Hemorheological alterations in carotid artery stenosis

Totsimon, Kinga; Nagy, Alexandra; Sandor, Barbara; Biró, Katalin T.; Csathó, Árpád; Szekeres, L.; Tóth, Kálmán; Márton, Zsolt; Kenyeres, Péter

doi:10.3233/ch-162043

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…Nevertheless, RBC aggregation has been shown to affect blood flow in both micro- and macro-vessels where shear rate is high, notably because of its effects on several rheological phenomena such as axial migration, cell free layer formation, and the Fahraeus effect, the latter occurring mainly in the microcirculation (Baskurt and Meiselman, 2008 ). Recently, it was shown that patients with symptomatic ischemic cerebral events had increased blood viscosity in comparison to asymptomatic patients (Li et al, 2015 ; Totsimon et al, 2016 ) and healthy controls (Velcheva et al, 2006 ). Lower RBC deformability could be at the origin of this blood hyper-viscosity (Totsimon et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

“…Recently, it was shown that patients with symptomatic ischemic cerebral events had increased blood viscosity in comparison to asymptomatic patients (Li et al, 2015 ; Totsimon et al, 2016 ) and healthy controls (Velcheva et al, 2006 ). Lower RBC deformability could be at the origin of this blood hyper-viscosity (Totsimon et al, 2016 ). Research also suggests that RBC aggregation could play a role in ischemic cerebral disease (Zeltser et al, 2001 ).…”

Section: Introductionmentioning

confidence: 99%

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Higher Daily Physical Activity Level Is Associated with Lower RBC Aggregation in Carotid Artery Disease Patients at High Risk of Stroke

et al. 2017

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Aim: Carotid artery disease (CAD) is an atherosclerotic inflammatory disease that affects the arterial wall, specifically at points of bifurcation where blood flow is disturbed. Abnormal blood rheology could participate in the pathophysiology of ischemic cardiovascular disease. Physical activity (PA) is known to improve blood rheology in several chronic disorders. This study aims to (i) compare the hemorheological profile of CAD patients and controls and (ii) investigate the associations between daily PA and hemorheological parameters in CAD patients.Methods: Blood viscosity, red blood cell (RBC) aggregation and RBC deformability were assessed in 80 patients (15 symptomatic and 65 asymptomatic) and 14 age-matched controls. Patients' PA levels were evaluated using questionnaires.Results: Symptomatic patients showed increased blood viscosity and RBC aggregation compared to healthy controls. RBC aggregation was significantly lower in the most physically active patients compared to the least physically active ones. Blood viscosity and RBC deformability did not vary according to physical activity level.Conclusions: Our results showed greater hemorheological abnormalities (blood hyper-viscosity and hyper-aggregation of red blood cells) in the most severe CAD patients, which could exacerbate the risk of stroke in patients with stenosis. As the most physically active patients had lower RBC aggregation than those who were less physically active, it is possible that regular PA may limit hemorheological alterations in CAD patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Higher Daily Physical Activity Level Is Associated with Lower RBC Aggregation in Carotid Artery Disease Patients at High Risk of Stroke

et al. 2017

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“…Several previous studies have shown elevated WBV in stroke [6][7][8][28][29][30][31][32][33][34]. However, whether the elevated WBV reduces cerebral reperfusion in stroke has not been definitely established.…”

Section: Discussionmentioning

confidence: 99%

Whole blood viscosity is associated with baseline cerebral perfusion in acute ischemic stroke

et al. 2021

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Whole blood viscosity (WBV) is the intrinsic resistance to flow developed due to the frictional force between adjacent layers of flowing blood. Elevated WBV is an independent risk factor for stroke. Poor microcirculation due to elevated WBV can prevent adequate perfusion of the brain and might act as an important secondary factor for hypoperfusion in acute ischaemic stroke. In the present study, we examined the association of WBV with basal cerebral perfusion assessed by CT perfusion in acute ischaemic stroke. Confirmed acute ischemic stroke patients (n = 82) presenting in hours were recruited from the single centre. Patients underwent baseline multimodal CT (non-contrast CT, CT angiography and CT perfusion). Where clinically warranted, patients also underwent follow-up DWI. WBV was measured in duplicate within 2 h after sampling from 5-mL EDTA blood sample. WBV was significantly correlated with CT perfusion parameters such as perfusion lesion volume, ischemic core volume and mismatch ratio; DWI volume and baseline NIHSS. In a multivariate linear regression model, WBV significantly predicted acute perfusion lesion volume, core volume and mismatch ratio after adjusting for the effect of occlusion site and collateral status. Association of WBV with hypoperfusion (increased perfusion lesion volume, ischaemic core volume and mismatch ratio) suggest the role of erythrocyte rheology in cerebral haemodynamic of acute ischemic stroke. The present findings open new possibilities for therapeutic strategies targeting erythrocyte rheology to improve cerebral microcirculation in stroke.

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“…[56][57][58] In fact, higher levels of WBV have been reported in stroke groups when compared with healthy control groups. 40,41,[59][60][61][62][63][64][65] More importantly, higher incidence of stroke has been associated with elevated WBV. 40,66,67 In the Edinburgh Artery Study, a prospective study of a randomly selected general population, 1 SD unit increase in WBV increased the risk of stroke by 1.41 times.…”

Section: Microcirculation Disturbances In Strokementioning

confidence: 99%

Whole Blood Viscosity and Cerebral Blood Flow in Acute Ischemic Stroke

Gyawali,

Lillicrap,

Esperon

et al. 2023

Semin Thromb Hemost

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Existing effective treatments for ischemic stroke restore blood supply to the ischemic region using thrombolysis or mechanical removal of clot. However, it is increasingly recognized that successful removal of occlusive thrombus from the large artery—recanalization, may not always be accompanied by successful restoration of blood flow to the downstream tissues—reperfusion. Ultimately, brain tissue survival depends on cerebral perfusion, and a functioning microcirculation. Because capillary diameter is often equal to or smaller than an erythrocyte, microcirculation is largely dependent on erythrocyte rheological (hemorheological) factors such as whole blood viscosity (WBV). Several studies in the past have demonstrated elevated WBV in stroke compared with healthy controls. Also, elevated WBV has shown to be an independent risk factor for stroke. Elevated WBV leads to endothelial dysfunction, decreases nitric oxide-dependent flow-mediated vasodilation, and promotes hemostatic alterations/thrombosis, all leading to microcirculation sludging. Compromised microcirculation further leads to decreased cerebral perfusion. Hence, modulating WBV through pharmacological agents might be beneficial to improve cerebral perfusion in stroke. This review discusses the effect of elevated WBV on endothelial function, hemostatic alterations, and thrombosis leading to reduced cerebral perfusion in stroke.

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Hemorheological alterations in carotid artery stenosis

Cited by 4 publications

References 12 publications

Higher Daily Physical Activity Level Is Associated with Lower RBC Aggregation in Carotid Artery Disease Patients at High Risk of Stroke

Higher Daily Physical Activity Level Is Associated with Lower RBC Aggregation in Carotid Artery Disease Patients at High Risk of Stroke

Whole blood viscosity is associated with baseline cerebral perfusion in acute ischemic stroke

Whole Blood Viscosity and Cerebral Blood Flow in Acute Ischemic Stroke

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