Clinical Hemorheology and Microcirculation - Volume 66, issue 2

Authors: Lee, Hoyoon | Lee, Kisung | Lee, Byoung-Kwon | Priezzhev, Alexander V. | Shin, Sehyun

Article Type: Research Article

Abstract: Mechanical shear stress is one of the important factors for platelet activation. Although shear stress has been frequently utilized in many applications of diagnostic bio-equipment, there has been little consideration as to whether shear stress induces platelet activation and consequently alters hemorheological characteristics. Therefore, we investigated the effect of shear-induced platelet activation on red blood cell (RBC) aggregation. The hypothesis of the present research is as follows: Platelets activated by high shear stress secrete substances, which can affect hemorheological characteristics to promote RBC aggregation. In our study, an increase in RBC aggregation indices (critical shear stress (CSS) and aggregation index …(AI)) by shear-induced platelet activation was observed. Significantly, an increase of 19% in CSS was observed. However, deformability remained unchanged. These phenomena could be a result of the increased cellular adhesion force on RBC membranes due to secreted substances from activated platelets. Therefore, since high shear application results in the unexpected effect on RBC aggregation, conditions for shear application in diagnostic bio-equipment are to be carefully determined. Show more

Keywords: RBC, CSS, aggregation, platelet activation, shear stress

DOI: 10.3233/CH-16191

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 97-104, 2017

Authors: Tang, Wei | Hu, Fei-Xiang | Zhu, Hui | Wang, Qi-Feng | Gu, Ya-Jia | Peng, Wei-Jun

Article Type: Research Article

Abstract: PURPOSE: To compare the diagnostic efficiency of digital breast tomosynthesis (DBT) plus digital mammography (DM) and magnetic resonance imaging (MRI) plus DM in symptomatic women. MATERIALS AND METHODS: The protocol used in our study was accepted by the ethics committee at our hospital, and informed consent was obtained from all patients. Between June and December 2014, 197 patients with 238 histologically proven lesions all underwent DM, DBT and MRI. Two radiologists were responsible for interpreting all images according to the Breast Imaging Reporting and Data System (BI-RADS). The diagnostic performance of each method was assessed by receiver-operating …characteristic (ROC) curve. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were compared using McNemar’s test and Fisher’s exact test. A Kappa test was used to assess the interobserver agreement. RESULTS: The area under the ROC curve (AUC) was lower in the group that underwent DM alone (Radiologist1 [R1 ], 0.849; Radiologist2 [R2 ], 0.850) than in the group that underwent DBT plus DM (R1 , 0.907, P  = 0.0204; R2 , 0.900, P  = 0.0239) and MRI plus DM (R1 , 0.939, P  = 0.0006; R2 , 0.935, P  = 0.0009). However, the difference between the group that received DBT plus DM and the group that received MRI plus DM was not significant (R1 , P  = 0.1262; R2 , P  = 0.0843). The accuracy (R1 , 71.8%; R2 , 71.4%) and sensitivity (R1 , 71.9%; R2 , 71.2%) of DM were lower than those of DBT ((accuracy: R1 , 85.3%, P  = 0.001; R2 , 83.6%, P  < 0.001; sensitivity: R1 ,92.1%, P  < 0.001; R2 , 90.8%, P  < 0.001) and MRI combined with DM (accuracy: R1 , 90.3%, P  = 0.001; R2 , 90.7%, P  < 0.001; sensitivity: R1 , 94.7%, P  < 0.001; R2 , 95.4%, P  < 0.001). In contrast, no significant difference was observed between DBT and MRI combined with DM (accuracy: R1 , P  = 0.644; R2 , P  = 0.360; sensitivity: R1 , P  = 0.502; R2 , P  = 0.359). The interobserver agreement of each method was excellent (k  = 0.894 0.919 and 0.882 for DM, DBT and MRI combined with DM, respectively). CONCLUSION: The diagnostic performance of DBT and MRI combined with DM is superior to that of DM alone in symptomatic women; MRI plus DM is slightly better than that of DBT plus DM, but this difference was not statistically significant. Show more

Keywords: Breast diseases, full-field digital mammography, magnetic resonance imging, digital breast tomosynthesis

DOI: 10.3233/CH-16242

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 105-116, 2017

Authors: Silva, Ivone | Teixeira, Andreia | Oliveira, José | Almeida, Rui | Vasconcelos, Carlos

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate endothelial dysfunction and microvascular damage in secondary Raynaud Phenomenon (SRP) and Systemic sclerosis (SSc)-associated patients as possible predictors of ischemic fingertip digital ulcers (DU) in a 3-year clinical follow-up. METHODS: Flow-mediated dilatation (FMD), nailfold videocapillaroscopy (NVC), endothelin-1 (ET-1) and asymmetric dimethylarginine (ADMA) were analysed in a 3-year observational cohort study of 77 SRP patients with systemic sclerosis. The primary outcome was the occurrence of a new DU. RESULTS: Risk factors for DU at baseline were low FMD% (p  < 0.001 ), NVC pattern (p  < 0.001 ), high microangiopathy evolution score (MES) (p  < 0.001), …increased ET-1 (p  < 0.001) and increased ADMA serum levels (p  = 0.001). Median time to the occurrence of a new DU was 4.50 (1.25–16.25) months. The risk factors for the occurrence of at least one new DU episode in follow-up included a history of at least one DU before enrolment (p  < 0.001 ), autoantibody anti-scleroderma-70 (p  = 0.012 ), NVC late pattern (p  < 0.001 ), high MES score (p  < 0.001 ), low FMD% (p  < 0.001 ) and increased ET-1 serum levels (p  < 0.001 ). We used univariate Cox regression analysis to show that FMD >9.41% (HR: 0.37 95% CI: 0.14–0.99) and ET-1 >11.85 pmol/L (HR: 3.81 95% CI: 1.41–10.26) and NVC (HR: 2.29 95% CI: 0.97–5.38) were predictors of DU recurrence. In terms of first DU event in naïve DU patients at baseline, late NVC pattern (HR: 12.66 95% CI: 2.06–77.89) and MES score (HR: 1.693 95% CI: 1.257–2.279) were independent predictors. CONCLUSION: This study identified endothelium dysfunction biomarkers (FMD and ET-1) and severe microvascular damage in NVC as strong predictors of new DU in SSc patients. Show more

Keywords: Systemic sclerosis, digital ulcers, flow-mediated dilatation, capillaroscopy, Allen test, ET-1, ADMA, and microangiopathy evolution score

DOI: 10.3233/CH-150044

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 117-130, 2017

Authors: Fontana, Vito | Spadaro, Savino | Bond, Ottavia | Cavicchi, Federica Zama | Annoni, Filippo | Donadello, Katia | Vincent, Jean-Louis | De Backer, Daniel | Taccone, Fabio Silvio

Article Type: Research Article

Abstract: BACKGROUND: Increased red cell distribution width (RDW), a quantitative measure of erythrocyte size variability, has been associated with increased mortality in critically ill patients. METHODS: In this post-hoc analysis of prospectively collected data, we studied 122 septic patients with and without shock who had undergone sublingual microcirculatory assessment using Sidestream Dark Field (SDF) videomicroscopy. Patient demographics, comorbidities, the Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission and the Sequential Organ Failure Assessment (SOFA) score on the day of the microcirculatory assessment were collected. The RDW was retrospectively collected on the day of the …microcirculatory evaluation from the routine daily blood count analysis. RESULTS: Median patient age was 68[55–77] years, and median APACHE II and SOFA scores were 22[17–28] and 10[8–12], respectively; ICU mortality was 43%. On the day of the microcirculatory analysis, the median RDW was 13.8[12.8–15.5]% and was elevated (>13.4%) in 74 (61%) patients. There was no correlation between RDW and microcirculatory parameters (functional capillary density, r2  = 0.12; proportion of small perfused vessels, r2  = 0.17; mean flow index, r2  = 0.14). RDW was not related to disease severity, the presence of shock or survival. CONCLUSIONS: RDW is not associated with microcirculatory alterations or prognosis in septic patients. Show more

Keywords: Red blood cell distribution width, microcirculation, sepsis and septic shock

DOI: 10.3233/CH-160154

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 131-141, 2017

Authors: Ugurel, Elif | Kucuksumer, Zeynep | Eglenen, Buse | Yalcin, Ozlem

Article Type: Research Article

Abstract: BACKGROUND: Erythrocytes undergo irreversible morphological and biochemical changes during storage. Reduced levels of deformability have been reported for stored erythrocytes. Erythrocyte deformability is essential for healthy microcirculation. OBJECTIVE: The aim of this study is to evaluate shear stress (SS) induced improvements of erythrocyte deformability in stored blood. METHODS: Deformability changes were evaluated by applying physiological levels of SS (5 and 10 Pa) in metabolically depleted blood for 48 hours and stored blood for 35 days with citrate phosphate dextrose adenine-1 (CPDA-1). Laser diffractometry was used to measure erythrocyte deformability before and after application of SS. …RESULTS: Erythrocyte deformability, as a response to continuous SS, was significantly improved in metabolically depleted blood, whereas it was significantly impaired in the blood stored for 35 days with CPDA-1 (p ≤0.05). The SS-induced improvements of deformability were deteriorated due to storage and relatively impaired according to the storage time. However, deformability of stored blood after exposure to mechanical stress tends to increase at low levels of shear while decreasing at high SS levels. CONCLUSION: Impairment of erythrocyte deformability after storage may contribute to impairments in the recipient’s microcirculation after blood transfusion. The period of the storage should be considered to prevent microcirculatory problems and insufficient oxygen delivery to the tissues. Show more

Keywords: Erythrocyte deformability, blood storage, shear stress, CPDA-1, metabolic depletion

DOI: 10.3233/CH-160219

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 143-155, 2017

Authors: Filar-Mierzwa, Katarzyna | Marchewka, Anna | Bac, Aneta | Kulis, Aleksandra | Dąbrowski, Zbigniew | Teległów, Aneta

Article Type: Research Article

Abstract: OBJECTIVE: The aim of this study was to analyze the effects of dance therapy on selected hematological and rheological indicators in older women. METHODS: The study included 30 women (aged 71.8±7.4), and the control group comprised of 10 women of corresponding age. Women from the experimental group were subjected to a five-month dance therapy program (three 45-minute sessions per week); women from the control group were not involved in any regular physical activity. Blood samples from all the women were examined for hematological, rheological, and biochemical parameters prior to the study and five months thereafter. RESULTS: …The dance therapy program was reflected by a significant improvement of erythrocyte count and hematocrit. Furthermore, the dance therapy resulted in a significant increase in the plasma viscosity, while no significant changes in glucose and fibrinogen levels were noted. CONCLUSIONS: Dance therapy modulates selected hematological parameters of older women; it leads to increase in erythrocyte count and hematocrit level. Dance therapy is reflected by higher plasma viscosity. Concentrations of fibrinogen and glucose are not affected by the dance therapy in older women, suggesting maintenance of homeostasis. Those findings advocate implementation of dance therapy programs in older women. Show more

Keywords: Ageing, dance therapy, hematology, hemorheology, plasma viscosity

DOI: 10.3233/CH-160241

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 157-165, 2017

Authors: Vörös, Eszter | Deres, László | Halmosi, Róbert | Várady, Edit | Tóth, Kálmán | Battyáni, István

Article Type: Research Article

Abstract: BACKGROUND AND PURPOSE: Iodinated contrast media (Xenetix® , Ultravist® , Omnipaque® , Visipaque® and Iomeron® ) used for computed tomography (CT) may decrease fibrinolysis by recombinant tissue plasminogen activator (rt-PA). We hypothesized that receiving iodinated contrast media before rt-PA may impair thrombolysis as measured by a new model system. METHODS: Whole blood from Wistar Kyoto rats (n  = 10) was obtained and allowed to form blood clots. Thrombolysis was performed by placing individually the prepared clots into 15 mL tubes and adding 5 mL saline buffer, 100μg rt-PA and a different contrast media; adjusting the quantity of iodine to …either 30 mg or 60 mg. The thrombolytic efficacy was quantified by measuring the optical density (OD415 ) of the supernatant at different time points, namely at 0, 30, 60, and 90 min. RESULTS: There was a significant decrease in clot lysis efficiency observed in presence of iodine containing contrast media comparing to positive control group. Moreover, when the quantity of iodine was increased from 30 mg to 60 mg; the dissolution rate downturned with additional ∼50%. CONCLUSION: In conclusion, our study suggests that high dose of iodine potentially could negatively affect the efficiency of the thrombolytic therapy performed by rt-PA. Show more

Keywords: Contrast media, thrombus, rt-PA, thrombolytic therapy, computed tomography

DOI: 10.3233/CH-170261

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 167-174, 2017

Authors: Ranieri, M. | Klein, S. | Taeger, C. | Kotrade, A. | Nerlich, M. | Dolderer, J. | Prantl, L. | Geis, S.

Article Type: Research Article

Abstract: BACKGROUND: Measurement of skin oxygen is of great interest in diverse fields of medicine. Different pathologies, e.g. infection, ischemia cancer or chronic wounds show a characteristic oxygen distribution and skin oxygen tension. Additionally diverse operative procedures require a reliable postoperative monitoring in order to ensure success of the therapy. OBJECTIVE: Aim of this study was to assess transepidermal oxygen flux for postoperative wound monitoring after operative treatment of fractures close to the hip. METHODS: 22 patients underwent transepidermal oxygen flux measurement at the first postoperative day. Transepidermal oxygen flux measurement was performed using ratiometric luminescence …imaging. Examination was conducted in close proximity to the operation wound. The corresponding area at the contralateral side served as reference. RESULTS: Oxygen flux in the operation area was higher (0.084±0.021) than the contralateral side (0.071±0.029). CONCLUSIONS: Transepidermal oxygen flux imaging by ratiometric luminescence imaging seems to be a reliable tool to assess postoperative wound healing. However further investigations in greater populations and under pathologic conditions have to be performed to prove these first results. Show more

Keywords: Tissue oxygenation, wound monitoring, postoperative monitoring, microcirculation

DOI: 10.3233/CH-170265

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 175-182, 2017

Authors: Windberger, Ursula

Article Type: Announcement

Citation: Clinical Hemorheology and Microcirculation, vol. 66, no. 2, pp. 183-183, 2017