Clinical Hemorheology and Microcirculation - Volume Pre-press, issue Pre-press

Authors: Chung, Young Hak | Lee, Kyung Ah | Cho, Minhee | Shin, Sehyun | Lee, Byoung Kwon

Article Type: Research Article

Abstract: BACKGROUND: Analysis of responsiveness to antiplatelet therapy is crucial in the management of patients with cardiovascular diseases. OBJECTIVE: This study aimed to evaluate a new platelet function analysis system (Anysis-200) and to compare it with VerifyNow (Accumetrics, San Diego, CA) in cardiology patients. METHODS: Overall, 125 citrated blood samples were collected from 85 cardiology patients referred for platelet function testing. In Anysis-200, platelet function was measured as blood migration distance (MD) until clogging of flow passage, which is comparable to aspirin resistance units obtained using VerifyNow. The two devices were simultaneously used and compared. …RESULTS: The MDs before and after taking aspirin were 174±51 and 247±27 mm, respectively (p  < 0.0001). Compared with VerifyNow (reference), the sensitivity and specificity of Anysis-200 was 91.5% and 75.5%, respectively (area under the curve, 0.829). Further, the true positive rate in patients newly taking aspirin was 85% for VerifyNow and 92.5% for Anysis-200, respectively. The Cohen’s kappa coefficient between the two devices was 0.682, indicating a relatively high agreement. CONCLUSIONS: Anysis-200, a novel system for assessing platelet aggregation, has accuracy and precision equivalent to that of, and significant agreement with, VerifyNow. Anysis-200 may be useful in screening patients with abnormal platelet reactivity and aspirin nonresponsiveness. Show more

Keywords: Platelet function, aspirin, Anysis-200 analyzer, VerifyNow

DOI: 10.3233/CH-200822

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2020

Authors: Zhang, Yan-Qun | Wen, Jie-Xian | Luo, Rong-Kui | Yuan, Hai-Xia | Wang, Wen-Ping

Article Type: Research Article

Abstract: Duodenal neuroendocrine tumors are rare neoplasms arising from endocrine cells. Here we present a case of 32-year-old woman with Duodenal neuroendocrine tumors, report the imaging and contrast-enhanced Ultrasound (CEUS) features and review previous literatures of neuroendocrine tumors, which may be valuable for the differential diagnosis of duodenal neoplasms.

Keywords: Neuroendocrine tumors, duodenal, contrast-enhanced ultrasound (CEUS), imaging features

DOI: 10.3233/CH-200816

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-6, 2020

Authors: Zheng, Yi | Xia, Shujun | Ren, Xinping | Zhan, Weiwei | Zheng, Zhan | Chen, Zhijie

Article Type: Research Article

Abstract: PURPOSE: To evaluate the value of spleen shear-wave elastography (sound touch elastography [STE], sound touch quantification [STQ]) in indirect prediction of liver fibrosis in patients with chronic hepatitis B (CHB). METHODS: The Young’s modulus (kPa) of spleen STE, STQ and liver FibroScan were measured in 112 patients with CHB. The final diagnosis was according to histological results from liver biopsy based on Scheure G/S scoring system and liver FibroScan was considered as a reference index of prediction efficiency. Grouped by the stage of liver fibrosis, data were analyzed by Spearman correlation analysis, Mann-Whitney test and receiver operating characteristic …curve (ROC). RESULTS: Spleen STE was positively correlated with the degree of liver fibrosis, but spleen STQ was not. STEmean and STEmax of spleen were statistically different between the groups categorized by S = 2, S = 3 and S = 4 (all p  < 0.05), respectively. Spleen STEmean had the best predicting performance on staging liver fibrosis. The areas under the ROC (AUC) for spleen STEmean were 0.66 (95% confidence interval [CI], 0.56– 0.76) for stage S = 2 or higher, 0.72 (95% CI, 0.60– 0.83) for S = 3 or higher, 0.83 (95% CI, 0.74– 0.92) for S = 4 (all P  < 0.01). The differences between the AUC for STEmean and liver FibroScan in liver fibrosis staging were not statistically significant when the groups categorized by S = 2 and S = 4 (P  = 0.146 and P  = 0.052). But when categorized by S = 3, the evaluating performance of liver FibroScan was better (P  = 0.004). CONCLUSION: STEmean of spleen is applicable in indirect predicting fibrosis stage in patients with CHB. Show more

Keywords: Spleen elastography, shear-wave elastography, transient elastography, chronic hepatitis B, liver fibrosis

DOI: 10.3233/CH-200869

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2020

Authors: Loibl, Csaba | Rozanovic, Martin | Bogár, Lajos | Pankaczi, Andrea | Kovács, Patrícia | Miseta, Attila | Molnár, Tihamér | Csontos, Csaba

Article Type: Research Article

Abstract: BACKGROUND: Major burn injury causes massive tissue destruction consequently enhanced platelet function and leukocyte-mediated inflammatory response. METHODS: In a prospective, observational study 23 consecutive patients with more than 20% body surface burn injury were followed for five days (T1–T5) after admission to a university intensive care (ICU). Platelet and leukocyte antisedimentation rate (PAR and LAR) was measured by one-hour gravity sedimentation. It detects the percentage of total platelet and leukocyte number crossed the half line of blood sample column, therefore, they can be regarded as cells of decreased specific gravity. We aimed to investigate the time course of …PAR and LAR after burn injury, as the trend of platelet and the leukocyte activation in the early post-burn period. RESULTS: Daily mean PAR and LAR values continuously increased in the observation period (T1 to T5). Daily mean PAR and LAR were lower in ICU non-survivors (n  = 7) compared to survivors (n  = 16) between T2 and T4 (p  < 0.05 and p  < 0.01). PAR values of septic patients (n  = 10) were lower than that of non-septic ones (n  = 13, p  < 0.01 at T5). CONCLUSIONS: Both PAR and LAR, as novel bedside test can predict septic complications and unfavorable outcome after major burn injury. Further studies with higher sample size are warranted. Show more

Keywords: Platelet activation, leukocyte activation, burns, sepsis after burns

DOI: 10.3233/CH-190779

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2020

Authors: Wu, Zhihua | Zhao, De | Duan, Yourong | Dong, Yi | Li, Yaogang

Article Type: Research Article

Abstract:  Cell metabolism decides the state of cells in division, differentiation and growth, maintaining intracellular balance. Monitoring the metabolic behavior of cells is of great significance to study the development of diseases in cell levels. Surface-enhanced Raman spectroscopy (SERS) is a powerful technique to detect and quantify analytes in extremely low concentration. Combined with SRES technology, we can monitor the concentration of metabolites in live cells and thus study the biological behavior of cells. In this work, Raman-tag labelled [email protected] nanoparticles were used to monitor the distribution of reactive oxygen species (ROS) in SKOV3 cells. With the help of the ultrasensitive …Raman enhancement material, the distribution of ROS in SKOV3 cells was mapped, the results were further confirmed in the fluorescent images. The SERS platform provides an ultrasensitive monitoring method of ROS distribution, which may offer an opportunity for real-time monitoring the cell metabolism in the cell biology applications. Show more

Keywords: Reactive oxygen species, cell metabolism, SERS, detection, Raman mapping

DOI: 10.3233/CH-200861

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2020

Authors: Amoroso, Matteo | Apelgren, Peter | Elander, Anna | Säljö, Karin | Kölby, Lars

Article Type: Research Article

Abstract: BACKGROUND: Acute normovolemic hemodilution (ANH) has been proposed as a microsurgical technique to improve blood flow in free flaps. OBJECTIVE: Here, we present the first systematic review of clinical and experimental studies on the effect of ANH. METHODS: We performed a systematic literature search of PubMed, Medline, the Cochrane Library, Google Scholar, and ClinicalTrials.gov using search strategies and a review process in agreement with the PRISMA statement and the Cochrane Handbook for systematic reviews of interventions. PICO criteria were defined before bibliometric processing of the retrieved articles, which were analyzed with the SYRCLE RoB tool for …risk of bias and the GRADE scale for level of evidence. RESULTS: We retrieved 74 articles from the literature search, and after processing according to PICO criteria, only four articles remained, all of which were experimental. The rating for risk of bias was uncertain according to SYRCLE RoB results, and the level of evidence was low according to GRADE evaluation. CONCLUSIONS: There is no clinical evidence for the effect of ANH on microcirculation in free flaps, and experimental studies provide weak evidence supporting the use of hemodilution in reconstructive microsurgery. Show more

Keywords: Acute normovolemic hemodilution, free flap, blood flow, systematic review, reconstructive surgery

DOI: 10.3233/CH-200832

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2020

Authors: Meissner, Florian | Plötze, Katrin | Matschke, Klaus | Waldow, Thomas

Article Type: Research Article

Abstract: BACKGROUND: Tranexamic acid (TXA) reduces perioperative bleeding among patients undergoing heart surgery. It is uncertain whether its postoperative administration, after prior administration before cardiopulmonary bypass (CPB), has an additional benefit. OBJECTIVE: Our study aimed to evaluate whether the postoperative administration of TXA reduces the blood loss after heart surgery. METHODS: In a retrospective cohort study at the University Heart Center Dresden, patients who underwent on-pump open-heart surgery and received 1 g TXA before CPB were included. Patients with postoperative administration of 1 g TXA were compared to patients without. Primary endpoint was the postoperative blood loss …within 24 hours. RESULTS: Among 2,179 patients undergoing heart surgery between 1 July 2013 and 31 October 2014, 92 (4.2%) received TXA postoperatively. After matching, 71 patients with postoperative administration of TXA were compared to 71 without (n  = 142). Postoperative administration of TXA did not result in decreased blood loss (MD 146.7 mL; p  = 0.064). There was no evidence of an increased risk for thromboembolic complications. CONCLUSIONS: The postoperative administration of TXA did not reduce blood loss. The use of TXA was shown to be safe in terms of thromboembolic events and hospital mortality. Unless there is no clear evidence, the postoperative administration of TXA should be restricted to patients with massive blood loss and signs of hyperfibrinolysis only. Show more

Keywords: Tranexamic acid, antifibrinolytics, hyperfibrinolysis, blood loss, open-heart surgery, cardiac surgery

DOI: 10.3233/CH-200836

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-7, 2020

Authors: Bruno, Raphael Romano | Masyuk, Maryna | Muessig, Johanna M. | Binneboessel, Stephan | Bernhard, Michael | Bäz, Laura | Franz, Marcus | Kelm, Malte | Jung, Christian

Article Type: Research Article

Abstract: BACKGROUND: Dehydration occurs frequently in older patients and constitutes a significant clinical problem. OBJECTIVE: This proof-of-concept study examines whether 1) sublingual measurement in dehydrated old patients is feasible, 2) frailty and incompliance in old, awake patients affects video-quality, 3) dehydration impacts microcirculation METHODS: This prospective observational study included clinically dehydrated patients aged ≥65 years immediately after admission. Dehydration was assessed clinically. A sidestream dark field camera (SDF) was used for measurement. Video-quality was evaluated with MIQS (microcirculation image quality score). Both AVA 4.3C- and AVA POEM-software analyzed the videos. Seventeen patients ≥65 years not showing dehydration …served as control. RESULTS: Thirteen patients (8 female) were included. The average age was 83±8 years. The mini-mental test was 17±15 points, the Clinical Frailty Scale 4±3, the Barthel-Index 59±39. None of these parameters correlated with MIQS (3.4±4.2 SD (“acceptable”)). Dehydrated patients had a slightly impaired microcirculation, with a significantly lower percentage of perfused small vessels compared to control (83.1±7.7% versus 88.0±6.0%, P  < 0.05). After rehydration, there was acute improvement in the microcirculation. CONCLUSIONS: Sublingual microcirculatory SDF-measurement is both, safe and valid for dehydrated old patients - regardless of frailty, age or cognitive performance. Dehydration leads to an impaired microcirculation. Show more

Keywords: Microcirculation, elderly, dehydration, older, rehydration, cognitive impairment, SDF-measurement.

DOI: 10.3233/CH-200859

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-13, 2020

Authors: Bahrami, Saeed | Norouzi, Mahmood

Article Type: Research Article

Abstract: Cardiovascular disease is now under the influence of several factors that encourage researchers to investigate the flow of these vessels. Oscillation influences the blood circulation in the volume of red blood cells (RBC) strongly. Therefore, in this study, its effects have been considered on hemodynamic parameters in the elastic wall and coronary bifurcation. In this study, a 3D geometry of non-Newtonian and pulsatile blood circulation is considered in the left coronary artery bifurcation. The Casson model with various hematocrits is analyzed in elastic and rigid walls. The wall shear stress (WSS) cannot show the stenosis artery alone, therefore, the oscillatory …shear index (OSI) is represented as a hemodynamic parameter of WSS individually of time. The results are determined using two-way fluid-structure interaction (FSI) coupling method using an arbitrary Lagrangian-Eulerian method. The most prominent difference in velocity happened in the bifurcation and at hematocrit 30 with yield stress 6.59E-04 Pa. The backflow and vortex flow in the LCx branch grown with increasing shear rates. The likelihood of plaque generation at the ending of the LM branch is observed in hematocrits 10 and 20, while the WSS magnitude is normal in the hematocrit 60 with the greatest yield stress in the bifurcation. The shear stress among the rigid and elastic models is the highest at the ending of the LM branch. The wall shear stress magnitude among the models decreased at most of 24.49% by dividing the flow. Time-independent results for models showed that there is the highest value of OSI at the bifurcation, which then quickly dropped. Show more

Keywords: Fluid solid interaction, blood flow, hematocrit, Casson model, hemodynamic parameter

DOI: 10.3233/CH-200854

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-18, 2020

Authors: Maruyama, Toru | Arita, Takeshi | Yokoyama, Taku | Hieda, Michinari | Fukata, Mitsuhiro | Fujino, Takehiko | Mawatari, Shiro | Akashi, Koichi

Article Type: Research Article

Abstract: BACKGROUND: Disturbed microcirculation is related to diabetic complications, and erythrocyte deformability is a critical factor regulating microcirculation. OBJECTIVES: To know the relationship between the impaired deformability and density profile in diabetic erythrocytes. METHODS: We recruited patients with type 2 diabetes (n  = 15, diabetic group) and age- and sex-matched non-diabetic subjects (n  = 15, control group). Erythrocyte density (ED) profile was obtained by the phthalate ester separation technique. ED distribution was fitted by sigmoidal curve, yielding SG of phthalate ester allowing passage of half erythrocytes population (ED50 ) and slope factor. Erythrocyte deformability was estimated by our specific …filtration technique. RESULTS: Diabetic group showed significantly (p  < 0.001) higher HbA1c and fasting blood glucose concentration. Erythrocyte deformability in diabetic group was impaired as compared with that in control group (p  < 0.001) and proportional to HbA1c (p  = 0.009). However, ED50 and the slope factor in diabetic group did not differ from respective parameters in control group. CONCLUSIONS: This study demonstrated that erythrocyte deformability was impaired in diabetic patients even under treatment. HbA1c up to 7.5% is concluded not to alter the erythrocyte density but to impair the deformability, which might be a warning to clinicians for prevention of diabetic complications. Show more

Keywords: Deformability, density, diabetes, erythrocyte, hemoglobin

DOI: 10.3233/CH-200873

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2020