Clinical Hemorheology and Microcirculation - Volume 65, issue 3

Authors: Melik, Ziva | Zaletel, Polona | Virtic, Tina | Cankar, Ksenija

Article Type: Research Article

Abstract: BACKGROUND: Reduced availability of nitric oxide leads to dysfunction of endothelium which plays an important role in the development of cardiovascular diseases. OBJECTIVE: The aim of the present study was to determine whether the dietary supplement L-arginine improves the endothelial function of microvessels by increasing nitric oxide production. METHODS: We undertook experiments on 51 healthy male volunteers, divided into 4 groups based on their age and physical activity since regular physical activity itself increases endothelium-dependent vasodilation. The skin laser Doppler flux was measured in the microvessels before and after the ingestion of L-arginine (0.9 g). The …endothelium-dependent vasodilation was assessed by acetylcholine iontophoresis and the endothelium-independent vasodilation by sodium nitroprusside iontophoresis. In addition, we measured endothelium-dependent and endothelium-independent vasodilation in 81 healthy subjects divided into four age groups. RESULTS: After the ingestion of L-arginine, the endothelium-dependent vasodilation in the young trained subjects increased (paired t -test, p  < 0.05), while in the other groups it remained the same. There were no differences in the endothelium-independent vasodilation after ingestion of L-arginine. With aging endothelium-independent vasodilation decreased while endothelium-dependent vasodilation remained mainly unchanged. CONCLUSION: Obtained results demonstrated that a single dose of L-arginine influences endothelium-dependent vasodilation predominantly in young, trained individuals. Show more

Keywords: L-arginine, nitric oxide, skin microcirculation, laser Doppler flux, endothelium-dependent vasodilation, endothelium-independent vasodilation, physical activity, aging

DOI: 10.3233/CH-16159

Citation: Clinical Hemorheology and Microcirculation, vol. 65, no. 3, pp. 205-217, 2017

Authors: Medeiros-Lima, Daniel Jose Matos | Mendes-Ribeiro, Antonio Claudio | Brunini, Tatiana Marlowe Cunha | Martins, Marcela Anjos | Mury, Wanda Vianna | Freire, Raul Almeira | Monteiro, Walace David | Farinatti, Paulo Tarso Veras | Matsuura, Cristiane

Article Type: Research Article

Abstract: Growing evidence has shown that acute exercise impairs erythrocyte membrane structure and function as a consequence of increased physical and chemical stress. Erythrocyte-synthesized nitric oxide (NO) is known to modulate membrane fluidity, and its bioavailability depends on the balance between its production and scavenging by reactive oxygen species. Here, we investigated whether a maximal exercise test could affect erythrocyte NO bioavailability and oxidative stress. Twelve men (26±4 years old, V ̇ O2peak 44.1±4.3 mL·kg–1 ·min–1 ) performed a treadmill maximal cardiopulmonary exercise test. Blood was collected at rest and immediately after exercise for erythrocytes isolation. Maximal exercise caused an increase in …erythrocytes count, haemoglobin and haematocrit levels. There was no change in L-arginine influx into erythrocytes after exercise. Yet, nitric oxide synthase activity, and thus, NO production, was increased after maximal test, as well cyclic GMP levels. In relation to biomarkers of oxidative stress, maximal test resulted in increased levels of lipid peroxidation, and diminished superoxide dismutase activity. Neither glutathione peroxidase nor catalase activity was affected by maximal test. Our findings demonstrate that the increased erythrocyte membrane rigidity caused by an acute bout of exercise may be caused, in part, by an increased lipid oxidative damage caused by ROS produced exogenously. Show more

Keywords: Reactive oxygen species, red blood cells, arginine, nitric oxide synthase

DOI: 10.3233/CH-16162

Citation: Clinical Hemorheology and Microcirculation, vol. 65, no. 3, pp. 219-228, 2017

Authors: Nagy, Tibor | Hardi, Péter | Takács, Ildikó | Tóth, Mónika | Petrovics, Laura | Jancsó, Gábor | Sínay, László | Fazekas, Gábor | Pintér, Örs | Arató, Endre

Article Type: Research Article

Abstract: AIMS: We studied the new anti-inflammatory effects of non-specific phosphodiesterase (PDE) inhibitor pentoxifylline (PTX) on ischaemia-reperfusion injury and postconditioning of the lower extremities. We aimed to examine the oxidative stress parameters (OSP), the inflammatory response and the changes in structure of skeletal muscle after revascularization surgery. METHODS: 50 Wistar rats in five groups underwent a 60 min infrarenal aortic cross clamping. After the ischaemia in IR+PC group ischemic postconditioning was performed, intermittent 15 seconds reperfusion, 15 seconds ischaemic periods were applied four times. The ischemic phase was followed by a 120 min of reperfusion. In IR+PTX group the animals …were treated with PTX. In IR+PC+PTX group both ischemic postconditioning and PTX treatment were performed. Blood samples and biopsy from quadriceps muscle were collected. Plasma malondialdehyde, reduced glutathione, -SH-groups, TNF-alpha, IL-6 concentrations and superoxide dismutase enzyme activity were measured. RESULTS: The levels of OSP and the inflammatory proteins were significantly higher in the IR group. PTX treatment and PC could significantly decrease the levels of OSP and inflammatory proteins. When the animals were co-treated with PTX and PC the results were even better. CONCLUSIONS: Inhibition of PDE by PTX could markedly decrease the inflammatory response and moderate the ischaemia-reperfusion damages after lower limb ischemia and reperfusion. Administration of PTX could potentiate the beneficial effects of PC. Show more

Keywords: Postconditioning, reperfusion injury, vascular surgery, reactive oxygen species, TNF-alpha, leukocyte, inflammatory response, pentoxifylline (PTX)

DOI: 10.3233/CH-16169

Citation: Clinical Hemorheology and Microcirculation, vol. 65, no. 3, pp. 229-240, 2017

Authors: Tripolino, Cesare | Irace, Concetta | Carallo, Claudio | Scavelli, Faustina Barbara | Gnasso, Agostino

Article Type: Research Article

Abstract: BACKGROUND: In recent years, new measures of body adiposity have been introduced: lipid accumulation product (LAP), body adiposity index (BAI) and body shape index (ABSI). These indices have been demonstrated to better associate with cardiovascular disease than other measures of adiposity. OBJECTIVES: The aim of the present study was to evaluate if LAP or BAI better associate with blood viscosity than other measures of adiposity (body mass index, BMI; waist circumference, WC; waist-to-hip ratio, W/HR; waist-to-height ratio, W/HtR). METHODS: 344 subjects were recruited for the present investigation. Exclusion criteria were: diabetes, elevated triglycerides, smoking and …drug use. Blood lipids and glucose were measured by routine methods. Blood and plasma viscosity were measured by a cone-plate viscometer. Adiposity measures were computed as previously described. RESULTS: In simple correlation analyses, blood viscosity (BV) correlated with BMI, BAI, and LAP in males and with LAP in females. Correlations between plasma viscosity and adiposity indices were weak and not statistically significant. Other variables significantly related with BV were: gender, HDL- and LDL-Cholesterol, and triglycerides (p  < 0.05). In multiple regression analysis only LAP was associated with BV. CONCLUSIONS: Our data suggest that LAP index is strongly associated to blood viscosity. This result, along with previous evidence, identifies LAP index as a potential cardiovascular risk marker. Show more

Keywords: Blood rheology, adiposity indices, cardiovascular risk

DOI: 10.3233/CH-16172

Citation: Clinical Hemorheology and Microcirculation, vol. 65, no. 3, pp. 241-248, 2017

Authors: Geng, Xiaoqiang | Lei, Tianluo | Zhou, Hong | Yao, Weijuan | Xin, Weihong | Yang, Baoxue

Article Type: Research Article

Abstract: OBJECTIVE: Urea transporter-B (UT-B), highly expressed in erythrocyte, confers specific permeability to urea, urea analogues and water. The purpose of this study was to determine the hemorheological properties of UT-B null erythrocyte using a series of biophysical techniques. METHODS AND RESULTS: The blood was taken from UT-B knockout and wild-type mice and the hemorheological parameters were measured. The UT-B inhibitor, PU-14, was used to treat the erythrocyte of wild-type mice in vitro and the deformability of the treated erythrocyte was analyzed. The results showed that UT-B knockout improves the hemorheological properties of erythrocyte, including increased erythrocyte …deformation index, small deformation index, orientation index, low osmotic fragility and high electrophoretic rate. The UT-B inhibitor PU-14 had the similar effect as UT-B knockout on the deformation indices. The whole blood viscosity in UT-B knockout mice showed reduction trend as compared to wild-type mice. CONCLUSIONS: The data indicate that UT-B is involved in the regulation of hemorheology, which suggests that UT-B may be a potential therapeutic target for improving the hemorheology in some metabolic and hereditary diseases. Show more

Keywords: Urea transporter, UT-B, erythrocyte, hemorheology, knockout

DOI: 10.3233/CH-16174

Citation: Clinical Hemorheology and Microcirculation, vol. 65, no. 3, pp. 249-257, 2017

Authors: Chen, Bao-Ding | Xu, Hui-Xiong | Zhang, Yi-Feng | Liu, Bo-Ji | Guo, Le-Hang | Li, Dan-Dan | Zhao, Chong-Ke | Li, Xiao-Long | Wang, Dan | Zhao, Shuang-Shuang

Article Type: Research Article

Abstract: BACKGROUND: Non-calcified thyroid nodules are relatively difficult to diagnose only relying on features of at conventional US images. OBJECTIVE: To investigate the diagnostic performances of conventional strain elastography (SE), acoustic radiation force impulse (ARFI) SE and point shear-wave speed (pSWS) measurement for non-calcified thyroid nodules. METHODS: A total of 201 non-calcified thyroid nodules in 195 patients were studied. They were examined with conventional ultrasound (US), conventional SE, ARFI SE and pSWS measurement. Their diagnostic performances and multivariable models were assessed with receiver operating characteristic (ROC) curve and logistic regression analyses respectively. RESULTS: There …were 156 benign and 45 malignant non-calcified nodules proven by histopathology or cystology. The mean diameters of the nodules were 21.2±10.8 mm. Areas under receiver operating characteristic curve (AUCs) of elastography features (ranged, 0.488–0.745) were all greater than that of US (ranged, 0.111–0.332). At multivariate analysis, there were three predictors of malignancy for non-calcified nodules, including pSWS of nodule (odds ratio [OR], 34.960; 95% CI, 11.582–105.529), marked hypoechogenicity (OR, 16.223; 95% CI, 1.761–149.454) and ARFI SE grade (OR, 10.900; 95% CI, 3.567–33.310). US+SE+pSWS owned the largest AUC (0.936; 95% CI, 0.887–0.985; P  < 0.05), followed by US+pSWS (0.889; 95% CI, 0.823–0.955), and the poorest was US (0.727; 95% CI, 0.635–0.819). CONCLUSIONS: ARFI SE and pSWS measurement had better diagnostic performances than conventional SE and US. When US combined with SE and pSWS measurement, it could achieve an excellent diagnostic performance and might contribute a better decision-making of FNA for non-calcified thyroid nodules. Show more

Keywords: Ultrasound, strain elastography, acoustic radiation force impulse, point shear-wave speed measurement, elastography

DOI: 10.3233/CH-16178

Citation: Clinical Hemorheology and Microcirculation, vol. 65, no. 3, pp. 259-273, 2017

Authors: Koutsiaris, Aristotle G.

Article Type: Research Article

Abstract: AIM: The purpose of this study was the application of a second derivative near infrared spectrophotometric (NIRS) technique to the human calf muscle in order to see if peripheral arterial disease (PAD) patients can be discriminated from control subjects, before, during and after a standard treadmill exercise test. METHODS: Three groups of human subjects were studied: group A consisted of 10 control subjects and groups B and C were formed by PAD patients classified as Fontaine’s stage 2a (5 patients) and 2b (10 patients), respectively. The measurement protocol for all groups was 9.75 minutes of standing up …(phase 1), 1 minute of exercise (phase 2) and 1 minute of rest (phase 3). Seven variables were defined at different times from the onset of the measurement protocol. RESULTS: All variables were significantly higher (p  < 0.05) in group A in comparison to groups B and C. The level of significance was ten times higher (p  < 0.005) at the onset (15 seconds) of the experiment and during phases 2 and 3. However, none of the variables in group B was significantly different from those in group C. CONCLUSIONS: It is shown for the first time that a second derivative NIRS technique can discriminate (p  = 0.003) healthy subjects from PAD patients, in just 15 seconds of standing, with no exercise requirement. More experiments are required in order to uncover the full potential of the technique in the diagnosis of the PAD. Show more

Keywords: Near infrared spectrophotometry (NIRS), second derivative, humans, calf muscle, peripheral arterial disease (PAD), claudication

DOI: 10.3233/CH-16181

Citation: Clinical Hemorheology and Microcirculation, vol. 65, no. 3, pp. 275-284, 2017

Authors: Jung, Jong Hwan | Chae, Yoon Jung | Lee, Dong Hwan | Cho, Young I. | Ko, Mi Mi | Park, Sung Kwang | Kim, Won

Article Type: Research Article

Abstract: Whole blood viscosity (WBV) plays a role in hemorheology and is determined by many factors such as red blood cell factors, plasma protein and blood volume. As WBV changes during hemodialysis, mortality may be due to changes in WBV in patients on hemodialysis. However, there are few prospective data on the relationship between changes in WBV and overall mortality in dialysis patients. We tried to investigate the correlations between values of WBV at variable shear rates before and after hemodialysis and overall or atherosclerosis-related mortality in patients with end-stage kidney disease. Forty-three patients receiving hemodialysis were enrolled in this …study. In this 5.8-year prospective observational study, analyses of the effects of WBV at shear rates of 300 s−1 (systolic WBV; SBV), 5 s−1 (diastolic WBV5; DBV5), and 1 s−1 (diastolic WBV1; DBV1) during dialysis on all-cause and atherosclerotic mortality was performed. Among a total of 43 patients, 27 (62.7%) died over the course of the study. Thirteen deaths were caused by atherosclerotic events. A high degree of change in WBV at shear rates of 300 s−1 and 5 s−1 during hemodialysis (ΔSBV, ΔDBV5) was positively correlated with overall mortality (HR = 4.688, 95% confidence interval [CI], 1.269–17.319, p  = 0.020; HR = 3.941, 95% CI, 1.057–14.701, p  = 0.041, respectively). A high degree of change in diastolic blood pressure (ΔDBP) during hemodialysis was also positively correlated with overall mortality (HR = 3.035, 95% CI, 1.039–8.867, p  = 0.042). However, comparative analysis between WBV at shear rates of 300 s−1 , 5 s−1 , and 1 s−1 and overall mortality did not reveal any significant relationships. Kaplan-Meier analysis revealed that the all-cause mortality was significantly higher in patients from a high degree of change of WBV at shear rates of 300 s−1 , compared to those from the moderate or low degree of changes of WBV at shear rates of 300 s−1 (p  = 0.020, log-rank test). Survival rate in high ΔDBP was lower than that of moderate or low ΔDBP group in Kaplan-Meier survival analysis (p  = 0.004, log-rank test). Our data showed that a high degree of change in WBV at variable shear rates during hemodialysis might impact overall survival in patients with end-stage kidney disease. However, large-scale studies to evaluate the relationship of WBV with overall mortality and atherosclerotic mortality will be needed. Show more

Keywords: Blood viscosity, dialysis, mortality, renal insufficiency

DOI: 10.3233/CH-16183

Citation: Clinical Hemorheology and Microcirculation, vol. 65, no. 3, pp. 285-297, 2017

Authors: Zagidullin, Naufal Shamilevich | Dunayeva, Alina Rinatovna | Plechev, Valdimir Vyacheslavovich | Gilmanov, Alexander Zhanovich | Zagidullin, Shamil Zarifovich | Er, Fikret | Pavlov, Valentin Nikolaevich

Article Type: Research Article

Abstract: BACKGROUND: Contrast-induced nephropathy (CIN) is a formidable side effect of iodinated contrast medium use in subjects undergoing coronary angiogram (CAG). Remote ischemic preconditioning (RIPC) may reduce the risk of CIN. AIM: The aim of the study was to investigate the nephroprotective effects of RIPC in coronary heart disease (CHD) in patients, undergoing CAG, with mild to moderate lowered estimated glomerular filtration rate (eGFR). MATERIALS: In the randomized, blinded, sham RIPC (sRIPC) controlled study 51 patients with CHD and GFR less than 80 mL/min/m2 , undergoing CAG, were investigated. The patients were randomized for RIPC (n  = 26, …60.5±2.0 years) or sRIPC (n  = 25, 62.96±1.7). RIPC was performed before the CAG by means of 3–5-minute cycle cuff pumped on the upper arm + 50 mm Hg above the systolic blood pressure (BP), while in sRIPC it corresponded to diastolic BP. The primary endpoint was the development of CIN and secondary – change of biomarkers (creatinine, urea, neutrophil gelatinase-associated lipocalin (NGAL), cystatin-C). RESULTS: In RIPC group, CIN occurred in 28% of cases, while in sRIPC – 3.8%. All investigated markers increased in sRIPC and declined in RIPC; the difference was significant in markers between the groups before and after CAG. CONCLUSIONS: RIPC proved nephroprotective effect in prevention of contrast-induced nephropathy in CHD subjects with mild to moderate lowered eGFR. Show more

Keywords: CIN, RIPC, cystatin, NGAL

DOI: 10.3233/CH-16184

Citation: Clinical Hemorheology and Microcirculation, vol. 65, no. 3, pp. 299-307, 2017