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

Authors: Hahn, Robert G.

Article Type: Research Article

Abstract: BACKGROUND: “Interstitial washdown” is an edema-preventing mechanism that implies a greater redistribution of interstitial albumin occurs whenever the capillary filtration is increased. OBJECTIVE: To study the effect of interstitial washdown on fluid distribution in normovolemic and hypovolemic volunteers. METHODS: Capillary filtration was increased by infusing 25 mL/kg Ringer’s acetate intravenously over 30 min 10 male just after withdrawal of 0, 450, and 900 mL of blood. Population volume kinetic analysis was used to assess the effects of washdown and hemorrhage on fluid distribution, using the difference in plasma dilution based on hemoglobin and albumin as biomarker of washdown. …RESULTS: Blood withdrawal during 10–15 min recruited 100–150 mL of fluid of high albumin content to the plasma, which was probably lymph. The albumin recruitment was temporarily reduced during the fluid loading but increased from 40 min post-infusion and was then greater when preceded by hemorrhage. Simulations suggested that interstitial washdown decreased the extravascular fluid volume by 200 mL over 3 h. The plasma volume and urinary excretion both increased by approximately half this amount. CONCLUSIONS: Blood loss without hypotension probably recruited lymph to the plasma, but interstitial washdown played no major role in determining the distribution of crystalloid fluid after hemorrhage. Show more

Keywords: Crystalloid solution, pharmacokinetics, extracellular space, physiology, lymphatic flow, pharmacokinetics

DOI: 10.3233/CH-221531

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2022

Authors: Toprak, Kenan | Kaplangoray, Mustafa | Palice, Ali | İnanır, Mehmet | Memioğlu, Tolga | Kök, Zafer | Altıparmak, İbrahim Halil | Toprak, İbrahim Halil | Biçer, Asuman | Demirbağ, Recep

Article Type: Research Article

Abstract: BACKGROUND: Complete atrioventricular block is most commonly caused by age-related degeneration and fibrosis in the cardiac conduction system and is called primary idiopathic complete atrioventricular (iCAVB). Although many factors affect this situation, which increases with age in the cardiac conduction system, the relationship between whole blood viscosity (WBV) and iCAVB has not been clarified until now. In this study, we aim to reveal the relationship between iCAVB and WBV. METHODS AND RESULTS: 141 patients with dual-chamber permanent pacemaker implanted for iCAVB and 140 age- and sex-matched subjects were included in this study. The WBV values of the study …groups were compared in both high shear rate (HSR) and low shear rate (LSR). Both WBV at HSR and WBV at LSR were significantly higher in the iCAVB group compared to the control group (16.11 [15.14–16.89] vs 14.40 [13.62–15.58]; 39.82 [17.43–55.23] vs 1.38 [–13.14–26.73]; p  <  0.001, respectively). The patient population was followed up for an median of 38 months for all-cause mortality. Higher mortality rates were found in higher WBV at HSR and WBV at LSR (p  <  0.001,for both). CONCLUSIONS: In this study, WBV was found to be an independent predictor for iCAVB, and in these patients WBV was associated with poor clinical outcomes. Show more

Keywords: Primary idiopathic complete atrioventricular block, whole blood viscosity, high shear rate, low shear rate

DOI: 10.3233/CH-221596

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-11, 2023

Authors: Qiu, Yi-Jie | Cheng, Juan | Zuo, Dan | Zhang, Qi | Tian, Xiao-Fan | Lu, Xiu-Yun | Chen, Sheng | Dong, Yi | Wang, Wen-Ping

Article Type: Research Article

Abstract: OBJECTIVE: To explore the value of vascular architecture detected by micro vascular imaging (MVI) in preoperative diagnosis of focal liver lesions (FLLs). METHODS: In this retrospective study, patients with surgery and histopathologically proved or radiologically confirmed FLLs were included. Vascular architecture of FLLs were acquired by color Doppler flow imaging (CDFI) and MVI on LOGIQ™ E20 ultrasound machine (C1–6 convex array probes). Alder semiquantitative analysis (grade 0–3) and morphologic features of blood vessels (pattern a–f) were used to assess the blood flow within the FLLs. Interobserver agreement for evaluating blood flow of FLLs was analyzed. Using Adler’s grading …or morphologic patterns as diagnostic criteria for malignant FLLs, the diagnostic efficiency was analyzed and compared. RESULTS: From October 2021 and February 2022, 50 patients diagnosed with 40 malignant FLLs and 10 benign FLLs were finally included. The Kappa value within two observers for evaluating the blood flow of FLLs was 0.78 for MVI and 0.55 for CDFI. According to Alder semiquantitative analysis, more high-level blood flow signals (grade 2–3) were detected by MVI than CDFI (P  <  0.05). Based on high-level blood flow signals (grade 2–3) and hypervascular supply patterns (pattern e and f), the diagnostic accuracy for malignant FLLs were 76% and 68% for MVI, 56% and 38% for CDFI, respectively. CONCLUSION: MVI is superior to CDFI in evaluating vascular architecture of FLLs. The high-level flow signals and hypervascular pattern detected by MVI have a useful and complementary value in preoperative non-invasive identification of malignant FLLs. Show more

Keywords: Micro vascular imaging (MVI), color Doppler flow imaging (CDFI), focal liver lesions (FLLs), blood flow, vascular architectures

DOI: 10.3233/CH-221682

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-10, 2022

Authors: Huang, Yunlin | Wang, Ying | Liu, Lingxiao | Zhu, Lei | Qiu, Yijie | Zuo, Dan | Lu, Xiuyun | Dong, Yi | Jung, Ernst-Michael | Wang, Wenping

Article Type: Research Article

Abstract: OBJECTIVES: To explore the potential added value of dynamic contrast enhanced ultrasound (DCE-US) using VueBox® software for the diagnosis of small solid thyroid nodules (≤1.0 cm). PATIENTS AND METHODS: This prospective study was approved by the institutional review board and it was performed at two hospitals from January 2020 to October 2020. B mode ultrasound and contrast enhanced ultrasound (CEUS) images were obtained for 79 small solid thyroid nodules (≤1.0 cm) confirmed by ultrasound-guided fine needle aspiration cytology results in 79 consecutive patients (55 women and 24 men, median age: 41 years). The CEUS time-intensity curves (TICs) of thyroid nodules …and surrounding parenchyma were created by VueBox® software (Bracco, Italy). The CEUS quantitative parameters were obtained after curve fitting. The diagnostic efficiency of the diagnostic performance of CEUS and DCE-US was evaluated and compared. The weighted kappa statistic (κ) was performed to assess the interobserver agreement and consistency between the diagnosis of CEUS and DCE-US. RESULTS: Among the 79 thyroid nodules, 56 (70.9 %) were malignant and 23 (29.1 %) were benign lesions. Hypoenhancement during the arterial phase of CEUS was associated with malignancy (P  <  0.001), with an AUC of 0.705 (sensitivity 71.4 %, specificity 69.6 %). Among all CEUS quantitative parameters, the peak enhancement (PE), wash-in rate (WiR), and wash-out rate (WoR) of DCE-US in malignancies were significantly lower than those in benign nodules (P  = 0.049, P  = 0.046, and P  = 0.020, respectively). The AUCs of PE, WiR, and WoR were 0.642 (sensitivity 65.2 %, specificity 67.9 %), 0.643 (sensitivity 43.5 %, specificity 91.1 %), and 0.667 (sensitivity 69.6 %, specificity 69.6 %) in differentiation between benign and malignant small solid thyroid nodules (≤1.0 cm), respectively. Comparing the quantitative parameters of DCE-US between small solid thyroid nodules and surrounding normal thyroid parenchyma, the PE, WiAUC, WiR, WiPI, WoAUC, WiWoAUC, and WoR of the nodules were significantly lower than those of normal thyroid tissue (P  = 0.008, P  <  0.001, P  = 0.037, P  = 0.009, P  = 0.003, P  = 0.002, P  = 0.049, respectively). A total of 16 (20.3 %) nodules showed isoenhancement during the arterial phase of CEUS, while the median PE ratio of surrounding tissue and thyroid nodules was 1.70 (IQR: 1.33–1.89). CONCLUSIONS: VueBox® is a helpful tool for the evaluation of dynamic microvascularization of thyroid nodules, and DCE-US using VueBox® perfusion analysis could provide added values for differential diagnosis of small solid thyroid nodules (≤1.0 cm). Show more

DOI: 10.3233/CH-221681

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2022

Authors: Schleder, Stephan | Jung, Ernst-Michael | Schicho, Andreas | Schreyer, Andreas G. | Habicher, Werner | Grassinger, Jochen | Dollinger, Marco

Article Type: Research Article

Abstract: BACKGROUND: Cervical lymphadenopathy can be benign or malignant. Its accurate diagnosis is necessary to determine appropriate treatment. Ultrasound-guided core needle biopsies (US-CNBs) are frequently used as a percutaneous sampling approach. OBJECTIVES: Our aim was to identify the efficacy and safety of US-CNBs in 125 patients with cervical lymphadenopathy and clinically suspected head and neck cancer during the COVID-19 pandemic with limited surgical resources. METHODS: US-CNBs of pathological lymph nodes were performed in 146 lymph nodes on 125 patients. Biopsies were performed ultrasound-guided with a reusable gun core biopsy system and a 10-cm-long 16-G needle. Standard of …reference for the histological findings were panendoscopy, clinical and sonographic follow-up, surgical biopsy or a repeat US-CNB. RESULTS: Adequate material for histologic diagnosis was obtained in 111 patients (89%), of these 83 patients (75%) were diagnosed as malignant, whereas benign lymphadenopathy accounted for 28 patients (25%). Therefore, US-CNB was able to identify malignant or benign lymphadenopathy with an overall accuracy of 88% and 90%, respectively. CONCLUSIONS: Percutaneous US-CNB is a safe and effective alternative to surgical biopsy in the management of cervical lymphadenopathy in patients with clinically suspected head and neck cancer in a setting with limited resources. Show more

DOI: 10.3233/CH-221680

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-12, 2022

Authors: He, Dequan | Li, Zhiliang | Chen, Youquan | Huang, Ming

Article Type: Research Article

Abstract: BACKGROUND: Dysfunction of endothelial cells is now considered a vital contributor to the pathogenesis of atherosclerosis (AS). Moreover, circular RNA (circRNA) circ_0029589 has been found to be involved in the regulation of oxidized low-density lipoprotein (ox-LDL)-induced endothelial cell damage. Nevertheless, its molecular mechanism in ox-LDL-triggered endothelial cell injury is poorly defined. METHODS: Human umbilical vein endothelial cells (HUVECs) treated with ox-LDL were applied as cell models of AS. Circ_0029589, microRNA-1197 (miR-1197), and Ras-related protein Rab-22A (RAB22A) expression were detected using real-time quantitative polymerase chain reaction (RT-qPCR). Cell proliferation, apoptosis, angiogenesis, and invasion were detected using 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2-H-tetrazolium …bromide (MTT), 5-ethynyl-2’-deoxyuridine (EdU), flow cytometry, tube formation, and transwell assays. Western blot analysis of Cleaved-caspase-3, B-cell lymphoma-2 related X protein (Bax), and RAB22A. IL-6, IL-1β, and Tumor necrosis factor α (TNF-α) levels were gauged using ELISA kits. Superoxide Dismutase (SOD) activity and Malondiahyde (MDA) level were assessed using special kits. Bioinformatics software predicted the binding between miR-1197 and circ_0029589 or RAB22A, which was proved using dual-luciferase reporter and RNA pull-down assays. RESULTS: Circ_0029589 and RAB22A expression were strengthened, and miR-1197 was reduced in ox-LDL-treated HUVECs. Importantly, circ_0029589 silencing ameliorated ox-LDL-triggered HUVEC damage via promoting cell proliferation, tube formation ability, invasion, and repressing cell apoptosis, inflammation, and oxidative stress. Mechanical analysis suggested that circ_0029589 might affect RAB22A content through sponging miR-1197. CONCLUSION: Circ_0090231 might protect against ox-LDL-mediated HUVEC injury via the miR-1197/RAB22A axis, which provides a therapeutic strategy for endothelial cell damage of AS. Show more

Keywords: Circ_0029589, miR-1197, RAB22A, ox-LDL, atherosclerosis

DOI: 10.3233/CH-221657

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-18, 2023

Authors: Teng, Yanling | Ren, Fei | Wang, Yanan | Xu, Hua | Song, Hejian

Article Type: Research Article

Abstract: BACKGROUND: Previous data have shown that circ_0033596 is involved in the pathogenesis of atherosclerosis (AS). The study aims to reveal the detailed mechanism of circ_0033596 in AS. METHODS: Human umbilical vein endothelial cells (HUVECs) were treated with oxidized low-density lipoprotein (ox-LDL) to establish an AS cell model. Quantitative real-time polymerase chain reaction and western blot were implemented to detect the expression of circ_0033596, miR-637, growth factor receptor bound protein2 (GRB2), BCL2-associated x protein (Bax) and B-cell lymphoma-2 (Bcl-2). Cell viability, proliferation, apoptosis and tube formation were investigated by cell counting kit-8, EdU assay, flow cytometry and tube formation …assay, respectively. The production of interleukin (IL-6) and tumor necrosis factor-α (TNF-α) was evaluated by enzyme-linked immunosorbent assay. Oxidative stress was evaluated by lipid peroxidation malondialdehyde assay kit and superoxide dismutase activity assay kit. Dual-luciferase reporter assay, RNA pull-down assay and RIP assay were performed to identify the associations among circ_0033596, miR-637 and GRB2. RESULTS: The expression of circ_0033596 and GRB2 was significantly increased, while miR-637 was decreased in the blood of AS patients and ox-LDL-induced HUVECs compared with controls. Ox-LDL treatment inhibited HUVEC viability, proliferation and angiogenic ability and induced cell apoptosis, inflammation and oxidative stress, while these effects were attenuated after circ_0033596 knockdown. Circ_0033596 interacted with miR-637 and regulated ox-LDL-induced HUVEC damage by targeting miR-637. In addition, GRB2, a target gene of miR-637, participated in ox-LDL-induced HUVEC injury by combining with miR-637. Importantly, circ_0033596 activated GRB2 by interacting with miR-637. CONCLUSION: Circ_0033596 depletion protected against ox-LDL-induced HUVEC injury by miR-637/GRB2 pathway, providing a therapeutic target for AS. Show more

Keywords: AS, circ_0033596, miR-637, GRB2

DOI: 10.3233/CH-221686

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-18, 2023

Authors: Binneboessel, Stephan | Masyuk, Maryna | Piayda, Kerstin | Bruno, Raphael Romano | Wernly, Bernhard | Jirak, Peter | Wolff, Georg | Gerdes, Norbert | Baldia, Philipp Heinrich | Kelm, Malte | Nienhaus, Fabian | Lang, Alexander | Winkels, Holger | Geerling, Gerd | Guthoff, Rainer | Kaya, Sema | Flossmann, Gerald | Riemer, Thomas | Baertschi, Michael | Jung, Christian

Article Type: Research Article

Abstract: BACKGROUND: “Spaceflight associated neuro-ocular syndrome” (SANS) represents a challenging health condition in modern space medicine. Forty-eight percent of astronauts are diagnosed with SANS after long-term space missions. The pathophysiological mechanism seems to be multifactorial, and yet remains unknown. In this proof-of-concept study we plan to investigate retinal microcirculatory changes in weightlessness and aim to identify their role in the development of SANS. METHODS AND DESIGN: Healthy individuals will take part in a parabolic flight campaign, which recreates fractioned total weightlessness periods. The airplane is specifically equipped, and designed for the execution of parabolic flight maneuvers and scientific research …in microgravity. Retinal microcirculation will be assessed with a modified fundus camera, which allows dynamic vessel analysis. We will additionally measure intra-ocular pressure and hemodynamic changes during each phase of the flight. Blood samples will be analyzed at baseline, one hour and 24 hours after exposure to weightlessness. CONCLUSIONS: This pilot study aims to investigate the feasibility of retinal microcirculation assessment during varying gravity. Results of this study may generate insights whether venous stasis in the eye, surrogated by the dilatation of retinal vessels and increase in intraocular pressure as signs of venous insufficiency, may potentially contribute to the development of SANS. Show more

Keywords: Microgravity, parabolic flight campaign, retinal microcirculation, dynamic vessel analyzer, spaceflight associated neuro-ocular syndrome

DOI: 10.3233/CH-221691

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023

Authors: Hojker, Marta | Tršan, Jure | Tršan, Uroš | Gale, Ana | Jerman, Alexander | Košuta, Daniel

Article Type: Research Article

Abstract: BACKGROUND: The predictive value of coagulation markers for venous thromboembolism (VTE) in Covid-19 patients has been investigated with conflicting results. OBJECTIVE: Our aim was to investigate the correlation between biomarkers and VTE and the predictive value of D-dimer for VTE in hospitalized Covid-19 patients. METHODS: Complete blood count, inflammatory and coagulation biomarkers at admission were collected. VTE was defined as diagnosed pulmonary embolism or deep vein thrombosis. Events were defined as in-hospital death or ICU admission. Predictors of VTE were identified with Pearson prediction models. A ROC curve was constructed to assess the predictive value of …D-dimer. RESULTS: 1651 participants were included, 111 VTE were identified. Events incidence was higher in the VTE group (49.5% vs 28.2%, p  <  0.001). Neutrophil-lymphocyte ratio (NLR, 0.001; 95% CI 0.000–0.002; p 0.019) and D-dimer (0.00005; 95% CI 0.00002–0.00008; p  <  0.001), Geneva score (0.026; 95% CI 0.012–0.040; p  <  0.001) and Wells score (0.047; 95% CI 0.033–0.061; p  <  0.001) were associated with VTE. D-dimer had a goor predictive value for VTE (ROC area 0.85, 95% CI 0.816–0.893), with an optimal cut-off value of 2677μg/L (Youden index of 0,602). CONCLUSIONS: Among coagulation biomarkers D-dimer had the best predictive value for VTE, but higher cut-off values should be used in Covid-19. Show more

Keywords: D-dimer, venous thromboembolism, Covid-19, neutrophil-lymphocyte ratio, inflammatory biomarkers, coagulation biomarkers

DOI: 10.3233/CH-221664

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2022

Authors: Caimi, G. | Carlisi, M.

Article Type: Research Article

Abstract: According to Wells classification, it is possible to distinguish the primary hyperviscosity syndromes in polycythemic, sclerocythemic and sieric and/or plasmatic. In polycythemia vera, multiple myeloma, Waldenström’s macroglobulinemia, and monoclonal gammopathy of undetermined significance, we have observed an unexpected behaviour of the erythrocyte deformability. This data highlights that the hemorheological alteration present in polycythemia vera has not been related to the increase of RBC mass only, as well as that present in plasmacellular dyscrasias has not been attributable to the increase of plasma viscosity only. The aim of this paper is to suggest some starting points for an accurate reflection, …emphasizing the need of a revision of the current classification of primary hyperviscosity syndromes. Show more

Keywords: Erythrocyte deformability, primary hyperviscosity syndromes, polycythemia vera, multiple myeloma, Waldenström’s macroglobulinemia, monoclonal gammopathy of undetermined significance

DOI: 10.3233/CH-221549

Citation: Clinical Hemorheology and Microcirculation, vol. Pre-press, no. Pre-press, pp. 1-9, 2023