Clinical Hemorheology and Microcirculation - Volume 86, issue 4

Authors: Yao, Miao-Miao | Lin, Ting-Ting | Shi, Xu | Chen, Mei-Gui | Wu, Jia-Xiang | Zhao, Yan-Ping | Lin, Bao-Shan

Article Type: Research Article

Abstract: OBJECTIVE: Deep vein thrombosis (DVT) formation of lower extremities can lead to serious complications including pulmonary embolism (PE) and chronic post-thrombotic syndrome (PTS). We aimed to explore the relationship between the ratio of thrombotic density and the occurrence of PE and PTS in patients with DVT of the lower extremities. METHODS: A retrospective analysis was conducted in patients who performed computed tomography venography, dividing into DVT with PE group (54 patients) and DVT-alone group (34 patients), The clinical data were recorded. Univariate and multivariate logistic regression analysis were used to analysis variables associated with PE. The ability of …thrombosis density ratio and Wells score to diagnose PE was evaluated by using the receiver operating characteristic curve (ROC) area under the curve (AUC). According to the treatment and follow-up results, subgroup analysis was performed, and the Villata score was used to determine the presence or absence of PTS and its severity. RESULTS: Compare with the DVT-alone group, more patients had dyspnea and chest pain in the DVT with PE group. DVT with PE group had lower the percentage of neutrophils, white blood cell count and platelet count, while had higher blood cell count, D-dimer, wells score, thrombus and thrombus density ratio. Multivariate logistic analysis showed that percentage of neutrophils (OR(95% CIs)=1.15 (1.01,1.31), P  = 0.040), platelets (OR(95% CIs)=0.96 (0.93,0.99), P  = 0.011), and thrombus density ratio (OR(95% CIs)=5.99 (1.96,18.35), P  = 0.002) are independent predictors of PE. The Wells score and thrombosis density ratio were consistent in the diagnostic efficacy of PE. In the subgroup analysis, there was a relevance between the ratio of thrombosis density and the Villalta score. CONCLUSION: Percentage of neutrophils, platelets, and thrombus density ratio are independent predictors of PE. The thrombosis density of DVT patients may be an index to predict the risk of PE and PTS in DVT patients. Show more

Keywords: Deep vein thrombosis of lower limbs, thrombotic density ratio, pulmonary embolism, post-thrombotic syndrome

DOI: 10.3233/CH-231778

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 395-405, 2024

Authors: Yang, Yun-Ping | Chiu, Ching-Tang | Chao, Anne | Yeh, Yu-Chang | Sun, Wei-Zen | Liu, Chih-Min | Chan, Wing-Sum

Article Type: Research Article

Abstract: OBJECTIVE: This study measured normal ranges of microcirculatory parameters in healthy individuals and investigated differences in parameters by age and sex. METHODS: Participants were enrolled into three groups with equal numbers of male and female: young (20–39 years), middle-aged (40–59 years), and elderly (60–79 years). Sublingual microcirculation images were obtained using the incident dark field (IDF). RESULTS: A total of 75 female and 75 male healthy individuals were enrolled. The elderly group had a higher TVD (26.5 [2 ] vs. 25.2 [1.8 ]; p  = 0.019) and a lower PPV (97 [2 ] vs. 98 [3 ]; …p  = 0.03) than did the young group. In the elderly group, systolic blood pressure (SBP) and mean arterial pressure (MAP) were moderately and positively correlated with MFI score (r  = 0.407, p  < 0.05, and r  = 0.403, p  < 0.05, respectively). The female participants had a lower MFI score than did the male participants (2.9 [2.8–3 ] vs. 3.0 [2.9–3 ]; p  = 0.015). CONCLUSIONS: This study revealed the range of microcirculatory parameters between different ages and sexes in healthy individuals. We found that blood pressure levels were correlated with microcirculatory parameters, especially in elders and female. Show more

Keywords: microcirculation, healthy individuals, sublingual

DOI: 10.3233/CH-231807

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 407-417, 2024

Authors: Absatirova, Venera | Shandaulov, Assylbek | Khamchiyev, Kureysh | Shukurov, Firuz | Khalimova, Fariza

Article Type: Research Article

Abstract: BACKGROUND: The impact of gravity on the existence of all living things has long been of interest to scientists. The force of the Earth’s gravity combined with hypoxia significantly affects blood circulation and blood accumulation in various parts of the human and animal body. To date, the relationship between body position and blood circulation in pulmonary circulation under hypobaric hypoxia has not been sufficiently studied. OBJECTIVES: Therefore, the research aims to determine the possibility of changing the body position in space on the reactions in the pulmonary circulation in the plains and highlands. METHODS: …For this purpose, research was conducted on male Wistar rats, 44 of whom spent 150 days at an altitude of 3200 m above sea level, and 25 representatives of the control group - at an altitude of 164 m. RESULTS: The study revealed that gravitational redistribution of blood in mountainous conditions is less pronounced compared to the control group. This is explained by the remodeling of the vascular wall and an increase in its stiffness. It was found that a change in pulmonary artery pressure at the time of a change in body position was recorded both on the plains and in the highlands. On the plains, when the body position of rats was changed to passive orthostatic, a decrease in systolic and diastolic pulmonary artery pressure was noted, and when the body position was changed to passive anti-orthostatic, an increase in pulmonary artery pressure was observed. The increase in pulmonary artery pressure was a compensatory mechanism due to the increased stiffness of the pulmonary vasculature. CONCLUSIONS: The practical significance of this research is to expand the understanding of the pathogenesis of pulmonary hypertension in high-altitude hypoxia. Show more

Keywords: Pressure, hypoxia, blood supply, postural reactions, pulmonary artery

DOI: 10.3233/CH-231910

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 419-432, 2024

Authors: Wang, Nan | Yan, Xueliang | Zhang, Zhiqi | Liu, Luping | Zhu, Ju | Huang, Xiao | Nie, Fang

Article Type: Research Article

Abstract: OBJECTIVE: To explore whether the use of intravenous contrast-enhanced ultrasound (CEUS) can improve the diagnostic accuracy of T stage of gastric cancer on the basis of oral contrast-enhanced ultrasound (OCEUS). METHODS: Eighty-one patients with gastric cancer who underwent preoperative CEUS. Criteria for T staging was AJCC Stage 8th Edition. To compare the diagnostic accuracy, sensitivity and specificity of OCEUS and CEUS for T staging of gastric cancer using pathological results as the gold standard. RESULTS: There were differences in the diagnostic accuracy of T2 (P  = 0.048), T3(P  = 0.002) and T4 (P  = 0.000) between OCEUS and CEUS. …And there was no difference in diagnostic accuracy for T1 (P  = 0.118). CEUS significantly improved diagnostic sensitivity and specificity in T3 (42.86% to 61.90% for sensitivity, 86.96% to 93.75% for specificity), and T4 (64.71% to 76.47% for sensitivity, 78.33% to 95.74% for specificity). CONCLUSION: Compared with OCEUS, CEUS did improve the diagnostic accuracy of T2, T3, and T4 stages of gastric cancer. Show more

Keywords: T staging, ultrasonography, gastric cancer, intravenous contrast-enhanced ultrasound

DOI: 10.3233/CH-231949

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 433-440, 2024

Authors: Greiner, Barbara | Kaiser, Ulrich | Maurer, Katharina | Stroszczynski, Christian | Jung, Ernst Michael

Article Type: Research Article

Abstract: BACKGROUND: Rapid evolution of ultrasound technology has allowed widespread use of handheld ultrasound devices (HHUDs) for many possible applications. Along with the adult population, the use of HHUDs for Point of Care Ultrasound (POCUS) in pediatric medicine has been increasing over the last few years. However, pediatric-specific literature is still scarce on mobile vascular ultrasound. OBJECTIVE: To evaluate diagnostic capabilities of Vscan Air™ in comparison with high-end ultrasound for the assessment of the internal jugular vein in children and adolescents. METHODS: 42 Internal Jugular Veins (IJVs) of 21 pediatric patients were scanned by …an experienced examiner using a WLAN-supported handheld ultrasound device (Vscan Air™) and high-end cart-based ultrasound (LOGIQ E9) as reference. B-Mode and Color-coded Doppler (CCDS) were performed and compared. Image quality was assessed using a score of 0 to 5 and statistically analyzed. Results were interpreted independently by two readers in consensus. RESULTS: 21 patients (2–17 years; mean 11,00±4,5 years; female n  = 11, male n  = 10) were examined. The rating score never dropped below 3 for both devices. The median score evaluation of B-Mode and CCDS for the high-end device was 5.00, of Vscan Air™ 5.00 for B-Mode and 4.00 for CCDS. A significant difference was shown between the two devices in the evaluation of CCDS. CONCLUSIONS: Vscan Air™ ultrasound device allows sufficient assessability of the IJV in pediatric patients, opening up new possibilities for fast and mobile POCUS of cervical veins and potential guidance of central venous catheter placement. Show more

Keywords: Handheld ultrasound, Vscan Air, POCUS, internal jugular vein, pediatric

DOI: 10.3233/CH-231981

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 441-449, 2024

Authors: Luo, Nan | Liang, Xiao-yu | Li, Lu | Zhang, Xiao | Zang, Chun-mei | Liu, Xi | Fan, Xiao-zhou

Article Type: Research Article

Abstract: A rare foreign body accompanied by thrombosis in the right internal jugular vein was accidentally observed. We collected the medical history of this special patient, analyzed the causes and characteristics of the foreign body and thrombosis formation, and subsequently observed the changes in thrombosis. Finally, we discussed the diagnostic value of ultrasound for such rare intravascular lesions.

Keywords: Ultrasound, internal jugular vein, foreign body, thrombosis

DOI: 10.3233/CH-231988

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 451-455, 2024

Authors: Neira Agonh, Daniel | Scott, Cassidy | Trivedi, Purvi | Dickson, Kayle | White, Hannah | Zhou, Juan | Lehmann, Christian

Article Type: Research Article

Abstract: BACKGROUND: Pentobarbital and isoflurane are commonly used veterinary anesthetics. Due to the dangers of overdose by repeat-bolus regimen of pentobarbital, isoflurane has been recommended. However, literature suggests isoflurane-induced inhibition of cytokine and adhesion molecule release, impacting leukocyte adhesion. OBJECTIVE: This study aims to characterize the impacts of pentobarbital versus isoflurane on leukocyte interactions within the intestinal microcirculation with and without endotoxin challenge. METHODS: Female BALB/c mice were subjected to pentobarbital or isoflurane (N = 20) and challenged with endotoxin or saline by intraperitoneal injection. The mice were kept under anesthesia for 2 hours. Fluorochromes, rhodamine-6 G and fluorescein isothiocyanate, …were injected intravenously. To visualize leukocyte adhesion within the intestinal microcirculation, laparotomy and intravital microscopy was performed. Leukocyte rolling and adhesion was quantified offline in a blinded fashion. RESULTS: Within collecting venules, leukocyte rolling and adhesion showed no significant differences between pentobarbital and isoflurane anesthesia under basal conditions. Endotoxin challenge caused a similar response in both anesthetic groups. Within postcapillary venules, no statistical differences between the two anesthetics were found for adhering leukocytes under basal conditions or following endotoxin challenge either. However, leukocyte rolling after LPS-challenge was significantly decreased in postcapillary venules during isoflurane anesthesia compared to pentobarbital anesthesia. CONCLUSIONS: Isoflurane anesthesia showed only minor differences in the immune response to endotoxin within the intestinal microcirculation compared to pentobarbital anesthesia. Due to the superior safety profile of volatile anesthetics, immunological studies may choose isoflurane over pentobarbital as the veterinary anesthetic of choice. Show more

Keywords: Intravital microscopy, pentobarbital, isoflurane, leukocytes, microcirculation

DOI: 10.3233/CH-231989

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 457-465, 2024

Authors: Zhang, Wei | Liu, Yilun | Wu, Qiong | Wei, Xiaoer | Liu, Beibei | Jiao, Qiong | Zhang, Rui | Hu, Bing | Li, Yi | Ying, Tao

Article Type: Research Article

Abstract: OBJECTIVE: This article aims to clarify pitfalls and find strategies for the detecting and diagnosing hyperechoic liver metastases (LMs) using Sonazoid-contrast enhanced ultrasonography (Sonazoid-CEUS). METHODS: This study was a prospective self-controlled study. Patients with hepatic lesions suspected as LMs or benign lesions were included in the study. Baseline ultrasonography (BUS) and Sonazoid-CEUS were performed on every patient. Characteristics of LMs and benign nodules were compared by chi-square test and fisher test. Factors influenced the CEUS were demonstrated by univariate analysis and multivariate logistic regression analysis. RESULTS: 54 patients were included in this study. …CEUS found additional 75 LMs from 19 patients in Kupffer phase. We found hyperechoic focal liver lesions and deep seated in liver are main confounding factors in CEUS diagnosis. Sensitivity would be improved from 16.67% to 78.57%, negative predictive value (NPV) would be improved from 28.57% to 76.92% and accuracy would be improved from 37.5% to 87.50% when using rapid “wash-in” and “wash-out” as main diagnostic criteria. CONCLUSIONS: Hyperechoic LMs especially deeply seated ones are usually not shown typical “black hole” sign in Kupffer phase. Quickly “wash-in and wash out” shows high accuracy in diagnosing malignant nodules. We highly recommend CEUS as a routing exam to detect and diagnose LMs. Show more

Keywords: Contrast enhanced ultrasonography, focal liver lesion, liver metastases, Kupffer phase

DOI: 10.3233/CH-231995

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 467-479, 2024

Authors: Zeng, Yan-hao | Yang, Yu-ping | Liu, Li-juan | Xie, Jun | Dai, Hai-xia | Zhou, Hong-lian | Huang, Xing | Huang, Rong-li | Liu, Er-qiu | Deng, Yi-jing | LI, Hua-juan | Wu, Jia-jian | Zhang, Guo-li | Liao, Man-li | Xu, Xiao-hong

Article Type: Research Article

Abstract: OBJECTIVE: To explore the discriminatory diagnostic value of multimodal ultrasound(US) combined with blood cell analysis (BCA) for Granulomatous Lobular Mastitis (GLM) and Invasive Ductal Carcinoma (IDC) of the breast. METHODS: A total of 157 breast disease patients were collected and divided into two groups based on postoperative pathological results: the GLM group (57 cases with 57 lesions) and the IDC group (100 cases with 100 lesions). Differences in multimodal ultrasound features and the presence of BCA were compared between the two groups. The receiver operating characteristic (ROC) curve was used to calculate the optimal cutoff values, …sensitivity, specificity, 95% confidence interval (CI), and the area under the curve (AUC) for patient age, lesion size, lesion resistive index (RI), and white blood cell (WBC) count in BCA. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and AUC were calculated for different diagnostic methods. RESULTS: There were statistically significant differences (P  < 0.05) observed between GLM and IDC patients in terms of age, breast pain, the factors in Conventional US (lesion size, RI, nipple delineation, solitary/multiple lesions, margin, liquefaction area, growth direction, microcalcifications, posterior echogenicity and abnormal axillary lymph nodes), the factors in CEUS (contrast agent enhancement intensity, enhancement pattern, enhancement range, and crab-like enhancement) and the factors in BCA (white blood cells, neutrophils, lymphocytes and monocytes). ROC curve analysis results showed that the optimal cutoff values for distinguishing GLM from IDC were 40.5 years for age, 7.15 cm for lesion size, 0.655 for lesion RI, and 10.525*109 /L for white blood cells. The diagnostic accuracy of conventional US combined with CEUS (US-CEUS) was the highest (97.45%). The diagnostic performance AUCs for US-CEUS, CEUS, and US were 0.965, 0.921 and 0.832, respectively. CONCLUSION: Multifactorial analysis of multimodal ultrasound features and BCA had high clinical application value in the differential diagnosis of GLM and IDC. Show more

Keywords: Ultrasound, blood cell analysis, granulomatous lobular mastitis, invasive ductal carcinoma

DOI: 10.3233/CH-231999

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 481-493, 2024

Authors: Gao, Jie | Gao, Zhao

Article Type: Research Article

Abstract: OBJECTIVE: The present study probes into the role and mechanism of ubiquitin specific peptidase 14 (USP14) in coronary heart disease (CHD)-triggered endothelial cell pyroptosis. METHODS: An in vitro CHD model was established by inducing human coronary artery endothelial cells (HCAECs) with oxidized low-density lipoprotein (ox-LDL). HCAECs were transfected with si-USP14, followed by evaluation of cell viability by CCK-8 assay, detection of lactate dehydrogenase (LDH) activity by assay kit, detection of USP14, miR-15b-5p, NLRP3, GSDMD-N, and Cleaved-Caspase-1 expressions by qRT-PCR or Western blot, as well as IL-1β and IL-18 concentrations by ELISA. Co-IP confirmed the binding between USP14 …and NLRP3. The ubiquitination level of NLRP3 in cells was measured after protease inhibitor MG132 treatment. Dual-luciferase reporter assay verified the targeting relationship between miR-15b-5p and USP14. RESULTS: USP14 and NLRP3 were highly expressed but miR-15b-5p was poorly expressed in ox-LDL-exposed HCAECs. USP14 silencing strengthened the viability of ox-LDL-exposed HCAECs, reduced the intracellular LDH activity, and diminished the NLRP3, GSDMD-N, Cleaved-Caspase-1, IL-1β, and IL-18 expressions. USP14 bound to NLRP3 protein and curbed its ubiquitination. Repression of NLRP3 ubiquitination counteracted the inhibitory effect of USP14 silencing on HCAEC pyroptosis. miR-15b-5p restrained USP14 transcription and protein expression. miR-15b-5p overexpression alleviated HCAEC pyroptosis by suppressing USP14/NLRP3. CONCLUSION: USP14 stabilizes NLRP3 protein expression through deubiquitination, thereby facilitating endothelial cell pyroptosis in CHD. miR-15b-5p restrains endothelial cell pyroptosis by targeting USP14 expression. Show more

Keywords: Coronary heart disease, endothelial cell pyroptosis, USP14, miR-15b-5p, NLRP3

DOI: 10.3233/CH-232003

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 495-508, 2024

Authors: Astapenko, David | Zrzavecky, Marek | Gorskaja, Diana | Hyspler, Radomir | Ticha, Alena | Radochova, Vera | Lehmann, Christian | Malbrain, Manu L.N.G. | Cerny, Vladimir | Hahn, Robert G.

Article Type: Research Article

Abstract: BACKGROUND: Endothelial glycocalyx (EG) plays a crucial role in maintaining the plasma proteins within the intravascular space. OBJECTIVE: We studied whether exogenous albumin protects the EG in an experimental model of EG enzymatic damage in rats. METHODS: Rats were divided into three groups of 10 animals that received (1) Evans blue (2) Evans blue + hyaluronidase, or (3) Evans blue + hyaluronidase + 20% human albumin via the tail vein. Spectrophotometric analysis was performed 2 h later to quantify the leakage of Evans blue-labeled albumin into the heart, lungs, brain, kidneys, liver, small intestine, spleen, and skeletal muscle. RESULTS: Administration of …hyaluronidase numerically increased the capillary leakage of Evans blue in all examined tissues. Co-administration of albumin decreased the leakage of albumin in all tissues except the heart. In the lungs, the ratio between the absorbance and dry organ weight decreased from 5.3 ± 2.4 to 1.7 ± 0.5 (mean ± SD) (P  < 0.002), and in the liver, the absorbance decreased from 2.2 ± 0.7 to 1.5 ± 0.4 (P  < 0.011). CONCLUSION: Exogenous albumin decreased the capillary leakage of albumin which was interpreted as a sign of maintained EG integrity. Show more

Keywords: Albumin, endothelial glycocalyx, microcirculation, evans blue, spectrophotometry

DOI: 10.3233/CH-232027

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 509-517, 2024

Authors: Uygur, Lutfiye | Kabasakal Ilter, Merve | Helvacı, Nazlı | Mokresh, Muhammed Edib | Kahya, Muhammed | Muvaffak, Emir | Elmuhammed, Muhammet Huzeyfe | Ayhan, Isil | Kumru, Pınar

Article Type: Research Article

Abstract: BACKGROUND: Pregnancy is a dynamic process associated with changes in vascular and rheological resistance. Maternal maladaptation to these changes is the leading cause of pregnancy complications such as preeclampsia. OBJECTIVE: This study aimed to assess the hemorheological alterations in pregnancies with a high risk for preeclampsia in the first trimester. METHODS: Ninety-two pregnant women were allocated into the high preeclampsia risk group (37 cases) and control groups (55 cases). Plasma and whole blood viscosity and red blood cell morphodynamic properties, including deformability and aggregation were assessed by Brookfield viscometer and laser-assisted optical rotational cell analyzer (LORRCA) …at 11–14 gestational weeks. RESULTS: Whole blood viscosity was significantly higher in the high-risk group at all shear rates. Plasma viscosity and hematologic factors showed no differences between the groups. Hematocrit levels positively correlated with high blood viscosity only in the high-risk group. There were no significant changes in the other deformability and aggregation parameters. CONCLUSIONS: Changes in the whole blood viscosity of pregnant women with high preeclampsia risk refer to impaired microcirculation beginning from the early weeks of gestation. We suggest that the whole blood viscosity is consistent with the preeclampsia risk assessment in the first trimester, and its measurement might be promising for identifying high-preeclampsia-risk pregnancies. Show more

Keywords: Erythrocyte aggregation, preeclampsia, red blood cell deformability, whole blood viscosity

DOI: 10.3233/CH-232026

Citation: Clinical Hemorheology and Microcirculation, vol. 86, no. 4, pp. 519-530, 2024