Stable angina pectoris and controlled ischemia: What causes the abnormalities in whole blood filterability?

Ciuffetti, Giovańni; Mercuri, Michele; Lombardini, Rita; Bellomo, Gianni; Corea, L; Lowe, G. D. O.; Ventura, Alessandro

doi:10.1016/s0002-8703(05)80081-x

Cited by 8 publications

(3 citation statements)

References 25 publications

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“…[4][5][6][7][8] The activation of neutrophils renders them less distensible owing to an increase in the intracellular actin scaffold; hence, pentoxifylline improves the efficiency with which neutrophils can flow through the microvasculature. [9][10][11][12][13][14][15] Such an effect is particularly valuable when the pressure gradient across a microvasculature is diminished owing to an upstream stenotic obstruction; hence, it may be a key reason why pentoxifylline is clinically useful in intermittent claudication. The cumulative effect of a reduction in plasma viscosity, an increase in erythrocyte flexibility, and a suppression of neutrophil activation is improvement in capillary blood flow, particularly in vascular beds downstream from an arterial stenosis.…”

Section: Pentoxifylline Improves the Rheological Properties Of Blood mentioning

confidence: 99%

Pentoxifylline for vascular health: a brief review of the literature

2016

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Pentoxifylline is a methylxanthine derivative that has been used for several decades in the symptomatic management of intermittent claudication. For reasons that remain fairly obscure, this drug benefits blood rheology in a number of complementary ways: decreasing blood and plasma viscosity, lowering plasma fibrinogen while promoting fibrinolysis, and improving blood filterability by enhancing erythrocyte distensibility and lessening neutrophil activation. Anti-inflammatory effects on neutrophils and macrophage/monocytes—some of them attributable to pentoxifylline metabolites—appear to play a mediating role in this regard. Although clinical trials with pentoxifylline have often been too small in size to reach statistically significant findings regarding impacts on hard end points, a review of the existing literature suggests that pentoxifylline may have potential for slowing the progression of atherosclerosis, stabilising plaque, reducing risk for vascular events, improving the outcome of vascular events, dampening the systemic inflammatory response following cardiopulmonary bypass, providing symptomatic benefit in angina and intermittent claudication, enhancing cerebral blood flow in patients with cerebrovascular disease while slowing progression of vascular dementia, improving prognosis in congestive heart failure, and aiding diabetes control. This safe and usually well-tolerated drug works in ways quite distinct from other drugs more commonly used for cardiovascular protection, and hence may confer complementary benefit when used in conjunction with them. Major clinical trials of adequate statistical power are now needed to confirm the scope of benefits that pentoxifylline can confer; studies evaluating hard end points in acute coronary syndrome, stroke/transient ischaemic attack and systolic heart failure might be particularly valuable.

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Section: Pentoxifylline Improves the Rheological Properties Of Blood mentioning

confidence: 99%

Pentoxifylline for vascular health: a brief review of the literature

2016

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“…Alterations in the¯ow properties of leucocytes have been observed at the earliest sign of ischaemia, i.e. at the onset of calf pain [9] and chest pain [10]. When exercise increases the white blood cell count, it may re¯ect the``haematological stress syndrome'' [42], which occurs when white cells are released from marginal pools of adrenaline and cortisol dependent leukocytes [31].…”

Section: Discussionmentioning

confidence: 99%

Effects of iloprost on blood rheology and tissue perfusion in patients with intermittent claudication: Results of a double-blind placebo-controlled study

Ciuffetti¹,

Lombardini²,

Pirro³

et al. 2011

Int J Angiol

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The eects of an infusion of a single dose of Iloprost (from 0.5 up to a maximum of 2 ng/kg/min for six hours) in patients with stage II peripheral vascular disease (PVD) on blood rheology and tissue perfusion were determined in a double-blind placebo-controlled study using repeated treadmill exercise test to stress leg circulation. Blood viscosity (BV) at low shear, soluble Pselectin levels (expression of platelet activation), unfractioned leukocyte and erythrocyte ®lterability rates (using a constant-¯ow positive-pressure system), plasma ®brinogen concentration, haematocrit, leukocyte and platelet counts were measured in two matched groups of 8 PVD patients before and after treatment. Transcutaneous oxygen pressure 2 (TcPO 2 ) during controlled ischaemia was also measured. Controlled peripheral ischaemia generated an impaired haemorheological pro®le. Iloprost reduced the impairments in BV and the ®lterability rates of unfractioned leukocytes, inhibited platelet activation and improved erythrocyte deformability. These improvements were associated with signi®cant shortening of the TcPO 2 half recovery time, indicating that ischaemic damage had been contained.

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“…These alterations may amplify tissue injury by leucocyte obstruction of capillary venules (5) and post capillary venules (6) and by the detrimental action of toxic substances released by activated leucocytes (7). In experimental studies, changes in leucocyte rheology and activity have been observed after the induction of controlled acute ischaemia (8,9) thus confirming that changes in leucocyte activity and rheology follow acute ischaemia.…”

Section: Introductionmentioning

confidence: 88%

Leucocyte Rheological Properties Are Altered in Patients with Diffuse Atherosclerosis

Galante¹,

Pietroiusti²,

Magrini³

et al. 1997

Thromb Haemost

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SummaryTo evaluate whether atherosclerosis may be associated with altered leucocyte rheology, we assessed leucocyte count (by Coulter counter), aggregation (by means of the leukergy test) and expression of adhesion molecules integrin LFA-1 and CD 44 (by means of immunofluorescence staining and flow cytometry) in 9 patients with carotid plus lower limb artery atherosclerosis (group A), 14 patients with carotid atherosclerosis only (group B) and 23 controls without atherosclerosis (group C). The level of LFA-1 (calculated as mean fluorescence channels - MFCs) on neutrophils, lymphocytes and monocytes was significantly higher (p <0.05) in group A and B patients than in controls (group A - mean ± SE : 383.77 ± 9.42 vs 295.45 ± 5.76; 474.22 ± 8.86 vs ± 7.84; 457.66 ± 12.03 vs 396.25 ± 4.37. Group B: 322.42 ± 6.36 vs 295.45 ± 5.76; 421.42 ± 7.21 vs 388.35 ± 7.84; 415.71 ± 7.73 vs 396.25 ± 4.37, respectively); furthermore, the MFC of LFA-1 on neutrophils was significantly different (p <0.05) between group A and B patients. The percentage of aggregated leucocytes was significantly higher (p <0.05) in group A patients (4.46 ± 1.07) than those in groups B (1.75 ± 0.38) and C (1.43 ± 0.25), whereas no significant difference was detected between groups B and C. Leucocyte number and expression of CD44 were not significantly different among the 3 groups. In conclusion, changes in leucocyte rheology are present in patients with atherosclerosis and may contribute to chronic ischaemia.

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Stable angina pectoris and controlled ischemia: What causes the abnormalities in whole blood filterability?

Cited by 8 publications

References 25 publications

Pentoxifylline for vascular health: a brief review of the literature

Pentoxifylline for vascular health: a brief review of the literature

Effects of iloprost on blood rheology and tissue perfusion in patients with intermittent claudication: Results of a double-blind placebo-controlled study

Leucocyte Rheological Properties Are Altered in Patients with Diffuse Atherosclerosis

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