Thrombosis and hemorheology

Lowe, G. D. O.

doi:10.1007/978-94-009-4285-1_7

Cited by 14 publications

(7 citation statements)

References 129 publications

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“…Furthermore, the incidence of stroke is increased in the presence of diseases associated with pathologic flow properties of blood. 39 Eliminating accepted cardiovascular risk factors such as smoking reduces the incidence of strokes 40 and simultaneously normalizes blood rheology. 41 Finally, rheologic abnormalities can be shown in epidemiologic 42 and clinical studies 43 to persist long after an acute stroke, indicating that the limitation of blood fluidity is not solely a consequence of the acute event.…”

Section: Discussionmentioning

confidence: 99%

Blood rheology in patients with transient ischemic attacks.

Ernst

Mátrai

Marshall

1988

Stroke

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A complete ischemic stroke is associated with a significant hemorheologic disturbance leading to a rise of the viscous component of the peripheral resistance. This abnormality represents a consequence of the acute event. Nonetheless, it could be causally related to ischemia. In an attempt to clarify this question, 26 patients suffering from transient ischemic attacks were compared with controls in terms of blood and plasma viscosity, hematocrit, blood cell filterability, and erythrocyte aggregation. In patients there was a significant impairment of blood fluidity comprising plasma viscosity, blood cell filterability, and erythrocyte aggregation, suggesting that the flow properties of blood are jeopardized even before an acute stroke. Most likely this is due to the underlying arteriosclerotic process. Our results open the way to speculating that hemorheologic mechanisms might predispose to the development of a stroke by decreasing cerebral blood flow. If this hypothesis were true, it would have important therapeutic implications. (Stroke 1988;19:634-636) T here is ample information on the flow properties of blood after an acute ischemic stroke. 1 " 6 These studies unanimously agree that both cellular and plasmatic abnormalities lead to a marked limitation of blood fluidity. Such changes may be looked upon as a consequence of a stroke; however, they could also contribute to the development of ischemia by virtue of their detrimental influence on cerebral blood flow.7 - 8A transient ischemic attack (TLA) with hemodynamicalry relevant stenosis of the internal carotid artery represents a precursor of stroke.*" 11 Little is known about the flow properties of blood in this condition. Our study was aimed at investigating the blood rheology of TLA patients and testing the hypothesis that blood fluidity is impaired not only after, but also before, an ischemic stroke. Subjects and MethodsTwenty-six consecutive outpatients (12 women, 14 men; aged 50 ± 15 years) with a history of TIAs (a minimum of one attack within the last 4 weeks) and ultrasonic evidence of a stenosis of the internal carotid artery of at least 75% were investigated. A control group (n -26) was selected to match the age (47 ± 14 years) and sex distributions (12 women, 14 men) of the patients. The frequency and distribution of cardiovascular risk factors (hypertension, smoking, hyperlipidemias, diabetes, obesity) were comparable in both groups (Table 1). The control group

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Section: Discussionmentioning

confidence: 99%

Blood rheology in patients with transient ischemic attacks.

Ernst

Mátrai

Marshall

1988

Stroke

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“…Several studies report a stepwise increase in fibrinogen as a function of the number of affected coronaries [7,8,111, suggesting the existence of a relationship between the clinical and biochemical abnormalities. The elevation in fibrinogen levels causes plasma and blood viscosities to increase [7-lo].…”

Section: Coronary Heart Diseasementioning

confidence: 99%

Plasma fibrinogen — an independent cardiovascular risk factor

Ernst

1990

Journal of Internal Medicine

187

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. Apart from being an acute phase reactant, fibrinogen appears to play an important although not widely recognized role in athero‐/thrombogenesis. Arteriosclerotic diseases are associated with elevated levels of plasma fibrinogen. Strategies that lower the cardiovascular risk also lower fibrinogen levels. Virtually all accepted risk factors are associated with hyperfibrinogenaemia, while low risk populations usually have low fibrinogen levels. Epidemiological studies show that fibrinogen is a predictor of arteriosclerotic diseases. Its predictive power seems to be as high as or higher than accepted risk factors. These findings and other circumstantial, as well as experimental, evidence suggest that fibrinogen is a powerful, independent cardiovascular risk factor.

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“…Older subjects tolerate isovolaemic haemodilution without vaso-vagal side-effects or deterioration of the microcirculation but little is known about the microcirculatory changes following moderate hypovolaemia. The decrease in mean arterial pressure and cardiac output may cause deterioration of the microcirculation and oxygen supply, which can in turn further compromise cardiovascular function [8].…”

mentioning

confidence: 99%

The effect of moderate hypovolaemia on microcirculation in healthy older blood donors

Janetzko¹,

Klüter

Kirchner

et al. 2001

Anaesthesia

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SummaryCompensation for acute blood loss requires cardiovascular integrity. In older people, asymptomatic cardiovascular impairment is common. In these subjects, even moderate blood loss is often treated by external volume replacement although its benefits are not clear. We investigated the effect of 450 ml of blood loss on the microcirculation and compensatory mechanisms in healthy older blood donors. Red blood cell count, plasma viscosity and protein concentration were measured. Plasma volume replacement was calculated using haematocrit. We measured microcirculation tissue perfusion by laser Doppler fluxmetry prior to, during and after blood donation. Blood loss was immediately accompanied by a median rapid water shift of 208 ml (interquartile range 134±298 ml). Haemodilution led to a decrease in haematocrit, protein and plasma viscosity. We observed no changes in cutaneous microcirculation. Moderate blood loss is tolerated in older cardiovascularly asymptomatic patients without having an impact on microcirculation. This may reduce the need for external volume replacement.

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Thrombosis and hemorheology

Cited by 14 publications

References 129 publications

Blood rheology in patients with transient ischemic attacks.

Blood rheology in patients with transient ischemic attacks.

Plasma fibrinogen — an independent cardiovascular risk factor

The effect of moderate hypovolaemia on microcirculation in healthy older blood donors

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