Clinical Hemorheology and Microcirculation - Volume 55, issue 2
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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: Little is known about the impact of blood rheology on the occurrence of retinopathy in sickle cell disease (SCD). Fifty-nine adult SCD patients in steady-state condition participated to the study: 32 with homozygous SCD (sickle cell anemia; SCA) and 27 with sickle cell hemoglobin-C disease (SCC). The patients underwent retinal examination and were categorized according to the classification of Goldberg: 1) no retinopathy (group 1), 2) non-proliferative or proliferative stage I-II retinopathy (group 2) and 3) proliferative stage III-IV-V retinopathy (group 3). Hematological and hemorheological (whole blood viscosity, RBC deformability and aggregation properties) measurements were performed for each patient. In…the whole SCD group (SCA + SCC patients) and in SCC patients, the group 3 had higher platelets count than group 2 but the difference between group 3 and group 1 did not reach statistical significance. No difference was observed for the other parameters between the three groups. SCC patients from the group 3 exhibited higher whole blood viscosity than SCC patients from the group 1. No significant difference was observed between the three groups in SCA patients. This study revealed that severe sickle proliferative retinopathy is associated with blood hyperviscosity in SCC patients but not in SCA patients.
Abstract: OBJECTIVE: The positive correlation between the time from symptom onset to the appearance of an inflammatory response and erythrocyte aggregation (EA) in the peripheral blood of acute coronary syndromes (ACS) patients had been previously reported by us. We now analyze the added prognostic value of EA in ACS patients undergoing percutaneous coronary interventions (PCI). METHODS: We performed an analysis on prospectively collected data at a tertiary hospital catheterization laboratory between 2006–2011. Cox regression models were fitted for EA cut-offs and performed separately for myocardial infarction (MI) and unstable angina pectoris (UAP) patients. Major adverse cardiovascular events (MACE) were defined as…all-cause mortality, MI and stroke. Follow up time was defined as the time from PCI to either MACE or November 20, 2011. RESULTS: Included were 1055 patients (637 with MI and 418 with UAP). The median follow up in the MI and the UAP groups was 14 and 15 months, respectively (maximal follow up of 4.1 years). In the UAP group there was a significant increase in the MACE for the group with high EA (HR = 2.3, p = 0.04) compared to the group of patients with low EA. This was not found for patients presenting with MI. CONCLUSIONS: Elevated EA portends worse outcomes in UAP patients undergoing PCI.
Abstract: OBJECTIVE: The influence of lipids on blood and plasma viscosity has not been fully elucidated. In this study we evaluated the contribution of HDL cholesterol to blood and plasma viscosity, in healthy subjects. METHODS: One hundred and forty-four (80 males and 64 females) subjects were enrolled among free-living participants to a cardiovascular disease screening. Exclusion criteria were: diabetes, elevated triglycerides, elevated LDL cholesterol, smoking and drug use. Blood lipids were measured by routine methods. Blood and plasma viscosity were measured by a cone-plate viscometer (Wells-Brookfield DV-III, Stoughton, U.S.A.). Subjects were divided in two groups: at low (<50 mg/dl) and high…HDL cholesterol (>50 mg/dl). RESULTS: Blood and plasma viscosity were similar in subjects at low and high HDL cholesterol. In univariate analysis none of the lipid variables was significantly correlated with blood and/or plasma viscosity. In multivariate analysis only LDL cholesterol was marginally associated with blood viscosity. CONCLUSION: HDL cholesterol does not influence blood and plasma viscosity in healthy normolipidemic subjects. LDL cholesterol is marginally associated with blood viscosity.
Abstract: Red blood cell (RBC) aggregation is greatly affected by cell deformability and reduced deformability and increased RBC aggregation are frequently observed in hypertension, diabetes mellitus, and sepsis, thus measurement of both these parameters is essential. In this study, we investigated the effects of cell deformability and fibrinogen concentration on disaggregating shear stress (DSS). The DSS was measured with varying cell deformability and geometry. The deformability of cells was gradually decreased with increasing concentration of glutaraldehyde (0.001~0.005%) or heat treatment at 49.0°C for increasing time intervals (0~7 min), which resulted in a progressive increase in the DSS. However, RBC rigidification by…either glutaraldehyde or heat treatment did not cause the same effect on RBC aggregation as deformability did. The effect of cell deformability on DSS was significantly increased with an increase in fibrinogen concentration (2~6 g/L). These results imply that reduced cell deformability and increased fibrinogen levels play a synergistic role in increasing DSS, which could be used as a novel independent hemorheological index to characterize microcirculatory diseases, such as diabetic complications with high sensitivity.
Abstract: OBJECTIVE: Supplementing a local anaesthetic with epinephrine has advantages in hand surgery: faster onset of anaesthesia, extended effect of anaesthetics with prolonged pain reduction, decreased bleeding into the operative field, and abandoned need for tourniquet. We hypothesized that the use of ropivacaine with epinephrine additive in digits allows good skin perfusion rates with prolonged pain reduction. DESIGN: In this prospective, double-blinded, randomized study with 20 volunteers (80 fingers, without operation) the chronological course of changes in digit blood flow, post injection pain status and complication rates after two-injection dorsal technique anaesthetic block with ropivacaine (group 1: ropivacaine 0.75%, group 2:…ropivacaine 0.75% and epinephrine 1 : 1.000.000, group 3: local tumescent anaesthesia 0.15% TLA: ropivacaine, lidocaine, saline solution plus epinephrine 1 : 1.000.000) were examined. As a control group, injection of 2% lidocaine in the way with 20 minutes tourniquet (group 4) was used. MAIN OUTCOME: Group 1 showed increased skin perfusion with a maximum of 160.2%, group 2 showed no significant changes with a following significant increase of skin perfusion (+66.6%). In group 3, a significant reduction (−54.1%) was followed by an increase of skin perfusion (+45.7%). In the control group (group 4) the skin perfusion was decreased (−66.2%) and increased significantly after opening the tourniquet (+248.1%). The longest pain reduction was shown for ropivacaine 0.75% and epinephrine with 18.0 hours (group 2); the other groups were between 4.6 to 8.1 hours. CONCLUSION: Using ropivacaine with epinephrine additive in digits could improve the intra-, and postoperative terms.
Abstract: In the field of angiogenesis research considerable effort is put in the development of in vitro assays of angiogenesis to replace animal experiments. Unfortunately, reproducibility of these assays frequently fails depending on the particular batch of endothelial cells delivered by the distributor. This is due to the lack of reliable markers for the identification and isolation of angiogenic microvascular endothelial cells that have the capacity to perform all stages of the angiogenic cascade. This study was carried out to identify potential markers for angiogenic versus non-angiogenic endothelial cells. The protein expression profile of four capillary-derived human microvascular primary endothelial cell…cultures of which only two batches could be stimulated to angiogenesis was investigated and compared by two-dimensional gel electrophoresis. Seven proteins were found to be expressed in the angiogenic batches only. One protein was detected exclusively in the non-angiogenic batches. These proteins might be verified as markers for angiogenic endothelial cells.
Keywords: Angiogenic endothelial cells, in vitro model, two-dimensional gel electrophoresis
Abstract: Peripheral arterial disease (PAD), is a common manifestation of systemic atherosclerosis. Advances on the development of such vascular disease have described with a number of novel risk factors. Hyperviscosity, due to alterations of blood cells and plasma components, may play a role on the pathogenesis of the disease. Aim of this study was to evaluate the possible association between hemorheological variables and PAD. The hemorheological variables [whole blood viscosity (WBV), erythrocyte deformability index (DI), plasma viscosity (PLV)] were analyzed in 90 patients and in 180 healthy subjects. WBV and PLV were measured by a Rotational Viscosimeter and DI by a…filtrometer. DI and PLV were significantly different in patients as compared to controls. To investigate the possible association between these parameters and the disease we divided the study population into tertiles. At the univariate analysis, we found a significant association between the highest tertiles of PLV, of DI and the disease. A model adjusted for traditional risk factors showed an association between highest tertiles of PLV and PAD. After adjustment for confounding parameters highest tertiles of PLV remained to be significantly associated with the disease. Our data indicate that an alteration of plasma viscosity may modulate the predisposition to PAD.
Abstract: Psoriasis, a systemic immunomediated disorder, is associated with increased cardiovascular risk, although the contribution of rheological alteration to this risk has been seldom analyzed. We have determined erythrocyte deformability in 91 patients with psoriasis and in 101 sex- and age-matched control subjects by means of the Rheodyn SSD, along with hematological, biochemical and inflammatory parameters. Although psoriatic patients showed higher BMI, waist, triglyceride, C-reactive protein levels, neutrophils count and lower HDL-cholesterol (P < 0.001), no differences in the elongation index and in any of the shear stresses tested (12, 30, 60 Pa) were observed (P > 0.05). The results…of the present study indicate that patients with psoriasis do not present impaired erythrocyte deformability. Therefore this rheological parameter does not seem to be involved in the higher cardiovascular risk characterizing these patients.