Clinical Hemorheology and Microcirculation - Volume 9, issue 1

Authors: Bauersachs, R.M. | Wenby, R.B. | Meiselman, H.J.

Article Type: Research Article

Abstract: Although red blood cell (RBC) aggregation remains an important issue in hemorheology, measurements of specific aggregation parameters are not usually performed routinely in many laboratories; this is primarily due to the present lack of appropriate instrumentation. We have thus developed an automated and interactive system, based on light transmission measurements using a modified Myrenne Aggregometer and a laboratory computer, which provides rapid and routine determination of seven RBC aggregation indices. The computerized system allows control of shear rate as well as recording and analysis of digitized light transmission data. Aggregation indices measured with this system include: 1) extent of aggregation …at stasis (AI, AMP); 2) kinetics of aggregate formation (T1/2 , TFAST , TSLOW ); 3) shear resistance of RBC aggregates (YTmin ); 4) aggregate formation induced by low shear (FSAR). Results obtained for RBC/plasma suspensions indicated appropriate reproducibility, several cross-correlations between the indices (except between AI versus TFAST or TSLOW ), that fibrinogen affected all indices, and that donor age markedly influences aggregation behavior. Dextran suspending media demonstrated the expected biphasic aggregation response of this polymer. RBC modified by heat treatment or by shape altering agents exhibited changes versus control, and age fractionated red cells demonstrated marked differences in aggregation behavior. In overview, the results indicate the necessity to determine more than one parameter to fully describe the aggregation process, and suggest the usefulness of this newly developed system for both routine clinical studies and basic research investigations. Show more

Keywords: RBC aggregation, dextran, fibrinogen, erythrocyte properties

DOI: 10.3233/CH-1989-9101

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 1-25, 1989

Article Type: Editorial

DOI: 10.3233/CH-1989-9120

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 1-3, 1989

Authors: Forconi, S. | Guerrini, M. | Pieragalli, D.

Article Type: Research Article

Abstract: Red cell deformability is a widely accepted term to indicate a property of erythrocytes to adapt their shape to the forces acting in blood circulation. The concept of cell deformability is easy to understand, but it is very hard to evaluate in a numerical way. Several techniques have been proposed but, at present, none can express this biological property with absolute values. Important problems are not yet solvable. The studies in whole blood are influenced by the presence of leucocytes and platelets, and all the procedures which tend to isolate the erythrocytes transform the measurements into technical artifacts. The experience …we have had with some new sophysticated and expensive devices has suggested we should not abandon whole blood filtration which, with important but simple technical improvements, remains a method able to value “whole blood filterability’, which is a parameter only partly correlable to “red cell deformability” and not identifiable with it. So, while clinicians need new effected method from biorheologists, the only possible approach to red cell deformability in clinical hemorheology is by means of the interpretation of a pattern of different measurements (blood and plasma viscosity, whole blood filterability, hematocrit, fibrinogen concentration, leucocyte and platelet number and activity). Show more

Keywords: Hemorheology, red cell deformability, whole blood filterability, washed red cell filterability

DOI: 10.3233/CH-1989-9102

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 27-34, 1989

Authors: Harkness, J.

Article Type: Research Article

Abstract: On the basis of several thousands of parallel measurements of the viscosity of human blood plasma and the Erythrocyte Sedimentation Rate (ESR) as indices of the presence and severity of certain diseases it is concluded that there is no aspect, technical and clinical, in which the plasma viscosity test is not superior.

Keywords: Blood sedimentation, blood viscosity, plasma viscosity

DOI: 10.3233/CH-1989-9103

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 35-39, 1989

Authors: Rampling, M.W. | Martin, G.

Article Type: Research Article

Abstract: A comparison has been made of the response of the Myrenne Erythrocyte Aggregometer (MEA) with fibrinogeo concentration, low shear rate viscometry and the ESR used as indices of red cell aggregating potential of samples of normal blood. A good linear correlation has been found between the response of the MEA and each of the other indices in these circumstances. It is concluded that because of this correlation, combined with its ease and speed of use, it is a valuable instrument for the quantitation of erythrocyte aggregation.

Keywords: Erythrocyte aggregation, ESR, Blood viscosity, Fibrinogen

DOI: 10.3233/CH-1989-9104

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 41-46, 1989

Authors: Motta, C. | Conan, F. | Roche, M. | Thao Chan, M.

Article Type: Research Article

Abstract: Fluorescence polarization was used to investigate possible modifications of the fluidity and order in lymphocytes membranes from 19 patients treated with pentoxifylline (800 mg/day). We only studied patients with an atherosclerosis obliterans stage II (according Fontaines’ classification) having received the drug (pentoxifylline) for 10 days. Anisotropy fluorescence (AF) was measured before and after treatment for each patient using the classical fluorescence probe : 1,6- Diphenyl- 1,3,5- Hexatriene (DPH) and the TNBS-DPH quenching method for membrane resolution. Lymphocytes with high values of AF>1.95 (and hence high viscosity) were noticeably modified after the treatment. No similar modifications were observed in cells with …original values within the normal range. In these conditions pentoxifylline seems to act only on the perturbated lymphocyte membrane and do not modify the normal membrane. This could be of interest the modulation and restauration of some immunological properties of membrane properties under the lymphocyte membrane fluidity dependence. Show more

Keywords: Lymphocyte fluidity, pentoxifylline, peripheral vascular disease

DOI: 10.3233/CH-1989-9105

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 47-54, 1989

Authors: Pfafferott, C. | Zaninelli, R. | Bauersachs, R. | Volger, E. | Meiselman, H.J.

Article Type: Research Article

Abstract: Although previous reports have indicated that catecholamines can produce changes in RBC flow behavior, RBC microrheologic studies with these agents appear to be limited. The present study was therefore designed to evaluate the effects of both an alpha-stimulator norepinephrine (NE) and a beta-stimulator isoprenaline (IP) on RBC deformation in defined shear fields as well as on RBC filterability under pathologic conditions. Various concentrations of NE and IP (10-4M - 10-9M) were added to fresh human RBC suspended in isotonic phosphate or HEPES buffered saline at physiologic pH and the cells incubated for 30 min at room temperature. RBC deformation measurements …were carried out in a counter-rotating rheoscope over a shear stress range of .25 – 50 Pa. RBC filterability (5 µm pores, 10% Hct) was investigated at physiologic pH and under pathologic conditions using the following stress models: a) pH = 7.0; b) increased external calcium concentration (pH = 7.4, 9 mM Ca); c) 9mM Ca plus ATP depletion via 2-deoxyglucose. In the rheoscope, RBC incubated with 10-5M NE showed a decrease in cell deformation at low shear stresses and a decrease over the entire shear stress range was found after incubation with 10-4 M NE. IP at 10-4 and 10-5 M did not alter cell deformation at pH = 7.4, whereas lower IP concentrations (10-7 M and 10-9 M) lead to an increase in cell deformation at the lowest shear stresses. Compared to the filterability of controls at pH 7.4, RBC filterability was decreased in all stress situations. Increasing NE concentrations significantly worsened the reduction in cell filterability in the stress models, while the effects of IP were more variable: with IP, either there was no change in filterability or small but significant increases. Our results suggest that NE, an alpha-receptor agonist, may negatively alter RBC flow properties in regions of high NE concentrations (i.e. local areas of infarcted myocardium), whereas beta-receptor-agonists, such as IP, could be beneficial to blood flow in low concentrations. Show more

Keywords: RBC deformability, catecholamines

DOI: 10.3233/CH-1989-9106

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 55-67, 1989

Authors: Schmalzer, Emily A. | Chien, Shu

Article Type: Research Article

Abstract: Granulocyte rigidity was estimated from the pressure-time curves generated by constant flow through Hemafil filters. The curves were used to deduce β , a factor relating the flow resistance presented by a cell to that of suspending medium. The cells were prepared in two buffer systems, one which allowed partial stimulation as evidenced by pseudopod formation and one which did not. β for cells activated by buffer alone was twice that of resting (pseudopod-free) cells, while activation of resting cells by FMLP at 10 − 7 M raised β ten-fold. In 10 mM …pentoxifylline (PTX) β of buffer- or FMLP-activated cells fell to a level similar to that of resting cells, but PTX had no effect on resting cells. Cytochalasin B (CB) lowered β more than PTX. The effect of other methylxanthines (HWA 285 and HWA 448) was similar to PTX. β was found to be shear stress dependent, and differences between activated and PTX-treated cells were magnified at lower pressures. The behavior of granulocytes in this simple model system suggests that activation might lead to significant increases in the precapillary resistance, and that treatment with pharmacological agents might prevent this. Show more

Keywords: Cytochalasin B, Methylxanthines, Neutrophils, Pentoxifylline

DOI: 10.3233/CH-1989-9107

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 69-80, 1989

Authors: Montefusco, S. | Gnasso, A. | Scarpato, N. | Rubba, P. | Nappi, G. | Cortese, C. | Pandolfi, G. | Postiglione, A.

Article Type: Research Article

Abstract: Twelve patients with Familial Hypercholesterolemia (FH) have been treated by LDL-apheresis,a method for selective removal of apolipoprotein-B containing lipoproteins by adsorption on dextrane sulphate columns. Mean plasma cholesterol reduction after treatment was 57% (p<0.001),due to LDL decrease.High density lipoprotein (HDI.) cholesterol was decreased by 16%. Blood and plasma viscosity were assessed before and seven days after the treatment: blood viscosity was reduced by 26.8% (p<0.005) at shear rate 11.25 sec-1,as well as by 11.7% (p<0.005) at 450 sec-I. Hematocrit was 37.0 before and 35.9 seven days later. No statistically significant difference was observed for plasma viscosity. Relative blood viscosity (blood/ …plasma viscosity ratio) was significantly (p<0.05) decreased at high shear rates, suggesting that removal of LDL improves red cell deformability. Show more

Keywords: Familial Hypercholesterolemia, LDL-apheresis, blood viscosity

DOI: 10.3233/CH-1989-9108

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 81-87, 1989

Authors: Cherubini, P. | Bozzoni, M. | Agosti, R. | Clivati, A. | Somazzi, R. | Longhini, E.

Article Type: Research Article

Abstract: It is known that some authors found an impairment of hemorheological characteristics in essential hypertension, related to an increased relative apparent blood viscosity and to a decreased red blood cell filterability. This latter seems to be related to a defect of transmembranary ions transport systems so that erythrocyte membrane flexibility may be reduced. It is reported that the Na/K cotransport system is impaired in several tissues of essential hypertensive patients, such as red blood cells. The aim of this work was to study filterability of washed and resuspended red blood cells by means of an erythrocyte filtrometer MF4, before and …after furosemide challenge, this latter employed as a Na/K cotransport blocker. Basal filterability indices of hypertensive patients were impaired. in respect to normal controls, likely confirming a decreased red cells deformability. After furosemide addition, filterability indices of normal controls resulted impaired in respect to basal values, meanwhile parameters of hypertensives were unchanged. These findings seem to support the hypothesis of a genetically impaired Na/K cotransport system in essential hypertensive patients. Show more

Keywords: essential hypertension, erythrocyte filterability, intracellular sodium concentration, Na/K cotransport system, furosemide

DOI: 10.3233/CH-1989-9109

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 89-100, 1989

Authors: Rampling, M.W. | Feher, M.D. | Sever, P.S. | Elkeles, R.S.

Article Type: Research Article

Abstract: There are many reports in the literature describing haemorheological disturbances associated with diabetes. However, the majority of these studies have concentrated on insulin-dependent, rather than non-insulin dependent diabetes (NIDD). Furthermore, very little attention has been given to the effect of associated hypertension which is a common feature of NIDD. In this study the rheological profiles of blood from 41 NIDD subjects with treated hypertension (HT), 31 normotensive NIDD subjects (NHT) and 12 non-diabetic controls (C) were studied. Differences in haematocrit failed to reach statistical significance. However, the plasma fibrinogen concentrations (mean ± SD) were significantly different between the groups (HT: …4.7 ± 1.0, NHT: 4.0 ± 0.7, C: 3.5 ± 0.6 g/l) and were reflected in the plasma viscosity (1.52 ± .15, 1.46 ± .06, 1.41 ± 0.6 mPas) and relative blood viscosity at low shear rate, 0.277 s−1 , (38.1 ± 3.8, 35.9 ± 3.9, 32.9 ± 3.6). The rheological differences between the groups can be explained mainly in terms of the effects of altered fibrinogen concentration. Show more

Keywords: Hemorheology, fibrinogen, diabetes, hypertension, blood viscosity, plasma viscosity

DOI: 10.3233/CH-1989-9110

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 101-107, 1989

Authors: Koppensteiner, R. | Jung, M. | Minar, E. | Ehringer, H.

Article Type: Research Article

Abstract: Hemorheological abnormalities in completed vascular stroke are frequently reported. The purpose of our study was to examine whether patients with recent transient ischemic attacks (TIAs) show similar changes. In 15 patients with recent TIAs hematocrit, fibrinogen, red cell aggregation, red cell deformability and platelet aggregation were studied. In comparison to age-and sex-matched healthy controls a significant elevation of platelet aggregation (spontaneous, ADP-induced) was found; no differences were observed in the other parameters. Our findings suggest that normal hemorheological conditions (apart from increased platelet aggregation) - as found in our TIA-patients - may advance the recovery from a neurological deficit by …more effective activation of hemodynamic compensating mechanisms. Show more

Keywords: transient ischemic attacks, platelet aqgregation, hemorheology

DOI: 10.3233/CH-1989-9111

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 109-114, 1989

Authors: Robertson, J.D. | Maughan, R.J. | Leiper, J.B. | Davidson, R.J.L.

Article Type: Research Article

Abstract: Haemorheologtcal and red cell age-related indices were measured in male subjects before and after two bouts of prolonged walking (148km) each lasting 4 days. During the walk subjects consumed isoenergetic diets which were either low (2 ± 0%, mean ± SD) or high (85 ± 1%) in carbohydrate (CHO). There was a significant reduction in the uncorrected whole blood viscosity only on the high CHO diet, primarily due to a greater extent of the haemodilution which was evident on both diets. In addition, plasma viscosity was significantly elevated on the low CHO diet but unchanged on the high CHO diet, …these dietary differences being associated with alterations in serum protein concentration. Red cell deformability was reduced only on the low CHO diet and there was also an increase in median cell density in Percoll gradients indicating general aging of the cell population. Increases in reticulocyte number and red cell creatine recorded only on the low carbohydrate diet (high protein and fat) are consistent with increased erythropoietic activity. Show more

Keywords: Blood viscosity, diet, exprclse

DOI: 10.3233/CH-1989-9112

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 115-124, 1989

Authors: Neumann, F.-J. | Haupt, H. | Zimmermann, R. | Tillmanns, H.

Article Type: Research Article

Abstract: Purpose of the study was to investigate the sensitivity of metal microsieves (pore diameter 4.3±.2 µm) for detecting changes in red cell deformability through red cell filtration by the hydrostatic pressure of the sample in the MF4 filtrometer. To estimate the effects of pore clogging and of single pore conductance separately in the MF4 filtrometer, a new method of evaluation was introduced and validated using the St. George’s filtrometer. To test the microsieves in the MF4 filtrometer, normal red blood cells (haematocrit 6%) were filtered in parallel with artificially abnormal cells: Internal viscosity and cell volume were altered by changing …suspension osmolality, membrane stiffness by heat treatment, and cell shape by incubation with Na-salicylate or chlorpromazine. The induced abnormalities caused a change in single pore conductance or clogging rate and were more easily detected by filtration through metal microsieves than through polycarbonate membranes. Hence, metal microsieves proved a useful tool in red cell filtration. Show more

Keywords: erythrocyte, filtration, microsieve, viscosity

DOI: 10.3233/CH-1989-9113

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 125-137, 1989

Authors: Brown, P. | Harrison, M.J.G.

Article Type: Research Article

Abstract: Platelet aggregation and blood filtrability were studied in patients with aortic Starr Edwards valves and xenograft valves and in age and sex matched patients with unoperated aortic valve disease and in controls. Blood filtrability was found to be significantly impaired in both patients with aortic valve disease and with Starr Edwards valve replacements. Platelet aggregation in stirred whole blood was found to be significantly greater only in patients with Starr Edwards valves. Red cell release of adenosine diphosphate under shear stress is thus unlikely to mediate the reduced platelet survival in vivo or the increased platelet aggregability in vitro seen …in patients with aortic Starr Edwards valves, and it is suggested that the platelets themselves are affected by contact with such prosthetic valves. The relevance of these findings to the risk of thromboembolism is discussed. Show more

DOI: 10.3233/CH-1989-9114

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 139-147, 1989

Authors: Takamizawa, Keiichi | Hayashi, Kozaburo | Nakamura, Takao | Kato, Tadashi | Tsushima, Nobuko

Article Type: Research Article

Abstract: The effects of elastase administration on the rheological properties of blood were investigated in the rabbits fed 1 % cholesterol diet for 14 weeks. There was no significant difference in the whole blood viscosity among the cholesterol-fed animals, cholesterol-fed and elastase administered ones and non-treated control ones. The hematocrit was lowest in the rabbits fed cholesterol diet. The filtrability (deformability) of red blood cell was also decreased by the cholesterol diet. These changes indicate the decrease in the capability of oxygen delivery on macro- and micro-circulation levels. The elastase administration improved the macrocirculatory oxygen delivery index in the hypercholesterolemic rabbits, …although it had no appreciable effect on the red blood cell deformability. Show more

Keywords: Cholesterol, Elastase, Hypercholesterolemic Rabbits, Oxygen Delivery, Blood Viscosity, Red Blood Cell Deformability

DOI: 10.3233/CH-1989-9115

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 149-156, 1989

Article Type: Abstract

DOI: 10.3233/CH-1989-9116

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 157-166, 1989

Authors: Ernst, E.

Article Type: Other

DOI: 10.3233/CH-1989-9117

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 167-172, 1989

Article Type: Announcement

DOI: 10.3233/CH-1989-9118

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 173-176, 1989

Article Type: Other

DOI: 10.3233/CH-1989-9119

Citation: Clinical Hemorheology and Microcirculation, vol. 9, no. 1, pp. 177-177, 1989