Hemorheological Factors in the Pathophysiology of Acute and Chronic Cerebrovascular Disease

The hemorheologic changes in three groups of patients suffering from acute and chronic cerebrovascular diseases were studied. Firstly, a horizontal study on 57 patients with definite stroke and on 49 patients with TIA was made. Plasma viscosity, whole blood filtration rate, fibrinogen concentration and hematocrit were evaluated as markers of the rheological property of blood. Blood samples were drawn within 6 h from the onset of vascular syndrome. The findings were compared with values obtained in 112 as controls. At the same time, washed red cell filtration rate, together with lactoferrin, betaglucuronidase and beta-thromboglobulin plasma level were assayed. In both groups the onset of the vascular storm was associated with a marked increase of plasma fibrinogen and of blood and plasma viscosity and a significant decrease of whole blood filterability. Lactoferrin, betaglucuronidase and beta-thromboglobulin levels were also significantly increased. Following this, a longitudinal study was performed on 27 patients with definite stroke and 32 patients with TIA. The clinical regression of acute stroke was associated with the progressive reduction of rheological abnormalities. Finally, 81 patients with clinical diagnosis of cerebrovascular disease due to previous stroke or repeated TIA were studied together. An increase of blood viscosity, of fibrinogen concentration and of hematocrit and a decrease of blood filtration rate together with higher levels of beta-thromboglobulin were registered. These results confirm the existence of an association between CVD and hemorheological alterations and suggest more in depth research directed towards identifying the significance of these alterations in the pathogenesis of tissue ischemia. They also serve to introduce a rationale for the pharmacological and therapeutical corrections of these syndromes.

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Viscosity and Red Cell Deformity in Arterial Disease

10.1055/s-0038-1665789 ◽

1979 ◽

Author(s):

G Cella ◽

H de Haas ◽

M Rampling ◽

V Kakkar

Keyword(s):

Vascular Disease ◽

Blood Viscosity ◽

Whole Blood ◽

Arterial Disease ◽

Plasma Viscosity ◽

Control Group ◽

Fibrinogen Concentration ◽

Red Cell ◽

Whole Blood Viscosity ◽

Significant Difference

Haemorrheological factors have been shown to be affected in many kings of vascular disease. The present study was undertaken to correlate these factors in normal subjects and patients suffering from peripheral arterial disease. Twenty-two patients were investigated; they had moderate or severe intermittent claudication, extent of disease being confirmed by aorto-arteriography and ankle-systolic pressure studies. Twenty-five controls with no symptoms or signs of arterial disease were selected with comparable age and sex distribution. Whole blood viscosity was measured at shear rates of 230 secs-1 and 23 secs-lat 37°c using a Wells Brookfield cone plate microvisco meter. Plasma viscosity was also measured in an identical manner. Erythrocyte flexibility was measured by centrifuge technique and fibrinogen concentration as well as haematocrit by standard techniques. The fibrinogen concentration appeared to be the only significant parameter; the mean concentration in patients with peripheral vascular disease of 463 ± 73mg/l00ml in the control group ( < 0.05). Although whole blood viscosity was high in patients, when corrected to a common haematocrit, there was no significant difference between patients and controls. The same megative correlation was found for plasma viscosity. The red cell flexibility was found to be increased in patients as compared to the control group, but this effect appeared to be simply proportional to the fibrinogen concentration.

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Viscosity and Red Cell Deformity in Arterial Disease

10.1055/s-0039-1684517 ◽

1979 ◽

Author(s):

G. Cella ◽

H.A. de Haas ◽

M. Rampling ◽

V.V. Kakkar

Keyword(s):

Vascular Disease ◽

Blood Viscosity ◽

Whole Blood ◽

Arterial Disease ◽

Plasma Viscosity ◽

Control Group ◽

Fibrinogen Concentration ◽

Red Cell ◽

Whole Blood Viscosity ◽

Significant Difference

Haemorrheological factors have been shown to be affected in many kings of vascular disease. The present study was undertaken to correlate these factors in normal subjects and patients suffering from peripheral arterial disease. Twenty-two patients were investigated; they had moderate or severe intermittent claudication, extent of disease being confirmed by aorto-arteriography and ankle-systolic pressure studies. Twenty-five controls with no symptoms or signs of arterial disease were selected withcomparable age and sex distribution. Whole blood viscosity was measured at shear rates of 230 secs-1 and 23 sees-1 at 37°C using a Weils Brookfield cone plate microvisco meter. Plasma viscosity was also measured in an identical manner. Erythrocyte flexibility was measured by centrifuge technique and fibrinogen concentration as well as haematocrit by standard techniques. The fibrinogen concentration appeared to be the only significant parameter; the mean concentration in patients with peripheral vascular disease of 463 ± 73mg/100ml in the control group ( 〈 0.05). Although whole blood viscosity was high in patients, when corrected t. a common haematocrit, there was no significant difference between patients and controls The same megative correlation was found for plasma viscosity. The red cell flexibility was found to be increased in patients as compared to the control group, but this effect appeared to be simply proportional to the fibrinogen concentration.

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The Effects of KBT-3022, a New Anti-platelet Agent, on Hemorheological Properties in Guinea Pigs

Thrombosis and Haemostasis ◽

10.1055/s-0038-1653735 ◽

1995 ◽

Vol 73 (01) ◽

pp. 118-121 ◽

Cited By ~ 6

Author(s):

Noriko Yamamoto ◽

Koichi Yokota ◽

Akira Yamashita ◽

Minoru Oda

Keyword(s):

Shear Stress ◽

Blood Viscosity ◽

Guinea Pigs ◽

Direct Action ◽

Plasma Viscosity ◽

Fibrinogen Concentration ◽

Anti Platelet Agent ◽

Blood Filterability ◽

2,3 Dpg ◽

Rbc Deformability

SummaryUsing guinea pigs, a study was conducted on the effects of KBT-3022, a new anti-platelet agent, on hemorheological properties in various tests including blood filterability, blood viscosity, shear stress-induced red blood cell (RBC) deformability and contents of ATP and 2,3-diphosphoglycerate (2,3-DPG). Oral administration of KBT-3022 at 1 and 10 mg/kg significantly increased blood filterability, and significantly reduced blood viscosity at 10 mg/kg without changing the hematocrit, plasma fibrinogen concentration or plasma viscosity. KBT-3022 (10 mg/kg, p.o.) improved RBC deformability in response to shear stress, which was evoked by passing the blood through a thin tube. This dose of KBT-3022 also increased the contents of ATP and 2,3-DPG in RBC. These findings indicate that KBT-3022 may reduce blood viscosity as a sequel to improvement of RBC deformability through direct action on RBC. The increase in the intracellular levels of ATP and 2,3-DPG was considered to be involved in this improvement of hemorheological properties. These hemorheological effects of KBT-3022 appear to be promising for the treatment of patients with ischemic vascular disease.

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The Association of Platelet and Red Cell Count with Platelet Impedance Changes in Whole Blood and Light-Scattering Changes in Platelet Rich Plasma: Evidence from the Caerphilly Collaborative Heart Disease Study

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647287 ◽

1990 ◽

Vol 64 (02) ◽

pp. 211-215 ◽

Cited By ~ 13

Author(s):

Dan S Sharp ◽

Andrew D Beswick ◽

John R O'Brien ◽

Serge Renaud ◽

John W G Yarnell ◽

...

Keyword(s):

Platelet Count ◽

Heart Disease ◽

Platelet Aggregation ◽

Ischaemic Heart Disease ◽

Whole Blood ◽

Platelet Rich Plasma ◽

Plasma Viscosity ◽

Red Cell ◽

Increased Risk ◽

Rbc Count

SummaryThis epidemiological study was undertaken to explore possible relationships among various haematological indices, prevalent ischaemic heart disease and platelet “function” as measured by two rather different methods. ADP-induced platelet impedance changes in whole blood were strongly associated with prevalent ischaemic heart disease in a general population of 49-66 year men at increased risk. Adenosine diphosphate (ADP) induced platelet aggregation in platelet rich plasma (PRP) at a constant platelet count and also the whole blood platelet count and red cell (RBC) count were strongly and independently related to ADP-induced platelet impedance changes. Both platelet count and platelet aggregation in PRP assessed by changes in optical density were directly related to increasing platelet “sensitivity” as measured by impedance changes in whole blood but RBC count was inversely related. Positive independent relationships between platelet impedance changes and plasma viscosity and fibrinogen were markedly attenuated when platelet count was taken into account, but this finding does not discount a role for these factors in platelet aggregation. No relationship was noted between white blood cell (WBC) count and platelet impedance changes; however, a significant inverse relationship was noted with platelet aggregation in PRP. These findings indicate that laboratory-based experimental findings can be observed in population based studies, and that these haematological factors may be important indicators of ischaemic disease in the population.

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Effects of ovariectomy on blood and plasma viscosity, fibrinogen and whole blood filterability

Maturitas ◽

10.1016/0378-5122(89)90211-9 ◽

1989 ◽

Vol 11 (3) ◽

pp. 199-207 ◽

Cited By ~ 1

Author(s):

G. Gelmini ◽

A.Bacchi Modena ◽

D. Bresciani ◽

D. Fiaschetti ◽

R. Delsignore ◽

...

Keyword(s):

Whole Blood ◽

Plasma Viscosity ◽

Blood Filterability

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Effects of dextran-induced hyperviscosity on regional blood flow and hemodynamics in dogs

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1989.256.3.h898 ◽

1989 ◽

Vol 256 (3) ◽

pp. H898-H905 ◽

Cited By ~ 10

Author(s):

R. Y. Chen ◽

R. D. Carlin ◽

S. Simchon ◽

K. M. Jan ◽

S. Chien

Keyword(s):

Blood Flow ◽

Flow Resistance ◽

Regional Blood Flow ◽

Nutrient Transport ◽

Cell Aggregation ◽

Plasma Viscosity ◽

Red Cell ◽

Flow Ratio ◽

Progressive Reduction ◽

Red Cell Aggregation

In 10 pentobarbitalized dogs, plasma viscosity (Ep) was raised fourfold while apparent blood viscosity (Ea) increased about twofold by two steps of exchange transfusion of 200 ml of plasma with plasma containing high molecular weight dextran (mol wt 500,000, 20% wt/vol). Elevation of Ea was primarily caused by an increase of Ep but not red cell aggregation. As Ea increased, regional blood flow (by 15-microns microspheres) remained constant in most organs but reduced in the small intestine, spleen, and thyroid gland. Vascular hindrance (Z), which reflects the state of vascular geometry, was calculated as flow resistance per Ea. Among various organs, a reduction in Z was noted in the heart, liver, pancreas, kidney, brain, and adrenal gland. In myocardium, there was a progressive reduction of the endocardial-to-epicardial flow ratio, indicating a less profound vasodilation in endocardium than epicardium. These results indicate that dextran-induced hyperviscosity leads to a compensatory vasodilation in several vital organs thus serving to maintain blood flow and nutrient transport.

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Thrombelastography during and after Elective Abdominal Surgery

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646708 ◽

1978 ◽

Vol 39 (02) ◽

pp. 488-495 ◽

Cited By ~ 13

Author(s):

J M Butler

Keyword(s):

Abdominal Surgery ◽

Factor Viii ◽

Whole Blood ◽

Dominant Factor ◽

Fibrinogen Concentration ◽

Factor Viii Activity ◽

Elective Abdominal Surgery

SummaryThrombelastography has been performed on recalcified whole blood from 50 patients before, during and after elective abdominal surgery. The characteristic changes of the thrombelastographic indices r, k and mA are described.During operation r and k shortened, but no change in mA was observed. This response was in part associated with an increase in factor VIII activity. Following operation, while r time was somewhat shortened, much more marked changes in k and mA were evident. Increasing fibrinogen concentration was the dominant factor in determining the post-operative changes in the thrombelastograph.

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Arg506GIn Factor V Mutation (Factor V Leiden) in Patients with Ischaemic Cerebrovascular Disease and Survivors of Myocardial Infarction

Thrombosis and Haemostasis ◽

10.1055/s-0038-1653820 ◽

1995 ◽

Vol 73 (04) ◽

pp. 558-560 ◽

Cited By ~ 105

Author(s):

Kimmo Kontula ◽

Antti Ylikorkala ◽

Helena Miettinen ◽

Alpo Vuorio ◽

Ritva Kauppinen-Mäkelin ◽

...

Keyword(s):

Myocardial Infarction ◽

Cerebrovascular Disease ◽

Factor V Leiden ◽

Mutant Gene ◽

Arterial Disease ◽

Cerebrovascular Diseases ◽

Extensive Study ◽

Carrier Status ◽

Factor V ◽

Ischaemic Attack

SummaryThe point mutation Arg506->Gln of factor V was recently shown to be an important and relatively common genetic cause of venous thromboembolism. Using a DNA technique based on polymerase chain reaction, we surveyed the blood samples of 236 patients with ischaemic stroke or a transient ischaemic attack, 122 survivors of myocardial infarction and 137 control subjects for the presence of this mutation. Although the frequency of the factor V mutation in patients with arterial disease (4.5%) was not significantly different from that in healthy blood donors (2.9%), a carrier status for this mutant gene was associated with symptoms of migraine and relatively mild angiographic abnormalities among patients with cerebrovascular disease. A more extensive study addressing the occurrence and significance of the mutant factor V mutation in patients with vasospastic cerebrovascular diseases seems to be warranted.

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The Effects of Acute Smoking on Platelet Behaviour, Fibrinolysis and Haemorheology in Habitual Smokers

Thrombosis and Haemostasis ◽

10.1055/s-0038-1660996 ◽

1984 ◽

Vol 51 (01) ◽

pp. 006-008 ◽

Cited By ~ 96

Author(s):

J J F Belch ◽

B M McArdle ◽

P Burns ◽

G D O Lowe ◽

C D Forbes

Keyword(s):

Platelet Aggregation ◽

Factor Viii ◽

Plasminogen Activator ◽

Arterial Thrombosis ◽

Plasma Viscosity ◽

Red Cell ◽

Cell Deformability ◽

Red Cell Deformability ◽

Cigarette Smokers ◽

Smoking Group

SummaryThere is an increased frequency of arterial thrombosis in cigarette smokers. The changes in blood coagulation seen in these subjects have been studied by many workers but results have not always been in agreement. We wished to study the effects of acute .smoking on platelet behaviour, fibrinolysis and haemorheology in ten habitual smokers, and to compare these results with nonsmoking controls. Results show that the smoking group had higher plasma fibrinogen (p <0.04), lower plasminogen (p <0.02) and plasminogen activator (p <0.05), and higher plasma viscosity (p <0.003). The changes seen in cigarette smokers after smoking three cigarettes were an increase in the rate of platelet aggregation to ADP (p <0.02), an increase in α2M, (p <0.02), and factor VIII RAG (p <0.05). Plasma viscosity was decreased (p <0.02) as was red cell deformability (p >0.02).We confirm an increased tendency to hypercoagulability in smokers compared to controls which becomes more pronounced immediately after smoking three cigarettes.

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