Clinical Hemorheology and Microcirculation - Volume 61, issue 1

Authors: Du, Yuan | Sun, Xiaolu | Shao, Qiang | Zhang, Fengbo | Wen, Zongyao | Qian, Yeyong | Shi, Bingyi | Yao, Weijuan | Tian, Ye

Article Type: Research Article

Abstract: Living-donor renal transplantation is an ideal treatment for patients with end stage renal disease because it affords earlier transplantation and better graft for long term survival. CD14+ monocytes are the predominant inflammatory cells in renal allograft intimal arteritis. The biomechanical alterations in CD14+ monocytes would affect the function of graft. The aim of the present study was to explore the changes in the biorheological properties of CD14+ monocytes before and after the living donor renal transplantation. We found that the viscoelastic properties of CD14+ monocytes were greatly decreased after renal transplantation. Confocal microscopy showed that the …F-actin content was increased when the oral immunosuppressive agents started. We also found that two cytoskeletal regulatory proteins, cofilin1 and profilin1, changed. Our results suggest that the immunosuppressive agents could significantly change the biorheological characteristics of the CD14+ mononuclear cells and the biomechanical changes may greatly affects their function, which would play a critical role to gain longer immune-tolerance stage. Show more

Keywords: Living-donor renal transplantation, CD14+ monocytes, cytoskeletal regulatory proteins

DOI: 10.3233/CH-141806

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 1-11, 2015

Authors: Schleder, S. | Janke, M. | Agha, A. | Schacherer, D. | Hornung, M. | Schlitt, H.J. | Stroszczynski, C. | Schreyer, A.G. | Jung, E.M.

Article Type: Research Article

Abstract: Background: To evaluate the impact of high-resolution contrast-enhanced ultrasound (CEUS) in combination with Color Coded and Power Doppler Sonography (CCDS/PD) in the preoperative differentiation of thyroid adenomas and thyroid carcinomas. Methods: A total of 101 patients (55 female, median age 54 years) underwent surgery for thyroid adenoma and thyroid carcinoma. CCDS/PD and CEUS were performed in all patients by an experienced examiner using a multifrequency linear transducer (6–9 or 6–15 MHz) and were digitally stored. Reading of the ultrasound images was performed by two experienced radiologists in consensus. A histopathological evaluation was obtained as standard of reference in all …patients. Results: Altogether, 75 thyroid adenomas and 26 thyroid carcinomas were detected. Mean diameter of thyroid adenomas and thyroid carcinomas was 27 mm and 32 mm, respectively. The differences in microcirculation of thyroid adenomas and thyroid carcinomas were statistically highly significant (p  <  0.01). Representative features for thyroid adenomas were either no wash-out or wash-out with persisting edge in late phase, for thyroid carcinomas a complete wash-out in late phase. Thus, a calculation of sensitivity, specificity, positive and negative predictive value of 81% , 92% , 97% and 63%, respectively, for the differentiation of benignity and malignancy was possible. Conclusions: Dynamic evaluation of microcirculation using CEUS and CCDS/PD enables a more reliable preoperative discrimination between thyroid adenomas and thyroid carcinomas. Show more

Keywords: Ultrasound, CEUS, Power Doppler Sonography, thyroid adenoma, thyroid carcinoma

DOI: 10.3233/CH-141848

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 13-22, 2015

Authors: Diaw, Mor | Diop, Saliou | Soubaiga, Freddy Yannick Wennonga | Seck, Moussa | Faye, Blaise Felix | Niang, Mbayang Ndiaye | Samb, Abdoulaye | Connes, Philippe

Article Type: Research Article

Abstract: The aim of this study was to compare blood and plasma viscosities, as well as the hematocrit/blood viscosity ratio (HVR), between trained and sedentary SCT carriers. Thirty African male SCT carriers from the city of Dakar (Senegal) participated in the study: one group composed of 15 trained SCT carriers (TSCTc) and one group composed of 15 sedentary individuals (SSCTc). Blood was sampled in resting condition and blood and plasma viscosities were measured using a cone-plate viscometer. After the determination of hematocrit by microcentrifugation, HVR was determined for each subject. Blood and plasma viscosities, as well as hematocrit, were significantly reduced …in TSCTc compared to SSCTc. As a consequence, HRV was greater in TSCTc. These findings provide evidence that SCT carriers should be encouraged to practice regular physical activity to limit the cardiovascular strain usually caused by their blood hyperviscosity. Show more

Keywords: Hemoglobin S, blood rheology, training

DOI: 10.3233/CH-141852

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 23-29, 2015

Authors: Varlet-Marie, Emmanuelle | Raynaud de Mauverger, Eric | Brun, Jean-Frédéric

Article Type: Research Article

Abstract: In line with recent literature showing that both general adiposity and abdominal adiposity are independently associated with the risk of death, we recently reported that body mass index (BMI) and waist-to hip ratio (WHR) were independent predictors of blood viscosity, related to different determinants of viscosity (for BMI: plasma viscosity and red cell aggregation; for WHR: hematocrit). Since this report was challenged by a study showing that abdominal adiposity (as measured with waist circumference WC and not WHR) is the only independent determinant of viscosity, we re-assessed on our previous database correlations among viscosity factors, BMI, WHR and WC. Blood …viscosity was correlated to BMI (r  = 0.155 p  = 0.004), WHR (r  = 0.364; p  = 0.027) and WC (r  = 0.094; p  = 0.05). Hematocrit was correlated to WHR (r  = 0.524) but neither to BMI (r  =−0.021) nor waist circumference (r  = 0.053). WC was correlated with plasma viscosity (r  = 0.154; p  = 0.002) while WHR was not (r  =−0.0102 NS). A stepwise regression analysis selected two determinants of whole blood viscosity at high shear rate: BMI (p  = 0.0167) and WC (p  = 0.0003) excluding WHR. Therefore, in this sample, abdominal fatness expressed by WC and whole body adiposity remain independent determinants of blood viscosity. WHR and WC have not the same meaning, WC measuring the size of abdominal fat while WHR measuring the shape of body distribution regardless the degree of fat excess. Interestingly, hematocrit is rather related to shape (even within a normal range of body size) than the extent of abdominal fatness, and is not related to whole body adiposity. Show more

Keywords: Body mass index, waist-to-hip ratio, hemorheology, erythrocyte deformability, blood viscosity, erythrocyte aggregation

DOI: 10.3233/CH-141861

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 31-38, 2015

Authors: Brun, Jean-Frédéric | Varlet-Marie, Emmanuelle | Fedou, Christine | Raynaud de Mauverger, Eric

Article Type: Research Article

Abstract: We examined whether “metabolically healthy obesity” (MHO) is associated or not with hemorheologic alterations. We studied 110 subjects: 32 normal weight; 40 overweight; 38 obese. Overweight and obese subjects were divided into two subgroups according to the occurrence or not of a metabolic syndrome (METS). Subjects were thus categorized as follows: (1) metabolically healthy and normal weight (MHNW); (2) metabolically healthy but overweight (MHOW); (3) metabolically abnormally overweight (MAOW); (4) metabolically healthy but obese (MHOB); and (5) metabolically abnormally obese (MAOB). Across those various subgroups whole blood viscosity and plasma viscosity were not statistically different, although there was a tendency …to higher values in the subgroups with METS compared to those without METS. RBC aggregation “M” was higher in all obese than MHNW (7.25 ± 0.64 vs 4.31 ± 0.44 p  <  0.001 and was also higher in MHOB than MHNW (8.22 ± 1.07 vs 4.31 ± 0.44 vs 8.22 ± 1.07 p  <  0.02). It was higher in all obese subjects than in all overweight subjects (7.25 ± 0.64 vs 5.22 ± 0.40 p  <  0.01) but the difference between overweight and MHNW was not significant. M was negatively correlated with insulin sensitivity (r  =−0.457 p  = 0.0008). On the whole increased RBC aggregability “M” seems to be more related to fatness by its own than to the occurrence of metabolic abnormalities. MHO is not associated with alterations of blood viscosity at high shear rate, but exhibits a slight increase in RBC aggregability. These data are consistent with the assumption that MHO is on the whole a “hemorheologically healthy” situation, but that RBC aggregability is proportional to fatness even in “healthy” conditions, as already observed in samples of normal weight athletes. Show more

Keywords: Obesity, hemorheology, erythrocyte aggregation, insulin sensitivity

DOI: 10.3233/CH-141868

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 39-46, 2015

Authors: Seringec, Nurten | Guncu, Guliz | Arihan, Okan | Avcu, Nihal | Dikmenoglu, Neslihan

Article Type: Research Article

Abstract: Periodontal diseases are frequently associated with cardiovascular diseases (CVD). On the other hand, occurrence of CVD has also been related with increased blood viscosity. This study was planned to investigate four main hemorheological parameters contributing to blood viscosity – hematocrit, erythrocyte deformability, erythrocyte aggregation and plasma viscosity – and also some biochemical parameters (hs-CRP, fibrinogen, globulin etc.) in patients with periodontal disease. We hypothesized that poor periodontal health would be associated with deterioration of hemorheological properties. According to periodontal health status, subjects were divided into three groups as control (healthy), with plaque induced gingivitis and with chronic periodontitis. All groups …included 15 males who had not received periodontal therapy in the last six months before the study, were non-smokers, had no systemic diseases and were not on any medication. Erythrocyte deformability and erythrocyte aggregation were measured with laser-assisted optical rotational cell analyzer (LORCA). Plasma viscosity was measured by a cone-plate viscometer. Data were analyzed with Kruskal-Wallis, Mann-Whitney U Test and Spearman Correlation Coefficient. Plasma viscosity (1.36 ± 0.01 mPa.s in the control group and 1.43 ± 0.02 mPa.s in the chronic periodontitis group, P  <  0.01), erythrocyte aggregation tendency (aggregation index, amplitude and t½ were 58.82 ± 1.78% , 20.22 ± 0.40 au, 2.80 ± 0.25 s respectively in the control group, and 67.05 ± 1.47% , 22.19 ± 0.50 au, 1.84 ± 0.15 s in the chronic periodontitis group, P  <  0.01), hs-CRP, fibrinogen and globulin levels were significantly higher, whereas HDL level was significantly lower in the chronic periodontitis group (P  <  0.05) compared to the control group. All of these conditions may contribute to cardiovascular morbidity and mortality observed in people with periodontal disease, via increasing blood viscosity. Show more

Keywords: Blood viscosity, hemorheology, plasma viscosity, erythrocyte aggregation, erythrocyte deformability, chronic periodontitis, plaque induced gingivitis

DOI: 10.3233/CH-141892

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 47-58, 2015

Authors: Tan, Chunjiang | Lu, Xiao | Chen, Wenlie | Chen, Songming

Article Type: Research Article

Abstract: Extracellular ubiquitin (Ub) with platelet aggregation property was found higher in acute myocardial infarction (AMI) patients. Here we detected the platelet functions and serum Ub levels in 250 AMI patients and 50 healthy volunteers before and after aspirin treatment. The influence of serum Ub on platelet functions was determined in vitro . We found that 47 out of 250 AMI patients showed aspirin resistance (AR) and 203 showed aspirin sensitivity (AS). During hospitalization, AR group had higher serum Ub levels than the AS group or the healthy group, and the serum Ub levels was related to the rates of thrombosis …events. The patients with higher serum Ub levels showed that the platelets had more ubiquitinated platelets, higher contents of ubiquitinated proteins and ubiquitinated cyclooxygenase-1 (COX-1). The levels of ubiquitinated COX-1 in the platelets was inversely correlated with acetylated COX-1, the separated ubiquitinated COX-1 activity was approximately twofold or fourfold higher than the total COX-1(ubiquitinated COX-1 and COX-1) or COX-1. In vitro , we found that extracellular Ub, via the CXC chemokine receptor 4 (CXCR4) pathway, facilitated COX-1 to be ubiquitined and prevented aspirin to acetylate its target. Platelets had higher levels of ubiquitinated COX-1 showing poor response to aspirin. Such results were not detected in Ub-free serum or ovalbumin incubated platelets. Serum Ub, via the CXCR4 pathway, facilitated COX-1 to be ubiquitined and activated the platelets possibly involved in the pathogenesis of AR. Show more

Keywords: Serum ubiquitin, ubiquitination of cycloxygenase-1, CXC chemokine receptor 4, aspirin resistance

DOI: 10.3233/CH-141900

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 59-81, 2015

Authors: Lichtenauer, Michael | Goebel, Bjoern | Fritzenwanger, Michael | Förster, Martin | Betge, Stefan | Lauten, Alexander | Figulla, Hans-Reiner | Jung, Christian

Article Type: Research Article

Abstract: INTRODUCTION: Endothelial microparticles (EMP) are small membrane vesicles that originate from activated or apoptotic endothelial cells. Although the exact mechanism of EMP function is still relatively unknown, it has been shown that they modulate inflammatory processes, coagulation and vascular function. In this study we hypothesized that transient hypoxia may act as a trigger for the release of EMP into circulation. MATERIALS AND METHODS: Fourteen healthy volunteers were subjected to transient normobaric hypoxia in an air-conditioned chamber simulating an oxygen concentration of a height of up to 5500 meters. Blood samples were evaluated for EMP using flow cytometry. …RESULTS: During the experiment oxygen concentration was adjusted to a value equivalent to a height of 5500 meters to achieve hypoxic conditions. Oxygen saturation decreased to 78% . At the final height a significant increase of CD31+/Annexin+ EMP levels was evident (increase from 0.03% ± 0.01% SEM to 0.12% ± 0.04% SEM, p  = 0.0188). CONCLUSIONS: These experimental results show that temporary hypoxic conditions can trigger the release of CD31+/ Annexin+ EMP also in healthy volunteers. In our previous studies we have shown that apoptotic bodies can confer pro-survival signals to cardiomyocytes during myocardial ischemia. Based on the experimental results of this current study we believe that the release of CD31+/Annexin+ EMP during hypoxia might act as an endogenous survival signal. Show more

Keywords: Hypoxia, endothelial microparticles, human, apoptosis, oxygen saturation

DOI: 10.3233/CH-141908

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 83-90, 2015

Authors: Bianciardi, G. | Tanganelli, I.

Article Type: Research Article

Abstract: This paper investigates the use of computerized fractal analysis for objective characterization by means of transmission electron microscopy of the complexity of circulating platelets collected from healthy individuals and from type 2 diabetic patients, a pathologic condition in which platelet hyperreactivity has been described. Platelet boundaries were extracted by means of automatically image analysis. Local fractal dimension by box counting (measure of geometric complexity) was automatically calculated. The results showed that the platelet boundary observed by electron microscopy is fractal and that the shape of the circulating platelets is significantly more complex in the diabetic patients in comparison to healthy …subjects (p  <  0.01), with 100% correct classification. In vitro activated platelets from healthy subjects show an analogous increase of geometric complexity. Computerized fractal analysis of platelet shape by transmission electron microscopy can provide accurate, quantitative, data to study platelet activation in diabetes mellitus. Show more

Keywords: Platelets, type 2 diabetes mellitus, fractal analysis, differential diagnosis, transmission electron microscopy

DOI: 10.3233/CH-141910

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 91-97, 2015

Authors: von Tempelhoff, Georg-Friedrich | Schelkunov, Olga | Demirhan, Attila | Tsikouras, Panagiotis | Rath, Werner | Velten, Eva | Csorba, Roland

Article Type: Research Article

Abstract: In women with a history of recurrent/late abortion and confirmed genetic/acquired thrombophilia, LMWH was given during subsequent pregnancy and serial coagulation testing was performed. In 82 consecutive pregnant women with recurrent (≥2) and/or late abortion (>12 GW) in the presence of single (n  = 62; 75.6%) or combined (n  = 20; 24.4%) genetic and/or acquired thrombophilia, Thromboelastometry (n  = 50; ROTEM, TEM) and closure-time (n  = 82; PFA-100; Siemens) underwent serial testing before and during pregnancy while receiving LMWH and puerperal. Throughout pregnancy, clotting-time (CT) after intrinsic and extrinsic induced coagulation activation in Thromboelastometry remained unchanged. TF-induced coagulation activation resulted in statistically …significantly decreased mean clot-formation-times (CFT) (Trim I: 108.9 ± 5.2 S to Trim III; 81.7 ± 5.4 S; p  = 0.001), whereas after contact activation (Intem-S: Trim I: 70.1 ± 4.0 S to Trim III: 65.4 ± 6.8; n.s.) CFT remained unchanged. Mean maximal-clot-firmness (MCF) continuously increased in the Intem-S and Extem-S during each trimester and decreased until 4th puerperal week (Extem-S: Trim I: 61.9 ± 1.0 S; Trim II: 65.4 ± 0.58 S; Trim III: 68.3 ± 1.1 S; p  <  0.001; Intem-S: Trim I: 64.1 ± 0.6 S; Trim II: 66.8 ± 0.5 S; Trim III: 69.5 ± 1.2 S; p  <  0.001). Mean Closure-times after Epinephrine/ADP/Collagen stimulation remained unchanged during pregnancy. In women with different thrombophilia receiving LMWH at prophylactic dose a significant increase in MCF was accompanied by barely unchanged CT after intrinsic and extrinsic coagulation activation and platelet mediated closure-times in the course of the pregnancy. Decrease in CFT was only seen after extrinsic coagulation activation, whereas unchanged CFT after intrinsic coagulation activation may be the result of LMWH given at low dose. Show more

Keywords: Pregnancy, Thromboelastometry, platelet-function-analyser, low-molecular-weight-heparin, recurrent abortion

DOI: 10.3233/CH-151949

Citation: Clinical Hemorheology and Microcirculation, vol. 61, no. 1, pp. 99-110, 2015