Clinical Hemorheology and Microcirculation - Volume 62, issue 4

Authors: Wiesinger, I. | Schreml, S. | Wohlgemuth, W.A. | Stroszczynski, C. | Jung, E.M.

Article Type: Research Article

Abstract: AIM: Aim of this pilot-study was to quantify perfusion changes of vascular malformations before and after the first interventional treatment using contrast-enhanced ultrasound (CEUS). MATERIAL AND METHODS: 29 patients (10 male, 19 female) between 6 and 63 years (mean 28.1 years) with 12 arterio-venous (AVM) and 17 venous malformations (VM) were examined before and after their first percutaneous interventional treatment. CEUS was performed with a 2.4 ml bolus injection of sulfur-hexafluorid microbubbles, and a 6–9 MHz mulitfrequency transducer. A 60 sec cine sequence was recorded and regions of interest (10 mm×30 mm) were defined in the centre, and the margins of the …vascular malformation as well as in the surrounding healthy tissue. Time Intensity Curves (TIC) were analysed, and Time to Peak (TTP) as well as Area under the Curve (AUC) were calculated. RESULTS: For VM there was a significant perfusion difference (p  < 0.05) in AUC between centre and the surrounding tissue before (323.1 vs. 130.4 rU) and after treatment (331.0 vs. 106.9 rU). There was no significant difference for TTP in ROIs of VM (19.1 vs. 26.5 sec). After the treatment there was a significant decrease in AUC for all three regions in AVMs, and an increase in TTP for AVM. However TTP for AVM in the centre ROI still remained shorter than in the surrounding tissue even after therapy (20.9 vs. 25.4 sec). CONCLUSION: CEUS with TIC analysis is a promising imaging method for the evaluation of perfusion before and after percutaneous treatment of vascular malformations. AUC decrease indicates therapy-induced changes in perfusion of VM whereas an increase in TTP shows therapy-related changes in AVM. Show more

Keywords: Contrast-enhanced ultrasound (CEUS), venous malformation, arterio-venous malformation, TIC analysis

DOI: 10.3233/CH-151962

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 4, pp. 283-290, 2016

Authors: Li, Xue-song | Cheng, Su-jun | Cao, Zhi-gang | Li, Ying | Wang, Rui-tao

Article Type: Research Article

Abstract: BACKGROUND: Various vascular risk factors such as smoking, obesity, and diabetes mellitus are associated with hyperviscosity and lumbar disc herniation (LDH). However, the changes of viscosity in LDH have not been examined. AIMS: The present study was to elucidate 1) the rheological parameter levels in patients with LDH, 2) the risk factors that were related to rheological parameters. METHODS: Our study evaluated the rheological parameters in 307 cases with LDH and in 307 control subjects. Multiple linear regression analysis was conducted to assess the significant factors for whole blood viscosity (WBV) at low shear rate. …RESULTS: LDH patients had markedly lower physical activity and significantly higher WBV 3 s–1 compared with non-LDH subjects (p  < 0.001). Moreover, WBV (3 s–1 ) tended to increase as physical activity decreased. Multiple linear regression analysis revealed that reduced physical activity was a significant factor contributing to elevated WBV (3 s–1 ). CONCLUSIONS: WBV (3 s–1 ) is elevated in patients with LDH. In addition, reduced physical activity is a significant factor for WBV (3 s–1 ). Further studies are warranted to determine the role of WBV (3 s–1 ) in LDH. Show more

Keywords: Lumbar disc herniation, whole blood viscosity, physical activity, risk factor

DOI: 10.3233/CH-151970

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 4, pp. 291-298, 2016

Authors: Chiorean, Liliana | Caraiani, Cosmin | Radziņa, Maija | Jedrzejczyk, Maciej | Schreiber-Dietrich, Dagmar | Dietrich, Christoph F.

Article Type: Research Article

Abstract: The incidental finding of a liver lesion with basic ultrasound is one of the most common clinical issues. Some of the liver lesions which present typical morphological B-mode features (e.g. cysts, typically localized focal fatty sparing/accumulations, hyperechoic hemangiomas) can be easily diagnosed by conventional ultrasound without the need of further diagnostic procedures. Others frequently necessitate further investigation with contrast-enhanced imaging techniques or biopsy in order to differentiate benign from malignant lesions and obtain a final diagnosis. This paper will discuss differences between vascular phases of different cross-sectional contrast-enhanced methods, as well as their subsequent benefits for focal liver lesions (FLLs) …assessment, adding also a particular emphasis on small FLLs detection and characterization. Show more

Keywords: Focal liver lesions, imaging, diagnosis, ultrasonography, contrast-enhanced ultrasound, contrast-enhancedcomputed tomography, contrast-enhanced magnetic resonance imaging, guidelines

DOI: 10.3233/CH-151971

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 4, pp. 299-326, 2016

Authors: Mozar, Anais | Charlot, Keyne | Sandor, Barbara | Rabaï, Miklos | Lemonne, Nathalie | Billaud, Marie | Hardy-Dessources, Marie-Dominique | Beltan, Eric | Pandey, Ramesh C. | Connes, Philippe | Ballas, Samir K.

Article Type: Research Article

Abstract: The aim of the present study was to test the effects of Pfaffia paniculata (PP) extract on the red blood cell (RBC) rheological properties of patients with sickle cell disease (SCD) and healthy (AA) individuals. Blood from 7 SCD and 4 AA individuals were collected in EDTA tubes. Washed RBCs were incubated with various concentration of PP extract: 0.0, 0.2 or 0.5 mg/ml of PP solution for 5 hrs at 37°C. RBC deformability was measured by ektacytometry at 9 shear stresses ranging from 0.3 to 30 Pa, and RBC aggregation properties were determined by laser-backscattered techniques. Because RBCs from SCD patients are …fragile, a stability test was also performed to test for the fragility of RBC exposed to a constant shear stress (70 Pa) for 10 min. While RBC deformability was not improved by the use of PP extract in AA, we noted an improvement of this parameter in patients with SCD between the 0.0 and 0.5 mg/ml conditions. In contrast to AA RBCs, the fragility of SCD RBCs was not affected by PP extract. In conclusion, this study demonstrates the beneficial effects, in-vitro , of PP extract on the RBC deformability of SCD patients, notably at high shear stress (a shear stress condition usually found in capillaries). Show more

Keywords: Pfaffia paniculata, blood rheology, sickle cell anemia, sickle cell disease

DOI: 10.3233/CH-151972

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 4, pp. 327-333, 2016

Authors: Yu, Xin-yang | Li, Ying | Liu, Tiemin | Wang, Rui-tao

Article Type: Research Article

Abstract: BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is an independent risk factor for increased cardiovascular disease. Altered hemorheological parameters have also been shown to play a crucial role in atherogenesis. Moreover, increased viscosity is observed in insulin resistance, metabolic syndrome, hypertension, diabetes, ischemic heart disease, and stroke. A recent study confirmed that whole blood viscosity (WBV) is a predictor of cardiovascular events. AIMS: This study aimed to investigate the association of WBV with NAFLD. METHODS: In this cross-sectional study, we investigated the relationship between WBV and NAFLD in 1329 subjects (962 men and 367 women) in …a general health examination. RESULTS: WBV at low shear stress was elevated in patients with NAFLD. In addition, the prevalence of metabolic syndrome and NAFLD increased as WBV quartiles increased both in men and in women. Multiple regression analysis further identified WBV as an independent and significant determinant for NAFLD. CONCLUSIONS: The findings showed that WBV at low shear stress is increased in NAFLD. Moreover, WBV at low shear stress is independently associated with NAFLD even after adjusting other cardiovascular risk factors. Show more

Keywords: Whole blood viscosity, non-alcoholic fatty liver disease, metabolic syndrome

DOI: 10.3233/CH-151974

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 4, pp. 335-343, 2016

Authors: Abegunewardene, Nico | Kreitner, Karl-Friedrich | Oberholzer, Katja | Vosseler, Markus | Schmidt, Kai-Helge | Wimmer, Eva | Elsäßer, Amelie | Gori, Tommaso | Düber, Christoph | Münzel, Thomas | Horstick, Georg

Article Type: Research Article

Abstract: AIMS: The purpose of the study was to investigate, using cardiac magnetic resonance (CMR), the presence and time course of microvascular obstruction (MO) in patients with acute myocardial infarction (AMI), and to test its relationship with cardiac remodeling and clinical outcomes. METHODS AND RESULTS: 53 patients with AMI and successful percutaneous reperfusion underwent CMR examination at four separate timepoints: within the first 48 hours, at 10 days, at six and twelve months after infarction. MO was quantified immediately (early imaging) and 10 minutes (late imaging) after contrast administration in each session. The extent of MO decreased from …early to late imaging at both the first and the second CMR exam (p ≤0.001). Early MO was absent in 18(36%) patients both at 48 hours and 10 days after AMI. At 1 year follow-up, LVEF in these patients improved to normal (median = 62% (53–70)). Early MO was present in the first but not in the second CMR in 13 (26%) patients; LVEF at one year in these patients reached a median = 52% (47–61). Finally, Early MO was present in both exams in 19 (38%) patients, who at 1 year after infarction had a LVEF of median = 49% (42–54, P ≤0.001 across groups). The time course of MO was a predictor of prognosis upon Kaplan-Meier analysis (P  = 0.035). The presence of MO at 10 days after AMI was associated with a higher risk of MACE during a 5-years follow-up. CONCLUSIONS: The presence of MO within 48 hours after AMI, and its time course in the following ten days, provides complementary information on both functional myocardial recovery and long-term outcome. Show more

Keywords: Acute myocardial infarction, microvascular obstruction, prognosis, magnetic resonance imaging

DOI: 10.3233/CH-151975

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 4, pp. 345-357, 2016

Authors: Kord Valeshabad, Ali | Wanek, Justin | Gaynes, Bruce | Saraf, Santosh L. | Molokie, Robert | Shahidi, Mahnaz

Article Type: Research Article

Abstract: Painful vaso-occlusive crisis (VOC) is the clinical hallmark of sickle cell disease (SCD). Microcirculatory hemodynamic changes following painful VOC may be indicative of future development of VOC events in subjects with SCD. The purpose of the present study was to determine alterations in conjunctival microvascular hemodynamics during non-crisis state in SCD subjects with a history of VOC. Conjunctival microcirculation imaging was performed to measure conjunctival diameter (D) and axial blood velocity (V) in 10 control and 30 SCD subjects. SCD subjects were categorized into two groups based on their history of VOC within a 2-year period before imaging (with or …without VOC-H) and also based on whether there was progression in the rate of VOCs during a 2-year period following imaging as compared to before imaging (with or without VOC-P). Conjunctival V was significantly higher in SCD subjects with VOC-H than in both control subjects and SCD subjects without VOC-H (P ≤0.03). Conjunctival V was also significantly higher in SCD subjects with VOC-P compared with control subjects and SCD subjects without VOC-P (P ≤0.03). Assessment of the conjunctival microcirculation may be useful for understanding hemodynamic changes that lead to VOC events in SCD subjects. Show more

Keywords: Bulbar conjunctiva, sickle cell disease, vaso-occlusive crisis, hemodynamics, microcirculation

DOI: 10.3233/CH-151977

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 4, pp. 359-367, 2016

Authors: Rokicki, Wojciech | Zalejska-Fiolka, Jolanta | Pojda-Wilczek, Dorota | Kabiesz, Adam | Majewski, Wojciech

Article Type: Research Article

Abstract: BACKGROUND: This study was designed to examine oxidative and antioxidative changes in the red blood cells (RBCs) of patients presenting with glaucomatous degeneration. METHODS: The experimental design was a case-control study of strictly selected patients who required antiglaucomatous surgery during primary open-angle glaucoma despite relatively regulated intraocular pressure (IOP) (POAG group, n  = 30) and patients who underwent an operation for nonpathological cataracts (cataract group, n  = 25). The activities of total superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT), as well as the concentration of malondialdehyde (MDA), were measured. Glaucomatous damage was estimated from a transient pattern …electroretinogram. RESULTS: Significant increases in GPX (p  = 0.026) and CAT (p  = 0.000) activity were noted in the RBCs of POAG patients compared to those of cataract patients. Although SOD was elevated in patients with POAG, the differences compared to cataract controls were not significant (p  = 0.079). MDA concentrations were significantly increased in the glaucoma group compared to the cataract controls. CONCLUSION: An oxidative disorder primarily represented by catalase upregulation was observed during the course of glaucoma. Show more

Keywords: Glaucoma, oxidative stress, SOD, GPX, CAT, MDA, erythrocyte

DOI: 10.3233/CH-152029

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 4, pp. 369-378, 2016

Article Type: Other

Citation: Clinical Hemorheology and Microcirculation, vol. 62, no. 4, pp. 379-384, 2016