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PubMed1984

Contributions of red cells and plasma to blood viscosity in preterm and full-term infants and adults.

In preterm infants, plasma and red blood cells display several specific properties (eg, RBC size, plasma composition) that could influence blood flow behavior. Hemorheologic properties of blood from 20 preterm infants (24 to 36 weeks of gestation), ten full-term neonates, and ten adults were studied by means of a cone-plate viscometer adapted with a Couette-type chamber allowing viscometry at a wide range of shear rates (1.15 to 230/s). Blood viscosity (at given hematocrit of 60%), plasma viscosity, and RBC aggregation were very low in the smallest preterm infants, increased with gestational age, and reached the highest values in the adults. Whole blood viscosity increased directly with increasing plasma viscosity, plasma fibrinogen, and total plasma protein concentration, with the strongest correlations at the lowest shear rate of 1.15/s. The viscosity of RBCs suspended in a nonaggregating buffer solution was similar in all groups, thereby indicating that RBC deformability is similar in preterm infants, full-term neonates, and adults. Because mixing of neonatal and adult blood components occurs in most small preterm infants as a result of the transfusion of adult blood products, viscosities of cross suspensions (neonatal RBCs in adult plasma and adult RBCs in neonatal plasma) were measured. The exchange of neonatal plasma for adult plasma increased blood viscosity values in the neonates to adult values. On the other hand, the exchange of neonatal RBCs for adult RBCs did not affect blood viscosity. These results indicate that viscosity of blood with given hematocrit is lower in preterm infants than in term neonates and adults as a result of low plasma viscosity and low RBC aggregation, and that neonatal RBCs do not possess specific properties that influence blood viscosity.

Adult↗
PubMed2006

No effect of increased water intake on blood viscosity and cardiovascular risk factors.

Observational data have suggested that increased water intake decreases the risk of CHD. A postulated mechanism is that increased water ingestion reduces blood viscosity. The aim of the present study was to assess the effect of increased fluid intake on blood viscosity. Men (n 67) and postmenopausal women (n 27) with one or more risk factors for CVD who reported intake of < or =0.5 litres water daily were randomised to a control group (n 31), an intervention group (n 32) that increased their daily water intake by 1 litre/d and an intervention group (n 31) that ingested 1 litre blueberry juice/d. All were encouraged to continue their usual diet and lifestyle. Whole-blood viscosity and blood and urine chemistries were measured by standard techniques after 2 and 4 weeks. Urine volume increased (by a median of 872 and 725 ml in the water and blueberry juice groups, respectively, v. 10 ml in the control group; P< or =0.002), confirming the subjects' adherence to the protocol. Urine osmolality and urinary levels of Na, K and creatinine decreased in the water and blueberry juice groups v. the controls (P<0.05). No change was seen in whole-blood viscosity or in levels of fibrinogen, total protein, lipids, glucose, insulin, C-peptide or other chemistry and haematology variables. In conclusion, a postulated protective effect of increased water or fluid intake is not explained by a change in blood viscosity and increased fluid intake does not influence CVD risk factors in the short term.

Adult↗
PubMed1982

[Significance & treatment of abnormal blood viscosities in pre-eclamptic patients (author's transl)].

Blood viscosity, a blood flow volume determinant, is one of the primary indicators of the state of pregnancy. The viscosity of peripheral veins was measured using a cone-plate viscometer (share rate 150 sec-1, 375 sec-1) and the results were utilized in comparisons between control and experimental groups to determine their importance to pre-eclamptic patients. Compared with values of 11 non-pregnant subjects (3.614 cp), 165 normal pregnancy cases had lower measurements during the entire term of pregnancy. The viscosity of these normal pregnant subjects decreased up to the 24th week, and increased thereafter. It is hypothesized that this results from the increased plasma volume of pregnant women. In severe pre-eclamptic subjects (3.508 cp), viscosity was significantly higher than in normal pregnancy cases. The natural decrease in peripheral blood flow resulting from elevated viscosity threatens the lives of both mother and fetus. Further analysis of clinical symptoms placed these 31 preeclamptic subjects in the conventional categories of hypertensive, proteinuric, and edematic. Viscosity measurements were highest for hypertensive (4.0059 cp), and lowest for edematic (2.7615 cp) and of intermediate value for proteinuric (3.2122 cp). To normalize these viscosities, the administration of dextran infusion therapy to hypertensive subjects and short-term furosemide therapy to edematic subjects was undertaken and brought considerable beneficial results.

Adenosine Triphosphate↗
PubMed1984

Experimental hypervolemic hemodilution: physiological correlations of cortical blood flow, cardiac output, and intracranial pressure with fresh blood viscosity and plasma volume.

Rheological, cerebrovascular, and cardiovascular alterations induced by serial plasma volume (PV) expansion were evaluated in splenectomized dogs. Seven dogs received two infusions of autologous plasma within 120 minutes; each infusion equaled 20% of the respective dog's total blood volume (TBV). The PV increased 31% and then another 26% after the two respective infusions, and the hematocrit (Hct) was obligatorily decreased by 22% during the experiment. The fresh blood viscosity at the shear rate of 10 sec-1 varied inversely with the TBV and the PV and correlated directly with the Hct after these plasma infusions. Cardiac output (CO) increased 71% after the two infusions without significant alterations in mean arterial blood pressure. Additionally, CO was inversely related to both Hct and blood viscosity. Although the 15% rise in regional cortical blood flow (rCoBF) in the territory of the middle cerebral artery did not reach statistical significance, the rCoBF was related inversely to both Hct and blood viscosity and directly to TBV, PV, and CO after the plasma infusions. Cortical vascular resistance (CVR) decreased 18% after the two infusions. The CVR correlated inversely with PV and directly with Hct and blood viscosity. Our data suggest that hypervolemic hemodilution with expansion of PV increases CO more than cerebral blood flow in normal brain. Fresh blood viscosity seems to be a major factor determining CO and cerebral perfusion after IV expansion. This study adds support to the hypothesis that reductions of blood viscosity account for the direct relationship between cerebral blood flow and CO observed after intravascular volume expansion with hemodiluting agents. Hypervolemic hemodilution with plasma reduces CVR, possibly secondary to its effect on blood viscosity, and also raises intracranial pressure.

Animals↗
PubMed2004

Changes in blood viscosity with mucopolysaccharide polysulfate.

We examined the dose-dependent effects of mucopolysaccharide polysulfate (MPS) on coagulation variables and whole-blood viscosity in human blood. Both 0.01% and 0.1% MPS significantly reduced levels of both fibrin monomer and thrombin-antithrombin III complex in a manner similar to that of 2.0 IU/ml heparin sodium. Furthermore, MPS dose-dependently decreased whole-blood viscosity, as measured with an oscillation viscometer. Because MPS can be applied in creams and gels, percutaneous application of MPS may effectively reduce whole-blood viscosity in local veins.

Adult↗
PubMed1984

Comparative evaluation of blood viscosity in diabetic retinopathy.

The viscosity of the whole blood, plasma and serum, haematocrit and plasma fibrinogen were studied in diabetic patients with (DR) and without (D) retinopathy and in non-diabetic control subjects (C). Blood viscosity was significantly higher in diabetics than in controls. No significant differences in viscosity of the whole blood were found when various types of retinopathy were compared according to the severity of retinal damage. Plasma viscosity was significantly higher (P less than 0.01) than controls (C) only in diabetic patients with retinopathy (DR). Serum viscosity was significantly increased compared with controls (C) only in diabetic patients affected by proliferative retinopathy. Plasma fibrinogen was significantly higher than controls (C) both in diabetics with retinopathy (DR) and without retinopathy (D). Haematocrit did not show a significant difference in the three groups considered (C, D, DR).

Adult↗
PubMed1983

Abnormal blood viscosity and haemostasis in long-standing retinal vein occlusion.

Blood viscosity and several haemostatic factors were measured in 42 patients with long-standing retinal vein occlusion and 33 control subjects. Blood viscosity, haematocrit, plasma viscosity, fibrinogen, fibrinopeptide A, and beta-thromboglobulin were increased in the 20 subjects with capillary nonperfusion or new vessels, but not in the 22 subjects without these complications. Patients with nonperfusion or new vessels also had a lower platelet count than patients without complications. Increased levels of factor VIII antigen and decreased levels of antithrombin III were found in the retinal vein occlusion group as a whole. These findings suggest that blood viscosity, platelets, and coagulation may be involved in retinal vein occlusion and its vascular complications.

Aged↗
PubMed1982

Increased blood viscosity and fibrinolytic inhibitor in type II hyperlipoproteinaemia.

Blood rheology and several haemostatic factors were studied in patients with type II hyperlipoproteinaemia (HLP) and matched controls. HLP patients had increased blood viscosity (p less than 0.01), the mean level being 18% higher at a low shear-rate (0.94 s-1) and 13% higher at a high shear-rate (94 s-1). The increased viscosity was due partly to a raised haematocrit (p less than 0.05), and partly to increased plasma viscosity (p less than 0.01) associated with increased plasma fibrinogen (p less than 0.02). Red cell deformability was normal, and viscosity was unrelated to either lipid or lipoprotein concentrations. Levels of the major fibrinolytic inhibitor. alpha 2-antiplasmin, measured by both functional and immunological techniques were higher in HLP patients (mean increase 30-32%). Plasminogen activator levels were normal in HLP patients and the ratio of fibrinolytic inhibitor to activator was therefore increased. Plasminogen concentrations were also increased. Levels of factor VIII activity and antigen, antithrombin III and anti-factor Xa activity, alpha 2-macroglobulin, platelet count, and platelet aggregation by adenosine diphosphate and adrenaline did not differ significantly in HLP patients and controls. These results suggest that the premature arterial disease associated with HLP may be related to increased blood viscosity, which reduces arterial blood flow, and increased alpha 2-antiplasmin, the major inhibitor of fibrinolysis.

Adolescent↗
PubMed1964

BLOOD VISCOSITY IN HEALTHY SUBJECTS AND PATIENTS WITH CORONARY HEART DISEASE.

Viscosity of whole blood and plasma was measured in 258 apparently healthy subjects of both sexes from 5 to 60 years of age, and in 86 patients with unequivocal evidence of chronic coronary heart disease. Children and young healthy females had the lowest viscosity readings. Healthy young and middle-aged males had significantly higher blood viscosity than females. Patients with coronary heart disease had significantly higher blood viscosity values than healthy groups of the same sex. It is suggested that the higher viscosity of whole blood and of plasma is a contributory factor in development of clinical manifestations of coronary heart disease and possibly of the basic vascular lesion itself.

Adolescent↗
PubMed2006

Mechanotransduction and the homeostatic significance of maintaining blood viscosity in hypotension, hypertension and haemorrhage.

The increase of plasma and blood viscosity is usually associated with pathological conditions; however, elevation of both parameters often results in increased perfusion and the lowering of peripheral vascular resistance. In extreme haemodilution, blood viscosity is too low and insufficient to maintain functional capillary density, a problem that in experimental studies is shown to be corrected by increasing plasma viscosity up to 2.2 cP. This effect is mediated by mechanotransduction-induced nitric oxide (NO) production via shear stress in the endothelium as shown by microelectrode perivascular measurements of NO concentration. Moderate elevations of blood viscosity by increasing haematocrit ( approximately 10%) result in comparable reductions of blood pressure and peripheral vascular resistance, an effect also NO-mediated as it is absent after Nomega-nitro-L-arginine methyl ester treatment and in endothelial nitric oxide synthase-deficient mice. These findings show that the rheological properties of plasma affect vessel diameter in the microcirculation leading to counterintuitive responses to the changes in blood and plasma viscosity. Application of these findings to haemorrhagic shock resuscitation leads to the concept of hyperosmotic-hyperviscous resuscitation as a modality for maintaining the recovery of microvascular function.

Animals↗
PubMed1998

Influence of exercise training on blood viscosity in patients with coronary artery disease and impaired left ventricular function.

Exercise training has recently become an accepted therapeutic modality in chronic heart failure after myocardial infarction. Because the therapeutic mechanism behind it is controversial and not well understood, we analyzed the influence of exercise training on blood viscosity. Twenty-five patients with chronic heart failure (ejection fraction < 40%) after myocardial infarction were randomly assigned to either an 8-week intensive exercise program at a residential rehabilitation center or 8 weeks of sedentary life at home. Exercise consisted of two 1-hour walking sessions per day and four intensive bicycle ergometer training sessions of 40 minutes at 70% to 80% peak exercise capacity per week. Whole blood viscosity, viscosity at standardized hematocrit of 45% (P45) at high and low shear rates, and plasma viscosity were measured in a Couette-type viscometer before, during, and at the end of the study period. Exercise training, which significantly increased maximal cardiac output and oxygen uptake, did not change plasma viscosity, whole blood viscosity, and P45 significantly. Sedentary controls, however, had a higher whole blood viscosity and P45 after 8 weeks. No statistical difference was found, however, between the two groups. We conclude that blood rheology remains unaffected by exercise training in patients with chronic heart failure. The improvement of blood viscosity remains an interesting therapeutic option for the symptoms of these patients, which must be achieved by methods other than exercise training.

Blood Viscosity↗
PubMed2001

[Whole blood viscosity measurement in acute myocardial infarction: feasibility and significance].

Thrombolytic agents and new antiplatelet drugs used in acute myocardial infarction (AMI) could change whole blood viscosity. The aim of this pilot trial is to compare blood viscosity at four shear rate levels among three groups of patients: AMI receiving thrombolysis with alteplase (n: 10), AMI eligible for primary angioplasty with abciximab (n: 10), healthy volunteers (n: 10). Viscosity measurement was obtained in 30 minutes with a Couette hemoviscosimeter. At baseline, blood viscosity level was higher in patients with acute coronary syndromes than in healthy volunteers (72 +/- 32 mPa.s versus 51 +/- 13 mPa.s, p<0.05). After thrombolysis, viscosity was higher at 90 minutes than at third day, paradoxically with fibrinogen elevation (72 +/- 32 mPa.s versus 58 +/- 27 mPa.s, p=0.01). In primary angioplasty with abciximab, viscosity decreased significantly (56 +/- 28 mPa.s versus 43 +/- 13 mPa.s, p=0.01). The effects of ionic contrast agent and abciximab are discussed. In healthy volunteers group, 100 mg aspirin once a day during 7 days reduces blood viscosity at high shear stress. The small size of the study population restricts correlation analysis with major clinical adverse events. A larger trial is necessary to evaluate the predictive value of whole blood viscosity in reocclusive and/or hemorrhagic events in those reperfusion strategies but also in case of thrombolytic agent and abciximab combination.

Adult↗
PubMed1977

The relationship of plasma fibrinogen, erythrocyte flexibility and blood viscosity.

Measurements have been made of plasma fibrinogen concentration, erythrocyte flexibility and blood viscosity at shear rates from 5.75 to 230 sec-1 during and following surgery. In the post-operative period the plasma fibrinogen level in the patient rose to over 1,000 mg/dl and because there were subsequent complications, only returned to normal after 4 weeks. There was an associated change of erythrocyte flexibility, with a correlation coefficient of 0.98. The blood viscosity also varied with the plasma fibrinogen level, the effect being more pronounced at low shear rates. The internal viscosity of the red blood cell, calculated from the plasma viscosity and whole blood viscosity at 230 sec-1, decreases with increasing plasma fibrinogen concentration, in agreement with the direct measurements made of erythrocyte flexibility. It is proposed that at high shear rates an increase in plasma viscosity due to an elevation of fibrinogen concentration, is offset by a decrease in the rigidity of the erythrocytes, and these 2 effects counter-balance.

Blood Viscosity↗
PubMed1989

[Blood viscosity is a chronic adjustment factor of arterial vasodilatation in humans].

Arteriolar geometry and blood viscosity, the two main factors determining vascular resistance were studied in 44 normotensive subjects and 106 hypertensive patients at the brachial circulation level. Vascular resistance was calculated as the ratio between mean blood pressure and mean arterial flow determined by pulsed Doppler. Blood viscosity at 240 sec-1 was measured with a coaxial cylinder viscometer: Compared to controls, hypertensive patients had higher vascular resistance (161 + 8 vs 124 + 9 mmHg.ml-1.sec, P less than 0.05) and higher viscosity (4.75 + 0.05 vs 4.50 + 0.07 mPasec, P less than 0.01). Vascular resistance was negatively correlated to blood viscosity both in control (r = 0.48; P less than 0.001) and in hypertensive (r - 0.39, P less than 0.001) groups. Arteriolar equivalent radius (a) calculated from Poiseuille's equation from the relation a = (8 mu/pi R) 1/4 was positively correlated to viscosity in the two regressions were statistically different (P less than 0.001) indicating that at higher viscosity levels, arteriolar equivalent radius had lesser increase in normotensive than in hypertensive groups. Thus chronic increase in blood viscosity is accompanied by a small vessels vasodilatory phenomenon which seems less efficient in normotensive than in hypertensive subjects and might contribute in part to the mechanisms of vascular resistance elevation observed in hypertension.

Adult↗
PubMed1998

Whole blood viscosity and haematocrit are associated with internal carotid atherosclerosis in men.

BACKGROUND: Alterations in blood viscosity and haematocrit have been described in patients with coronary and cerebrovascular diseases. The results have not been conclusive, as modifications of these parameters are often associated with the presence of coronary heart disease (CHD) risk factors. The aim of this study was to verify whether blood viscosity and haematocrit are increased in patients with carotid atherosclerosis, independently of the presence of CHD risk factors. METHODS: Male patients with internal carotid atherosclerosis (ICA+, n = 28) were selected from participants in a cardiovascular disease prevention campaign. Controls (ICA-, n = 28), also participating in the prevention campaign, were matched for age and all the classical CHD risk factors. Plasma lipids, glucose and fibrinogen were determined by routine methods. Cigarette smoking and current drug therapy was established by questionnaire. Whole blood viscosity was measured at shear rates of 450 and 225/s, using a cone-plate viscometer. Echo-Doppler of carotid arteries was performed with an ATL Ultramark 9 HDI using a 5-10 MHz multifrequency probe. RESULTS: Blood pressure, plasma lipids, glucose, body mass index, fibrinogen and plasma viscosity were similar in the two groups. ICA+ patients, compared with the ICA- group, had significantly greater values of blood viscosity (4.52 +/- 0.37 cP compared with 4.18 +/- 0.45 cP, P < 0.005 respectively; shear rate 450/s) and haematocrit (48.57 +/- 3.19% compared with 45.57 +/- 4.81%, P < 0.008 respectively). CONCLUSIONS: Our findings demonstrate that blood viscosity and haematocrit are increased in men with internal carotid atherosclerosis, independently of the presence of risk factors for atherosclerosis.

Adipose Tissue↗
PubMedDate not supplied

Blood viscosity and filtration abnormalities in mixed cryoglobulinemia patients.

Blood, plasma and serum viscosity and blood filtration were investigated in 43 unselected mixed cryoglobulinemia patients. A hyperviscosity syndrome was present in only one patient, and rapidly improved after plasma exchange and cyclophosphamide therapy. A clear-cut increase in blood viscosity was infrequently observed in mixed cryoglobulinemia, although significant differences were present in the plasma and serum viscosity of patients and controls. In contrast, blood filtration was severely impaired in a high percentage of cases (51 and 72% of the values recorded at 37 degrees and 25 degrees C, respectively), and was on the average significantly higher in patients than in controls. Indirect evidence suggests that blood viscosity is at least in part related to cryoglobulins. In 19 patients studied before and after cryoglobulin removal, serum viscosity significantly decreased when the serum was deprived of cryoglobulins. In addition, the cryocrit correlated with all the hemorheological parameters with the exception of blood filtration. The hemorheological findings were compared with multisystemic features of the disease, i.e. liver, renal, lung, neurologic, vascular and funduscopic alterations. The potential clinical relevance of the hemorheological parameters was stressed by the close correlation between blood filtration parameters and serum creatinine. Furthermore, by discriminant analysis, viscosity and blood filtration changes were the serological parameters most significantly associated with the presence of renal, liver and neurological involvement. Thus, hemorheological parameters are frequently abnormal in mixed cryoglobulinemia patients, and seem to play a significant clinical role; they should therefore be included in the work-up of these patients.

Adult↗
PubMedDate not supplied

Elevated blood viscosity in patients with borderline essential hypertension.

In patients with borderline hypertension, total peripheral resistance (TPR) is either elevated or abnormally related to cardiac output. Since blood viscosity is one determinant of TPR, we compared various components of blood viscosity in 25 patients with borderline hypertension and 25 normal subjects. Under all experimental blood flow conditions examined, blood viscosity directly correlated with systolic and diastolic blood pressure (p less than 0.05 or better) and was greater in the hypertensive than in normal subjects. Venous hematocrit and plasma viscosity were higher in the hypertensive patients. These latter rheologic abnormalities accounted for the increased blood viscosity at higher shear rates. At lower shear rates, increased red cell aggregation, primarily mediated by elevated fibrinogen concentration, accounted for the higher blood viscosity in the hypertensive subjects. We conclude that even relatively small elevations in arterial pressure are associated with increased viscous resistance of blood to flow, and that the increased blood viscosity is a consequence of increased hematocrit, plasma viscosity, and red cell aggregation.

Adult↗
PubMed1983

[Effect of prostacyclin on erythrocyte deformability and blood viscosity].

The aim of our research was to investigate the effect of prostacyclin (PGI2) on red blood cell deformability and blood viscosity. Ten non-smokers healthy subjects (aged from 25 to 40) were examined. Different PGI2 concentrations were added to the blood sample and then red blood cell deformability and blood viscosity were measured: 1.2 and 2.4 ng/ml PGI2 concentrations, corresponding to plasma PGI2-like activity in man, increased red blood cell deformability and reduced blood viscosity. The PGI2 capacity of affecting red blood cell deformability and blood viscosity seems to be of clinical interest in conditions where the PGI2 production is reduced, such as ischemic heart disease, peripheral artery disease and diabetes mellitus.

Adult↗