Reference intervals for whole blood viscosity using the analytical performance-evaluated scanning capillary tube viscometer

Elevated blood viscosity has been shown to be independently correlated with cardiovascular risk factors and associated with increased risk of major cardiovascular events, including death and acute myocardial infarction. The aim of the present study was to investigate changes in whole blood viscosity (WBV) at shear rates of 1, 5, and 300 s-1 before and after hemodialysis in patients with end-stage renal disease (ESRD). We also examined the relationship between the changes of WBV and intravascular blood volume. 43 patients with ESRD receiving maintenance hemodialysis were enrolled. WBV was measured using a scanning capillary tube viscometer pre- and post-dialysis to quantify dialytic viscosity surges. Body weight, blood pressure, and hematocrit were also measured before and after hemodialysis, as was the fluid removed during the session. Hemodialysis had a 3 times greater impact on the low-shear WBV at a shear rate of 1 s-1 (i.e., 44.1% change) than on the high-shear WBV at a shear rate of 300 s-1 (i.e., 15.9% change). Changes in the low-shear WBV obtained at shear rates of 1 and 5 s-1 during hemodialysis were significantly correlated with changes in hematocrit. The intravascular blood volume reduction during hemodialysis was positively correlated with the changes in both high-shear and low-shear WBVs. These results suggest that the WBV parameter may hold additional information beyond hemoconcentration. Further research is needed to evaluate the relationship between low-shear WBV surges and increased morbidity in the patient population with ESRD.

The novel alkylxanthine, denbufylline [1,3-di-n-butyl-7-(2-oxopropyl)-xanthine] has been examined, in vitro, for effects on the viscosity of rat whole blood and on the filterability of rat blood cell suspensions. For comparison, pentoxifylline was also examined for rheological activity. Denbufylline reduced the viscosity of whole blood at all shear rates utilised, up to 128.5 s-1. The effect was, however, more pronounced at a low (0.7 s-1) than at a high (94.5 s-1) shear rate indicating that the compound reduces blood cell aggregation and increases blood cell deformability. Denbufylline also increased the filterability of blood cell suspensions. This is further evidence that the compound increases the deformability of blood cells. Denbufylline elevated the filterability of both pure erythrocyte and mixed erythrocyte/leucocyte suspensions, the effect being greatest with the latter. This suggests that denbufylline may influence the deformability of both red and white blood cells. However, the effect on white blood cells, under the experimental conditions employed, is apparently more marked. Pentoxifylline also reduced the viscosity of rat whole blood and increased the filterability of rat blood cell suspensions. However, denbufylline was 10-100-fold more potent in these tests than pentoxifylline.

Measurement of blood viscosity using mass-detecting sensor

Although increased blood viscosity occurs in several cardiovascular diseases, little is known of factors influencing blood rheology in normal adults. Accordingly, we examined the relations of whole blood viscosity (WBV) to its rheologic determinants (hematocrit level, plasma viscosity, protein concentration, and red cell aggregability and rigidity), to demographic and laboratory variables, and to cardiovascular risk factors in 128 normotensive employed adults. Hematocrit levels accounted for 67-84% of variability of WBV at shear rates from 208 to 0.1 sec-1 with lesser contributions from plasma viscosity, red cell aggregability, and rigidity (multiple r = 0.95-0.97); WBV was predicted accurately from standard measurements of hematocrit and total plasma protein levels (multiple r = 0.78-0.92 in "learning" and "test" analysis). Male sex, obesity, dietary Na+ intake, and increasing age had additive effects on WBV (multiple r greater than or equal to 0.59, p less than 0.00001); the last three of these factors and black race independently predicted plasma viscosity (multiple r = 0.36, p less than 0.001). Among regulators of plasma volume, plasma renin activity and urinary Na+ excretion bore independent positive relations to WBV. Diastolic and mean blood pressures were independent predictors of WBV and hematocrit levels (all p less than 0.05). Conventional risk factors (e.g., triglycerides, obesity, and cholesterol levels) were positively related to WBV or plasma viscosity. Thus, in apparently normal adults, 1) WBV or plasma viscosity are increased by male sex, obesity, high sodium intake, aging, and black race, 2) WBV is positively related to plasma renin activity, 3) WBV or plasma viscosity are related to diastolic and mean blood pressures, triglycerides and cholesterol concentrations, and 4) WBV can be predicted from simple measurements of hematocrit and total plasma protein levels.

Comparison tests for plasma viscosity measurements

Complete atrioventricular block is most commonly caused by age-related degeneration and fibrosis in the cardiac conduction system and is called primary idiopathic complete atrioventricular (iCAVB). Although many factors affect this situation, which increases with age in the cardiac conduction system, the relationship between whole blood viscosity (WBV) and iCAVB has not been clarified until now. In this study, we aim to reveal the relationship between iCAVB and WBV. 141 patients with dual-chamber permanent pacemaker implanted for iCAVB and 140 age- and sex-matched subjects were included in this study. The WBV values of the study groups were compared in both high shear rate (HSR) and low shear rate (LSR). Both WBV at HSR and WBV at LSR were significantly higher in the iCAVB group compared to the control group (16.11 [15.14-16.89] vs 14.40 [13.62-15.58]; 39.82 [17.43-55.23] vs 1.38 [-13.14-26.73]; p < 0.001, respectively). The patient population was followed up for an median of 38 months for all-cause mortality. Higher mortality rates were found in higher WBV at HSR and WBV at LSR (p < 0.001,for both). In this study, WBV was found to be an independent predictor for iCAVB, and in these patients WBV was associated with poor clinical outcomes.

It is well known that microcirculation is influenced by blood viscosity. We investigated the effects of noradrenaline (NA) infusion on the whole blood viscosity and viscosity's regulatory factors in order to elucidate the role of the sympatho-adrenal activity in microcirculation.The results are as follows.1. The whole-blood viscosity measured at five different shear rates proportionally increased as the plasma NA concentrations increased.2. The increments of the whole-blood viscosity after NA infusion (ΔCP) were greater at low shear rates than that at high shear rates.3. The mean ΔCP in sympathicotonic persons, who are so classified by autonomic nervous function tests, tended to be greater than that in nonsympathicotonic persons.4. The platelet aggregability, hematocrit, and contents of some plasma lipids and lipoproteins, which can influence the whole blood viscosity, also increased after NA infusion.Present data pointed out the possibility that the sympatho-adrenal hyperactivity may cause “the brain-inner ear circulatory insufficiency” due to impaired microcirculations being induced by the increased whole blood viscosity.

Higher baseline whole blood viscosity is associated with chronic SCD complications

We investigated experimentally the rheological behavior of whole human blood subjected to large amplitude oscillatory shear under strain control to assess its nonlinear viscoelastic response. In these rheological tests, the shear stress response presented higher harmonic contributions, revealing the nonlinear behavior of human blood that is associated with changes in its internal microstructure. For the rheological conditions investigated, intra-cycle strain-stiffening and intra-cycle shear-thinning behavior of the human blood samples were observed and quantified based on the Lissajous-Bowditch plots. The results demonstrated that the dissipative nature of whole blood is more intense than its elastic component. We also assessed the effect of adding EDTA anticoagulant on the shear viscosity of whole blood subjected to steady shear flow. We found that the use of anticoagulant in appropriate concentrations did not influence the shear viscosity and that blood samples without anticoagulant preserved their rheological characteristics approximately for up to 8 minutes before coagulation became significant.

A method of isolating surface tension and yield stress effects in a U-shaped scanning capillary-tube viscometer using a Casson model

Nitrates are one of the most prescribed medications in the treatment of angina pectoris today. Headache is the most common side effect of nitrates, and there is limited prospective data on the determinants of this effect. Our aim in this study is to open a foresight window for clinicians in clinical practice by explaining the possible relationship between nitrate-induced headache and whole-blood viscosity (WBV). After coronary revascularization treatment, 869 patients with angina who were prescribed nitrate preparations were divided into groups according to the development of headache or not and categorized according to the 4-grade scale level. Those who had no headache during nitrate use were graded as grade 0, those who felt mild headache were grade 1, those who felt moderate headache were grade 2, and those who described severe headache were graded as grade 3. The groups were compared according to WBV values. A total of 869 participants were included in the study. Most patients (82.1%) experienced some level of headache. Headache severity correlated with both WBV at high shear rate (r = 0.657; P < 0.001) and WBV at low shear rate (r = 0.687; P < 0.001). In multivariate analysis, WBV was determined as an independent predictor of headache experience. WBV predicted nitrate-induced headache with 75% sensitivity and 75% specificity at high shear rate and 77% sensitivity and 77% specificity at low shear rate. WBV seems to be one of the major determinants for nitrate-induced headache. WBV may be a guide for initiating alternative antianginal drugs without prescribing nitrates to the patient to increase patient compliance.

Segmental blood flow and rheological determinants in diabetic patients with peripheral occlusive arterial disease

Aim: Pulmonary embolism (PE) is a significant cardiovascular condition and a leading cause of mortality worldwide.Diagnosing PE remains challenging due to nonspecific symptoms and limited accessible laboratory tests beyond D-dimer.This retrospective study aimed to evaluate the predictive properties of blood parameters, particularly whole blood viscosity (WBV), for early PE diagnosis. Material and Methods:The study included 72 patients with acute PE and 72 age and sex-matched controls.Data regarding past illnesses, blood tests, and basic echocardiography findings of all patients were obtained.Whole blood viscosity was assessed at low shear rate (LSR) and high shear rate (HSR) using established formulas incorporating hematocrit and total plasma protein.Results: Significant differences were observed in various laboratory parameters between the groups.Whole blood viscosity at both LSR and HSR was significantly higher in the PE group than in controls (p <0.005).Receiver operating characteristic (ROC) analysis demonstrated strong diagnostic capability for WBV, with high specificity and positive predictive value.The optimal cut-off values for WBV at LSR and HSR were 4.20 and 27.22,respectively.Correlation analyses revealed a significant positive relationship between WBV and pulmonary arterial pressure. Conclusions:The findings suggest that WBV, which can be calculated using routine laboratory parameters, holds potential as a diagnostic tool for PE.Integrating WBV assessment could enhance the accuracy and efficiency of PE diagnosis, potentially reducing the need for invasive or radiation-exposing procedures.Further research is necessary to validate these findings in larger populations and establish standardized cut-off values for clinical application.

The influence of lipoproteins on whole-blood viscosity at multiple shear rates

Objective This article investigates the relationship of fractional flow reserve (FFR) with whole blood viscosity (WBV) in patients who were diagnosed with chronic coronary syndrome and significant stenosis in the major coronary arteries and underwent the measurement of FFR. Material and Method In the FFR measurements performed to evaluate the severity of coronary artery stenosis, 160 patients were included in the study and divided into two groups as follows: 80 with significant stenosis and 80 with nonsignificant stenosis. WBVs at low shear rate (LSR) and high shear rate (HSR) were compared between the patients in the significant and nonsignificant coronary artery stenosis groups. Results In the group with FFR < 0.80 and significant coronary artery stenosis, WBV was significantly higher compared with the group with nonsignificant coronary artery stenosis in terms of both HSR (19.33 ± 0.84) and LSR (81.19 ± 14.20) ( p < 0.001). In the multivariate logistic regression analysis, HSR and LSR were independent predictors of significant coronary artery stenosis (HSR: odds ratio: 1.67, 95% confidence interval: 1.17-2.64; LSR: odds ratio: 2.46, 95% confidence interval: 2.19-2.78). In the receiver operating characteristic (ROC) curve analysis, when the cutoff value of WBV at LSR was taken as 79.23, it had 58.42% sensitivity and 62.13% specificity for the prediction of significant coronary artery stenosis (area under the ROC curve: 0.628, p < 0.001). Conclusion WBV, an inexpensive biomarker that can be easily calculated prior to coronary angiography, was higher in patients with functionally severe coronary artery stenosis, and thus could be a useful marker in predicting the hemodynamic severity of coronary artery stenosis in patients with chronic coronary syndrome.