RESUMEN
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
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
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
Following an abbreviated historical review of literature related to angina pectoris spanning the period from olden days to the beginning of the XIX th century, this paper analyses Jan Cenner's doctoral dissertation entitled "Dissertation inauguralis medica de angor pectoris", written in Cracow, Poland in 1820. A conciliation of the information regarding coronary artery disease with the current state of medical understanding is made in a tabular form and an attempt at an assessment of treatment rules (including prevention, general non-specific therapy, local treatment, dietary management and the use of pharmacological agents) according to updated medical criteria follows. The authors' goal is an objective evaluation of the real scientific value of Cenner's work in light of nearly two centuries of progress in medical knowledge. Emphasis is placed on those diagnostic findings and therapeutic paths relating to coronary artery disease that are currently used in medical practice.
Asunto(s)
Tesis Académicas como Asunto/historia , Angina de Pecho/historia , Cardiología/historia , Angina de Pecho/fisiopatología , Historia del Siglo XIX , Humanos , PoloniaRESUMEN
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.