine, an agonist of α1 -adrenergic receptors, clonidine, an agonist of α2 -adrenergic receptors and isoproterenol, an agonist of β-adrenergic receptors) led to change in the RBC microrheological properties. When forskolin (10 μM), an AC stimulator was added to RBC suspension, the RBC deformability (RBCD) was increased by 17% (p<0.05). Somewhat more significant deformability rise appeared after RBC incubation with dB-AMP (by 27%; p<0.01). Red blood cell aggregation (RBCA) was significantly decreased under these conditions (p<0.01). All drugs having PDE activity increased red cell deformability similarly. Some more changes of deformability…was found after RBC incubation with pentoxifylline – 25% (p<0.05) and IBMX incubation was accompanied only by 15% rise of RBC deformability. The drugs with PDE inhibitory activity reduced red cell aggregation. The most significant RBCA reduction effect was found under cell incubation with pentoxifylline and inhibitor PDE1 –vinpocetine. On the whole RBCA reduction averaged 36% (p<0.05) under RBCs incubation with PDE inhibitors. The rise of Ca2+ influx, stimulated by A23187, was accompanied by an increase of RBCA, whereas red cell deformability was changed insignificantly. At the same time Ca2+ entry blocking into the red cells by verapamil or its chelating in medium by EGTA led to significant RBCA decrease and deformability rise (p<0.05). On the whole the total data clearly show that the red cell aggregation and deformation changes were connected with an activation of the different intracellular signaling pathways. It seems reasonable to suppose that RBCA decrease was mainly associated with an activation of the adenylyl-cyclase–cAMP system, while the red cell deformability was closely associated with Ca2+ control mechanisms.
Keywords: Catecholamines, forskolin, adenylyl cyclase, phosphodiesterase, adrenergic receptors, red blood cell deformability and aggregation, intracellular signaling pathways
Abstract: We examined lipid peroxidation, expressed as thiobarbituric acid-reactive substances (TBARS) and total antioxidant status (TAS) before and after a cardiopulmonary test, in 20 sedentary controls and in 62 unprofessional male athletes subdivided into 3 subgroups. The first included subjects who practised endurance sports (14 cyclists and 9 endurance swimmers), the second subjects who practised mixed sports (6 basket players, 6 judoists, 8 water polo players) and the third group subjects who practised power sports (3 sprint runners, 4 weightlifters, 12 sprint swimmers). In the whole group of athletes an increase in TBARS and a decrease in TAS were present at…baseline. Subdividing the whole group into three subgroups we observed an increase in TBARS in all and a decrease in TAS only in the endurance and mixed athletes. After the test, TBARS showed a more significant increase in controls compared to the whole group and each subgroup of athletes, while TAS increased only in the whole group and in those who practised mixed sports. In conclusion, at baseline in athletes the oxidative status shows a different behaviour compared to controls, while after the test the antioxidant protection is more marked and it may be related to an increase of antioxidant systems.
Keywords: Lipid peroxidation, total antioxidant status, exercise, metabolism, cardiopulmonary test, sport
Abstract: Atomic force microscope (AFM) is a powerful and prospective tool in the studies of the cellular deformability within a single cell. However, the reliability of using AFM in estimating the cellular average deformability was suspected. Hemorheology, one of common clinical examinations, can assess the deformability of erythrocytes. In order to validate the reliability in estimating the cellular deformability with AFM, the correlation was studied between the stiffness of the erythrocyte membrane with AFM and the deformation index with the hemorheology test. Blood samples were taken from 5 diabetes mellitus patients and 5 healthy non-obese people. The erythrocyte deformability was detected…by AFM and the hemorheology test, respectively. Excellent correlation (r=0.907, p=0.000<0.01) was found between the average erythrocyte stiffness with AFM and the deformation index obtained from the hemorheology test. Besides, it was found that the average stiffness and the deformation index of diabetes mellitus patients were significantly higher than those of healthy non-obese people (p=0.007 and p=0.003). The result was consistent with the impairment of erythrocytes form diabetes mellitus patients. Therefore, it is the first time that the quantification relation of the erythrocyte deformability was investigated with AFM and the hemorheology test, and the feasible and reliable were validated that AFM is used to investigate the mechanical properties of different living cells qualitatively and quantitatively.
Keywords: Atomic force microscopy, hemorheology, erythrocyte deformability, diabetes mellitus
Abstract: We evaluated, in a group of 41 CRF undialyzed subjects (29 men and 12 women, mean age 64.1 ± 11.3 years), some parameters that reflect leukocyte activation (elastase, myeloperoxidase – MPO), plasma NO metabolites (NOx ) and the oxidative status (lipid peroxidation expressed as thiobarbituric acid-reactive substances (TBARS) and total antioxidant status (TAS). Elastase was determined, on plasma separated from fasting venous blood, as elastase/α1-proteinase inhibitor complex. MPO was evaluated employing the Myeloperoxidase ELISA kit. The NO production was evaluated by a micromethod. The oxidation of polyunsaturated fatty acids was evaluated in plasma by detection of the thiobarbituric acid-reactive substances…(TBARS). Total antioxidant status was measured by spectrophotometry. We found a significant increase of elastase, TBARS and NOx , without any significant variation of MPO and TAS. In this group of CRF subjects, no statistical correlation was found between these examined parameters, creatinine level, creatinine clearance, leukocyte count and hemoglobin level. These findings need to be underlined if we consider that chronic renal failure is an inflammatory condition and this research furtherly supports literature data regarding the role of activated leukocytes in the development of the vascular complications. These observations explain why the examination of leukocyte count and function could become a tool to verify the clinical outcome in these patients.