ORIGINAL ARTICLES   

International Angiology 2002 December;21(4):355-9

Copyright © 2003 EDIZIONI MINERVA MEDICA

lingua: Inglese

Hemorrheological variables in critical limb ischemia

Köksal C. ¹, Ercan M. ², Bozkurt A. K. ³

¹ Cardiovascular Surgery Department Sureyyapasa SSK Thoracic and Cardiovascular Disease Hospital, Maltepe, Istanbul, Turkey 2 Department of Biophysics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey 3 Department of Cardiovascular Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

Background. Impaired hemor­rhe­o­log­i­cal prop­er­ties may wors­en the tis­sue hypox­ia dis­tal to an arte­ri­al nar­row­ing in ­patients with periph­er­al arte­ri­al occlu­sive dis­ease (PAOD). The objec­tive of this study was to inves­ti­gate the chang­es in red blood cell rigid­ity, blood vis­cos­ity and plas­ma vis­cos­ity as con­trib­ut­ing fac­tors in the devel­op­ment of hypox­ia in ­patients with crit­i­cal limb ische­mia (CLI).
Methods. Forty ­patients with crit­i­cal limb ische­mia and 40 ­healthy sub­jects were includ­ed in the study. The sub­jects includ­ed in the study were non-dia­bet­ic with blood pres­sure meas­ure­ments with­in the nor­mal range. Compound known to inter­fere with hemor­rhe­o­log­i­cal param­e­ters were not taken by the ­patients for at least 7 days prior to inves­ti­ga­tion. Routine blood ­counts (WBC, RBC, Hb, Hct), plas­ma fibrino­gen lev­els, plas­ma total cho­les­te­rol lev­els, red blood cell rigid­ity, blood and plas­ma vis­cos­ity were deter­mined in both ­groups. Statistical eval­u­a­tion of the ­results of both ­groups was com­pared by ­student’s “t”-test. The level of sig­nif­i­cance was set at p<0.05.
Results. Blood vis­cos­ity at a shear rate of 6.00 sec-1 was found to be sig­nif­i­cant­ly lower in the CLI group (p<0.001), where­as no sig­nif­i­cant dif­fer­ence was encoun­tered when blood vis­cos­ity was meas­ured at a shear rate of 225 sec-1. Plasma vis­cos­ity and plas­ma fibrino­gen lev­els were com­par­able. Plasma total cho­les­te­rol lev­els were found to be sig­nif­i­cant­ly high­er in the CLI group (p<0.05) and red blood cell rigid­ity sig­nif­i­cant­ly lower (p<0.001).
Conclusions. These find­ings may pro­vide new ­insights into the role of blood vis­cos­ity in ­patients with CLI con­trary to the pre­vi­ous ­reports in the lit­er­a­ture. Therapies that ­address red blood cell rigid­ity more direct­ly may ­decrease tis­sue hypox­ia dis­tal to arte­ri­al nar­row­ing by pre­vent­ing hemol­y­sis, improv­ing micro­cir­cu­la­tion, and increas­ing oxy­gen car­ry­ing capac­ity and may be more ben­e­fi­cial for these ­patients.