RESUMEN
Obstructive sleep apnea (OSA) is an important public health concern, which affects around 2-4% of the population. Left untreated, it causes a decrease not only in quality of life, but also of life expectancy. Despite the fact that knowledge about the mechanisms of development of cardiovascular disease in patients with OSA is still incomplete, observations confirm a relationship between sleep disordered breathing and the rheological properties of blood. One possible consequence of an increased incidence of cardiovascular disease may be a rise in mortality in OSA patients. Continuously improved research methods are allowing for an increasingly more accurate understanding of the significance of observed changes.
Asunto(s)
Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Hemorreología/fisiología , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/fisiopatología , Viscosidad Sanguínea/fisiología , Agregación Eritrocitaria/fisiología , Humanos , Factores de Riesgo , Apnea Obstructiva del Sueño/sangre , Apnea Obstructiva del Sueño/epidemiologíaRESUMEN
Some studies indicate that obesity is associated with rheological disturbances. Because there are usually sex differences in the type of obesity we decided to evaluate rheological differences between male and female obese patients. We studied 18 morbidly obese men, mean age 43.66 +/- 11.32 years, mean body mass index (BMI) 49.82 +/- 6.03 kg/m2 and 20 obese females, mean age 40.6 +/- 11.86 years, mean BMI 47.41 +/- 8.81 kg/m2. Blood and plasma viscosity measurements were performed using a cone-plate viscometer (Brookfield DV-II). Erythrocyte elongation and red blood cell (RBC) aggregation were measured using the Laser-assisted Optical Rotational Cell Analyser (LORCA). Whole blood viscosity and RBC deformability expressed by the elongation index were significantly higher in obese men. We did not observe differences in plasma viscosity, corrected blood viscosity and aggregation parameters among the obese population. Blood viscosity correlated with selected RBC aggregation indices. We conclude that morbidly obese patients presented sex-dependent differences in some rheological properties. This study indicates a relation between erythrocyte aggregation indices and blood viscosity in obese populations.
Asunto(s)
Viscosidad Sanguínea , Agregación Eritrocitaria , Obesidad Mórbida/sangre , Adulto , Anciano , Deformación Eritrocítica , Femenino , Hemorreología , Humanos , Masculino , Persona de Mediana Edad , Caracteres SexualesRESUMEN
Our aim was to analyze rheological properties of blood and plasma in patients (n=31) with obstructive sleep apnea (OSA) before and after five nights of continuous positive airway pressure (CPAP) therapy as compared with a well-matched control group (n=19). Rheology measurements included blood viscosity, plasma viscosity, erythrocyte elongation and erythrocyte deformability variables specific to the aggregation process. The mean whole blood viscosity of the OSA groups was 18.6% higher than that of the control group (P<0.001), plasma viscosity was 7.2% higher (P<0.001), and the blood count was 6% higher (P<0.001). The corrected viscosity of the OSA group was elevated 6.6% (P<0.05) and the aggregation index was 9.3% higher (P<0.05) relative to the control group. Aggregation half-time of the OSA group was 23.5% shorter than that of the control group (P<0.05). Following CPAP therapy, the rheological variables of the OSA group were significantly reduced: whole blood viscosity was 10.5% lower (P<0.001), plasma viscosity was 4.1% lower (P<0.05), corrected blood viscosity was 4.8% lower (P<0.05), and the aggregation index was 7% lower (P<0.05), while the aggregation half-time was increased 25.4% (P<0.05). There were significant correlations between rheologic and polysomnographic variables for the OSA group. Therefore, five consecutive nights of CPAP therapy improved blood rheological properties in patients with OSA. These findings may help to determine cardiovascular prognoses in these patients.
Asunto(s)
Presión de las Vías Aéreas Positiva Contínua , Hemorreología , Apnea Obstructiva del Sueño/sangre , Apnea Obstructiva del Sueño/terapia , Adulto , Viscosidad Sanguínea , Deformación Eritrocítica , Humanos , Masculino , Persona de Mediana Edad , Estrés Oxidativo , Polisomnografía , Apnea Obstructiva del Sueño/fisiopatologíaRESUMEN
The aim of this study was to correlate some pathogenetic factor with the hemorheological parameters in ills with age-related macular degeneration. The studies were performed on 52 patients suffering from AMD. The control group consisted of 42 healthy persons. Blood samples were taken from patients immediately after ophthalmological examination from antecubital vein and anticoagulated with K3EDTA. The symptoms of macular degeneration were drusen; changes in retinal pigmentation, areolar atrophy, neovascularization. Blood viscosity measurements were performed with use of cone-plate Brookfield viscometer at sheer rate 150 s(-1) and plasma viscosity with capillary Ubbelohde's viscometer. Fibrinogen concentration has been measured according to Clauss method, and level of triglycerides was measured using coupled enzymatic reactions. Haematocrit level was measured with the help of micromethod. The viscosity of whole blood, corrected viscosity and plasma viscosity were respectively 6.9%, 14.6% and 15.7% higher in the patient group than in the control group, while fibrinogen-plasma factor was 16% higher. Aggregation amplitude and time t(1/2) were 89.3% and 28.6% lower in AMD group. Erythrocyte deformability was 18% lower. The aggregation index was 7.6% higher in the AMD group then in the control group. Summing up in people suffering from AMD rheological disturbances is observed increased blood and plasma viscosity.
Asunto(s)
Hemorreología/métodos , Degeneración Macular/sangre , Degeneración Macular/fisiopatología , Anciano , Anciano de 80 o más Años , Viscosidad Sanguínea , Colesterol/sangre , Agregación Eritrocitaria , Deformación Eritrocítica , Fibrinógeno/metabolismo , Hematócrito , Historia del Siglo XVI , Humanos , Persona de Mediana Edad , Valores de Referencia , Triglicéridos/sangreRESUMEN
INTRODUCTION: The no-reperfusion phenomenon occurs in a considerable number of patients despite restoration of the infarct-related artery (IRA) patency. Factors responsible for this phenomenon include myocardial structural changes, whereas haemorheological parameters that significantly contribute to microvascular resistance, have not been studied so far. AIM: To determine the possible relationship between blood and plasma viscosity, red blood cell aggregation and their deformability, and myocardial reperfusion following effective mechanical intervention of IRA. METHODS: The analysis included 23 patients with myocardial infarction treated with primary coronary angioplasty with resultant TIMI (Thrombolysis in Myocardial Infarction) grade 3 flow. Myocardial reperfusion was found effective if myocardial perfusion grade (MPG) was 3. Blood and plasma viscosity were assessed using a Brookfield rotation viscometer. Red blood cell aggregation and deformability were measured with a Laser Optical Rotational Cell Analyzer (LORCA). Patients were divided into two groups with respect to obtained MPG: reperfusion group (14 subjects) and no-reperfusion group (9 patients). RESULTS: Corrected whole blood viscosity and plasma viscosity were significantly higher in the no-reperfusion group and exceeded the values obtained in the reperfused patients by 14% (p <0.05) and 10.5% (p <0.01), respectively. Red blood cell deformability index at shear stress ranging from 1.75 Pa to 60.03 Pa was significantly lower in the no-reperfusion group. Red blood cell aggregation index was significantly higher (by 14.3%, p <0.05), whereas aggregation halftime was significantly shorter (by 58%, p <0.05) in the no-reperfusion group. CONCLUSIONS: Our results indicate that haemorheological disturbances may be an important factor contributing to no-reperfusion after effective mechanical opening of IRA.
Asunto(s)
Angioplastia Coronaria con Balón , Viscosidad Sanguínea , Sistema de Conducción Cardíaco , Infarto del Miocardio/sangre , Infarto del Miocardio/terapia , Anciano , Electrocardiografía , Agregación Eritrocitaria , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reperfusión MiocárdicaRESUMEN
BACKGROUND: The study presents red blood cell (RBC) aggregability and deformability among obese patients qualified for bariatric surgery and its correlation with plasma lipid concentration. METHODS: We studied 40 morbidly obese patients who were qualified for bariatric surgery: mean age was 43.5 +/- 11.3 years, and mean body mass index (BMI) was 48.9 +/- 7.7 kg/m2. The RBC deformability and aggregation parameters: aggregation index (AI), syllectogram amplitude (AMP) and aggregation half-time (t1/2) were measured by Laser-assisted Optical Rotational Cell Analyser - LORCA. RESULTS: Elongation index of RBC was significantly lower in obese patients than in the control group (P<0.001) in 3.16-60.03 Pa shear stresses. Correlations between elongation index and triglyceride levels ranged between 0.42 to 0.44 (P<0.05). AI was significantly higher in the obese patients (P<0.001), t1/2 and the AMP were decreased (P<0.001) compared to the control group. The RBC aggregation index correlated positively with total cholesterol level (r = 0.61, P<0.05), non-HDL cholesterol level (r = 0.54, P<0.05) and BMI (r = 0.48, P<0.05). Negative correlation presented t1/2 with total cholesterol (r = -0.64, P<0.05), non-HDL cholesterol (r = - 0.51, P<0.05) and BMI (r= -0.59, P<0.05). CONCLUSION: Obesity is associated with RBC rheological disturbances expressed by a decrease in RBC deformability, increased total aggregation extent and the alteration of kinetics of RBC aggregation. These results may suggest the necessity of introducing treatment forms to correct erythrocyte rheological properties, which may improve the blood-flow condition in the microcirculation and prevent postoperative complications after bariatric surgery.
Asunto(s)
Deformación Eritrocítica , Eritrocitos/fisiología , Hemorreología , Obesidad Mórbida/sangre , Adulto , Índice de Masa Corporal , Agregación Celular , Humanos , Peroxidación de Lípido , Lípidos/sangre , Microcirculación/fisiología , Persona de Mediana Edad , Obesidad Mórbida/fisiopatología , Flujo Sanguíneo Regional , Triglicéridos/sangreRESUMEN
It has been suggested that patients with knee post-traumatic arthritis (PA), associated or not to haemarthrosis (HA), display altered oxidant and anti-oxidant systems in their synovial fluid. This study aimed to establish whether this is really the case. Synovial fluid samples were obtained by transdermal arthrocentesis from 69 patients with PA (36 of them had HA) and 22 control subjects. The activities of synovial fluid zinc-copper superoxide dismutase (ZnCuSOD) and manganese superoxide dismutase (MnSOD) isoenzymes, catalase (CAT), glutathione peroxidase (GPX), glutathione reductase (GR) and glutathione-S-transferase (GST) enzymes, and malondialdehyde (MDA) concentration and synovial fluid viscosity were measured in the study groups. Patients with PA had significantly increased activities of all antioxidant enzymes, except CAT, and MDA concentration than did the controls. However, synovial fluid viscosity was found to be decreased in the study group, mainly in the HA subgroup. Results suggest that excessive free radicals production may exist in synovial fluid of PA patients and may contribute to knee joint destruction.
Asunto(s)
Artritis/metabolismo , Traumatismos de la Rodilla/metabolismo , Peroxidación de Lípido , Oxidantes/metabolismo , Líquido Sinovial/enzimología , Adulto , Artritis/etiología , Artritis/patología , Catalasa/metabolismo , Femenino , Radicales Libres/metabolismo , Glutatión Peroxidasa/metabolismo , Glutatión Reductasa/metabolismo , Glutatión Transferasa/metabolismo , Hemartrosis/complicaciones , Hemartrosis/metabolismo , Hemartrosis/patología , Humanos , Traumatismos de la Rodilla/complicaciones , Traumatismos de la Rodilla/patología , Articulación de la Rodilla/metabolismo , Articulación de la Rodilla/patología , Masculino , Malondialdehído/metabolismo , Superóxido Dismutasa/metabolismo , ViscosidadRESUMEN
UNLABELLED: Obesity is associated with many comorbid pathologies that lead to increased morbidity and increased mortality. Hemorheological changes in obesity are currently investigated as one of the risk factors for many comorbid pathologies. It has been found that erythrocyte hyperaggregation and a decrease in erythrocyte filterability have also been well documented in obesity patients. The aim of this study is to present preliminary results of the influence of weight reduction after vertical banded gastroplasty (VBG) on aggregation of red cells and red blood cells deformability. We studied seven patients who underwent VBG, median age 46 years (range 35-52), median BMI 52.1 kg/m(2) (range 36.6-66). Blood rheology changes and selected biochemical parameters were examinated before and 6 months after VBG. Erythrocyte elongation and red blood cells (RBC) aggregation were measured using the Laser-assisted Optical Rotational Cell Analyser (LORCA). The RBC aggregation index was significantly decreased, while the aggregation half-time (t(1/2)) significantly elongated after surgery. The syllectogram amplitude did not change. No differences in RBC deformability were observed in the postoperative period. CONCLUSION: We could conclude that among morbidly obese patients six months after VBG some beneficial changes of erythrocyte rheological parameters are observed. Further studies are necessary to confirm our preliminary results.
Asunto(s)
Agregación Eritrocitaria , Deformación Eritrocítica , Obesidad Mórbida/fisiopatología , Adulto , Femenino , Gastroplastia , Hemorreología/instrumentación , Hemorreología/métodos , Humanos , Masculino , Persona de Mediana Edad , Obesidad Mórbida/mortalidad , Obesidad Mórbida/cirugíaRESUMEN
The pathogenesis of diabetic retinopathy is not clear, but it is generally agreed, that in addition to vascular components hemorheological disturbances can play a role in the impairment of microvascular flow. The aim of this study was to correlate the severity of retinopathy in diabetic patients with red blood aggregation and some parameters of aggregation. The study was carried out on 52 patients suffering from type 2 diabetes mellitus with non-proliferative retinopathy--25 men and 27 women (mean age 63.8 +/- 6.5 years) and 43 healthy--20 men and 23 women (mean age 55.5 +/- 9.6 years). The fundus appearance of patients showed non-proliferative diabetic retinopathy. Red blood cell aggregation was determined by LORCA aggregometer. Aggregation index (AI), disaggregation shear rate (gamma(p)), time to the half of the disaggregation (t1/2), time constant of fast component in syllectogram (T1), time constant of slow component (T2) and amplitude (total extent of aggregation Am) were measured. In diabetics with non-proliferative retinopathy we observed the increase of AI (66.5 +/- 7.2 vs 59.4 +/- 5.8; p < 0.001), decrease of Am (19.8 +/- 3.3 vs 21.2 +/- 2.7; p < 0.05), decrease of T1 (2.4 +/- 0.5 vs 2.75 +/- 0.42; p < 0.005), increase of T2 (27.6 +/- 4.7 vs 25.75 +/- 4.11; p < 0.05), decrease of t1/2 (1.98 +/- 0.72 vs 2.7 +/- 0.77; p < 0.001) and increase of gamma(p) (215.6 +/- 23.3 vs 98.1 +/- 8.7; p < 0.001). The parameters of erythrocytes aggregation were correlated with intensification of diabetic retinopathy symptoms. Our results show the importance of red blood cell aggregation parameters in the development of diabetic microangiopathy.
Asunto(s)
Retinopatía Diabética/fisiopatología , Agregación Eritrocitaria/fisiología , Anciano , Anciano de 80 o más Años , Retinopatía Diabética/diagnóstico , Femenino , Hemorreología/instrumentación , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la EnfermedadRESUMEN
UNLABELLED: The aim of this study was to correlate the severity of retinopathy in diabetic patients with the whole blood and plasma viscosity. The studies were performed on 52 patients suffering from type II diabetes mellitus with non-proliferative retinopathy (25 men and 27 females, mean age of patients 64+/-6.5 years). The mean duration of diabetes treatment was 13.7 years. The control group consisted of 43 healthy persons (20 men and 23 women, the mean age of controls was 55.9+/-9.2 years). Blood samples were taken from patients immediately after ophthalmological examination from anticubital vein and anticoagulated with K2EDTA. The symptoms of retinopathy were: macular edemas, microaneurysms, hard and soft exudates and hemorrhagic focuses. The severity of particular signs of retinopathy was expressed in a three point scale. The total number of rank points was correlated with blood and plasma viscosity, moreover with eyes acuity. Blood viscosity measurements were performed with the use of cone-plate Brookfield's viscometer at shear rate 150 s(-1), and plasma viscosity with capillary Ubbelohd's viscometer. Besides the viscometric examinations hematocrit, fibrinogen, blood morphology, total cholesterol concentration, LDL-cholesterol, HDL-cholesterol, triglycerides, blood glucose concentration and glycosylated hemoglobin were examined. The whole blood viscosity, the corrected blood viscosity adjusted to 45% of hematocrit were significantly higher in diabetics (p<0.001). The whole blood relative viscosity was also significantly elevated in diabetic patients (p<0.002). The correlation between visual acuity and rank point of retinopathy severity was negative (r= -0.91, p<0.001). The retinopathy severity was positively correlated with whole blood and plasma viscosity (r=0.51; p<0.001 and r=0.4; p<0.005, respectively). CONCLUSION: Elevated blood and plasma viscosity may play an additional and significant role in the development of diabetic retinopathy.
Asunto(s)
Viscosidad Sanguínea/fisiología , Retinopatía Diabética/sangre , Pruebas Hematológicas/métodos , Plasma/fisiología , Anciano , Glucemia/metabolismo , Proteínas Sanguíneas/metabolismo , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Retinopatía Diabética/fisiopatología , Oftalmopatías/clasificación , Oftalmopatías/epidemiología , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Degeneración Macular/epidemiología , Masculino , Persona de Mediana Edad , Distribución Normal , Valores de Referencia , Reproducibilidad de los Resultados , Triglicéridos/sangreRESUMEN
The aim of the study was to establish relation between hemorheological disturbances and the degree of pathological changes in patients with ischaemic cerebral stroke as well as to examine the dynamics of changes in blood and plasma viscosity during hospitalization and treatment. The patients were divided into two groups according to ischaemic changes extent recognized on the basis of tomogram and clinical examination: group I--ten patients at the age of 64 +/- 11.8 years with hemiparesis and with hypodense cerebral foci several mm in diameter; group II--eight patients at the age of 65 +/- 10 years with hemiplegia and more severe course of disease. The hypodense foci in the brain were several centimetres Blood viscosity measurements were carried out by Brookfild's viscometer using cone-plate system and plasma viscosity by Ubbelohd's capillary viscometer at the temperature of 37 degrees C. Apart from rheological examinations, blood morphological measurements, ESR and biochemical examinations, such as sugar blood concentration, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides and total serum proteins were performed. It was found that in patients in the group II both viscosity of whole blood and plasma as well as corrected viscosity were significantly higher. What is more, degree of rheological disturbances of blood and plasma was related to severity of the course of the disease. Observation of the dynamics of changes in rheological parameters showed that rheological parameters of blood and plasma during hospitalization and treatment improved along with recovery.
Asunto(s)
Viscosidad Sanguínea , Hemorreología , Accidente Cerebrovascular , Anciano , Coagulación Sanguínea , Proteínas Sanguíneas/metabolismo , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/terapia , Rehabilitación de Accidente Cerebrovascular , Factores de Tiempo , Triglicéridos/sangreRESUMEN
The whole blood and plasma viscosity changes in course of acute myocardial infarction were examined. The examination were performed at the beginning of acute phase of myocardial infarction (period 1), at second to third day (period 2) and after about 10 days of infarction episode (period 3). 77 patients (mean age 56.8 +/- 9.8 years) suffered from myocardial infarction were examined. The whole blood viscosity at following shear rates [s-1]: 0.116; 1.0; 4.59; 150 and plasma viscosity were performed. Besides the viscometric examinations the total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, glucose and fibrinogen as well as blood morphology and ESR were determined. All rheological measurements were carried out at the temperature of 37 degrees C immediately after blood drawing. The control group consisted of 110 healthy persons (aged 56.6 +/- 10 years). Some persons of control group have got risk factors of atherosclerosis as: obesity, artery hypertension and cigarette smoking. The following additional parameters were investigated: hematocrit, the artery pressure, the body mass index, total cholesterol concentration, serum LDL-cholesterol, HDL-cholesterol, fibrinogen and blood morphology. The corrected whole blood viscosity was adjusted to 45% of hematocrit. It was stated that the native whole blood viscosity was disturbed at all periods of disease. The corrected whole-blood viscosity in all periods of acute myocardial infarction comparing with controls increased. The greatest rise of corrected whole blood viscosity was especially observed in second period of acute myocardial infarction. Plasma viscosity in patients with acute myocardial infarction is increased in all periods. The greatest rise of plasma viscosity was in second period of disease. The rheological blood and plasma disturbances were connected with increase of total cholesterol, LDL-cholesterol, triglycerides and fibrinogen. These disturbances of blood and plasma viscosity may play a role in promoting myocardial infarction factors.