Clinical Hemorheology and Microcirculation - Volume 44, issue 3

Authors: Alexy, T. | Sangkatumvong, S. | Connes, P. | Pais, E. | Tripette, J. | Barthelemy, J.C. | Fisher, T.C. | Meiselman, H.J. | Khoo, M.C. | Coates, T.D.

Article Type: Research Article

Abstract: Sickle cell disease (SCD), a genetically-determined pathology due to an amino acid substitution (i.e., valine for glutamic acid) on the beta-chain of hemoglobin, is characterized by abnormal blood rheology and periods of painful vascular occlusive crises. Sickle cell trait (SCT) is a typically benign variant in which only one beta chain is affected by the mutation. Although both SCD and SCT have been the subject of numerous studies, information related to neurological function and transfusion therapy is still incomplete: an overview of these areas is presented. An initial section provides pertinent background information on the pathology and clinical significance of …these diseases. The roles of three factors in the clinical manifestations of the diseases are then discussed: hypoxia, autonomic nervous system regulation and blood rheology. The possibility of a causal relationship between these three factors and sudden death is also examined. It is concluded that further studies in these specific areas are warranted. It is anticipated that the outcome of such research is likely to provide valuable insights into the pathophysiology of SCD and SCT and will lead to improved clinical management and enhanced quality of life. Show more

Keywords: Sickle cell disease, autonomic nervous function, transfusion therapy

DOI: 10.3233/CH-2010-1270

Citation: Clinical Hemorheology and Microcirculation, vol. 44, no. 3, pp. 155-166, 2010

Authors: Kwaan, Hau C.

Article Type: Research Article

Abstract: Whole blood viscosity is affected by a number of factors, among which plasma proteins are a major component. They exert their effects either directly or through their influence on red cell aggregation. Changes in fibrinogen and in immunoglobulins, under both physiologic and pathologic conditions can increase whole blood viscosity. Blood flow through the microvasculature is impaired when viscosity increases, leading to tissue ischemia and a syndrome complex usually referred to as the hyperviscosity syndrome. Abnormalities of fibrinogen greatly increase its ability to cause red cell aggregation, and is a contributory pathogenic factor in ischemic heart disease and stroke. Immunoglobulins may …affect blood viscosity directly, or by increasing the red cell aggregation. Changes are seen in many clinical disorders, ranging from inflammatory diseases to plasma cell dyscrasias. The clinical manifestations may be mild and often unnoticed, or they may be life threatening requiring emergency plasmapheresis. Proper management requires a clear understanding of the underlying pathology. When the symptom complex indicates a high probability of the hyperviscosity syndrome, it should lead to early diagnosis and treatment. Therapeutic approaches should include both removing the abnormal plasma protein and treating the primary cause. Show more

Keywords: Fibrinogen, immunoglobulin, cold agglutinin disease, rheumatoid arthritis, myeloma, spontaneous echo contrast

DOI: 10.3233/CH-2010-1271

Citation: Clinical Hemorheology and Microcirculation, vol. 44, no. 3, pp. 167-176, 2010

Authors: Reinhart, Walter H. | Näf, Gabriela | Werth, Baseli

Article Type: Research Article

Abstract: Cholestasis is a frequent gastroenterological problem, which is tackled by endoscopic procedures. Little is known about bile viscosity, a major determinant of its flow. We measured the viscosity of bile from the common bile duct during endoscopic retrograde cholangiography. Bile was aspirated immediately after cannulation of the papilla and deep-frozen. Viscosity was measured with a rotational viscometer at 37°C and a broad range of shear rates (0.08–69.5 s−1 ). The majority of the 138 patients (64.5%) had bile viscosities between water (0.7 mPa.s) and the lower limit of plasma (1.1 mPa.s). In 20 patients (14.5%) it was above that of …plasma (>1.4 mPa.s), and showed a non-Newtonian behaviour, i.e. the viscosity increased exponentially with decreasing shear rate. Cholecystectomized patients had a lower bile viscosity. Bile viscosities did not differ between patient groups with either choledocholithiasis, sludge, cholangitis, biliary pancreatitis, pancreatic carcinoma, or cholangiocarcinoma. We conclude that bile viscosity in the common bile duct is usually lower than that of plasma, in 15% it is higher and increases exponentially with decreasing flow rate, which may lead to a vicious cycle. Show more

Keywords: Bile, cholecystectomy, common bile duct, viscosity

DOI: 10.3233/CH-2010-1272

Citation: Clinical Hemorheology and Microcirculation, vol. 44, no. 3, pp. 177-182, 2010

Authors: Molnar, Tihamer | Papp, Viktoria | Banati, Miklos | Szereday, Laszlo | Pusch, Gabriella | Szapary, Laszlo | Bogar, Lajos | Illes, Zsolt

Article Type: Research Article

Abstract: The purpose of this study was to determine the relationship between high-sensitive C-reactive protein (hsCRP) and leukocyte antisedimentation rate (LAR) as a specific test to detect early activation of leukocytes providing the first line of defence against infections in ischemic stroke. In 49 patients with acute ischemic events and 61 healthy subjects (HS), we examined LAR, astroglia specific S100B indicating the extent of brain tissue damage and hsCRP within 6 hours, as well as 24 and 72 hours after onset of symptoms. Serum levels of hsCRP on admission was significantly higher in patients with acute ischemic stroke (AIS) compared to …HS and were higher in patients with recurrent to first ever ischemic stroke. Increased basal levels of hsCRP also correlated with severity of stroke and extent of infarct reflected by S100B levels in sera, but did not correlate with post-stroke infections. However, a higher rate of infection was observed among patients, in whom hsCRP was elevated at 72 hours but LAR did not increase. Therefore, such late elevation of hsCRP may indicate pre-clinical infections due to deficient leukocyte activation. Simple tests like LAR and hsCRP may help in predicting outcome and high risk of infectious complications. Show more

Keywords: Stroke, CRP, leukocytes, post-stroke infection, outcome of stroke

DOI: 10.3233/CH-2010-1273

Citation: Clinical Hemorheology and Microcirculation, vol. 44, no. 3, pp. 183-192, 2010

Authors: Bhavsar, Jignesh | Rosenson, Robert S.

Article Type: Research Article

Abstract: Reperfusion injury and no-reflow phenomenon are known entities that contribute to persistent impairment in myocardial perfusion and regional myocardial dysfunction following restoration of epicardial coronary blood flow after a myocardial infarction. Following prolonged ischemia, oxidative stress and inflammation-mediated alterations in erythrocyte mechanics and microvascular architecture play a major role in ischemia/reperfusion injury and no-reflow phenomenon. An increase in red cell rigidity is an important rheological aspect of RBCs, which facilitates platelet aggregation with the subendothelium. Dipyridamole inhibits the reuptake of adenosine which causes platelet inhibition and vasodilatation. Dipyridamole improves microvascular function by increasing RBC deformability and reducing blood viscosity. In …addition, it has anti-oxidant and anti-inflammatory properties that provide protection to the microvasculature. This review discusses the potential role for dipyridamole therapy in the treatment of microvascular dysfunction. Show more

DOI: 10.3233/CH-2010-1274

Citation: Clinical Hemorheology and Microcirculation, vol. 44, no. 3, pp. 193-205, 2010

Authors: Zhang, Xiaolan | Yao, Weijuan | Jia, Binbin | Sun, Dagong | Ka, Weibo | He, Dongqi | Wang, Xifu | Wen, Zongyao

Article Type: Research Article

Abstract: Dichlorvos is an important insecticide used largely. Some studies have demonstrated that organophosphate pesticide has effects on erythrocyte membrane structures, which is critical to erythrocyte function and hemorheology. The aim of the present study was to explore the effect of oxidative stress on hemorheological changes during dichlorvos poisoning in rabbits. Data indicated that after dichlorvos exposure the hematocrit adjusted viscosity at high shear rate increased and erythrocyte membrane fluidity decreased. Data obtained from plasma showed that lipid peroxidative substance-malonaldehyde was elevated and superoxide dismutase was reduced. In summary, oxidative stress does occur in dichlorvos poisoning and may lead to hemorheological …alterations. The changes of hemorheology may be responsible for the pathophysiology of the dichlorvos poisoning. Show more

Keywords: Dichlorvos poisoning, oxidative stress, hemorheology, hematocrit adjusted viscosity

DOI: 10.3233/CH-2010-1264

Citation: Clinical Hemorheology and Microcirculation, vol. 44, no. 3, pp. 207-216, 2010

Authors: Dominighini, Alicia | Ferrero, Mariana | Crosetti, Diego | Alvarez, María de Luján | Ronco, María Teresa | Gonzálvez, José | Wagner, Marcelo | Gurni, Alberto | Carnovale, Cristina | Luquita, Alejandra

Article Type: Research Article

Abstract: We tested the in vivo and the in vitro effects of both Ligaria cuneifolia catechin- and quercetin-enriched fractions on erythrocyte shape and deformability, and on plasma cholesterol level. For in vivo studies, adult male Wistar rats were randomized in three experimental groups which received intraperitoneally, once a day, 3 days: Control: saline solution (C; n = 6); catechin from L. cuneifolia, 0.60 mg/100 g body weight (CLc; n = 6), or quercetin from L. cuneifolia, 2.3 mg/100 g body weight (QLc; n = 6). For in vitro studies, blood samples obtained from male Wistar rats were divided into three fractions, …which were incubated with saline solution (C), catechin (CLc; n = 5) and quercetin (QLc; n = 5), in a concentration equivalent to 0.60 mg/100 g body weight, and 2.3 mg/100 g body weight, respectively. CLc significantly reduced the rigidity index due to a diminished mean concentration volume. QLc induced erythrocyte rigidization (less deformability), thus increasing blood viscosity. Neither of the two treatments produced any changes in plasmatic or biliary excretion of cholesterol. Opposite results were observed in rigidity index with CLc and QLc. In vitro studies showed an interaction of both CLc and QLc with the erythrocyte membrane, which induced changes in the erythrocyte shape from discocyte to stomatocyte. Show more

Keywords: Ligaria cuneifolia, catechin, quercetin, whole blood viscosity, plasmatic and biliary excretion of cholesterol, erythrocyte deformability

DOI: 10.3233/CH-2010-1265

Citation: Clinical Hemorheology and Microcirculation, vol. 44, no. 3, pp. 217-225, 2010

Authors: Rabai, M. | Toth, A. | Kenyeres, P. | Mark, L. | Marton, Zs. | Juricskay, I. | Toth, K. | Czopf, L.

Article Type: Research Article

Abstract: The French paradox is based on epidemiological evidence which supports that moderate red wine consumption reduces the risk of cardiovascular diseases. A number of experimental animal studies reported favourable cardiovascular effects of alcohol-free red wine extract (AFRW). Our study was designed to determine red wine and AFRW induced changes in various hemorheological parameters. These effects may play a role in the pathophysiology of the French paradox regarding the cardiovascular protective impacts of red wine. Blood samples of healthy volunteers were mixed with red wine to achieve alcohol concentrations of 1‰, 3‰ and 10‰, respectively, with equivalent amount of AFRW or …physiological saline. Blood samples were pretreated with red wine or AFRW in order to prove the protective effects on erythrocytes from impairment of deformability caused by the free radical generator phenazine methosulfate (PMS). Erythrocyte aggregation (Myrenne and LORCA), deformability (LORCA) and platelet aggregation (Carat TX4) were measured. Erythrocyte aggregation using Myrenne aggregometer was inhibited by red wine and AFRW compared to the saline treated samples. The difference reached already significance at 1‰ concentration at the AFRW samples (p < 0.05). Furthermore, red wine caused stronger inhibition than AFRW. The difference between the two agents became significant at 10‰ concentration (p < 0.05). LORCA aggregation index and threshold shear rate supported these results at the highest concentration. Erythrocyte deformability of healthy volunteers did not change significantly for any concentrations of red wine and AFRW. On the other hand AFRW at 3‰ concentration significantly prevented erythrocytes from impairment of deformability caused by PMS (p < 0.05). Platelet aggregation was significantly inhibited by the highest concentration of AFRW (p < 0.05). Our results show that red wine and AFRW have some beneficial effects on hemorheological parameters that may contribute to the French paradox. Show more

Keywords: Polyphenols, ethanol, erythrocyte aggregation, erythrocyte deformability, platelet aggregation

DOI: 10.3233/CH-2010-1267

Citation: Clinical Hemorheology and Microcirculation, vol. 44, no. 3, pp. 227-236, 2010