RBC velocity profiles in arterioles and venules of the rabbit omentum

Blood Rheology and Hemodynamics

Seminars in Thrombosis and Hemostasis (STH) celebrates 50 years of publishing in 2024. To celebrate this landmark event, STH is republishing some archival material. This article represents the most highly cited paper ever published in STH. The original abstract follows.Blood is a two-phase suspension of formed elements (i.e., red blood cells [RBCs], white blood cells [WBCs], platelets) suspended in an aqueous solution of organic molecules, proteins, and salts called plasma. The apparent viscosity of blood depends on the existing shear forces (i.e., blood behaves as a non-Newtonian fluid) and is determined by hematocrit, plasma viscosity, RBC aggregation, and the mechanical properties of RBCs. RBCs are highly deformable, and this physical property significantly contributes to aiding blood flow both under bulk flow conditions and in the microcirculation. The tendency of RBCs to undergo reversible aggregation is an important determinant of apparent viscosity because the size of RBC aggregates is inversely proportional to the magnitude of shear forces; the aggregates are dispersed with increasing shear forces, then reform under low-flow or static conditions. RBC aggregation also affects the in vivo fluidity of blood, especially in the low-shear regions of the circulatory system. Blood rheology has been reported to be altered in various physiopathological processes: (1) Alterations of hematocrit significantly contribute to hemorheological variations in diseases and in certain extreme physiological conditions; (2) RBC deformability is sensitive to local and general homeostasis, with RBC deformability affected by alterations of the properties and associations of membrane skeletal proteins, the ratio of RBC membrane surface area to cell volume, cell morphology, and cytoplasmic viscosity. Such alterations may result from genetic disorders or may be induced by such factors as abnormal local tissue metabolism, oxidant stress, and activated leukocytes; and (3) RBC aggregation is mainly determined by plasma protein composition and surface properties of RBCs, with increased plasma concentrations of acute phase reactants in inflammatory disorders a common cause of increased RBC aggregation. In addition, RBC aggregation tendency can be modified by alterations of RBC surface properties because of RBC in vivo aging, oxygen-free radicals, or proteolytic enzymes. Impairment of blood fluidity may significantly affect tissue perfusion and result in functional deteriorations, especially if disease processes also disturb vascular properties.

Scattering-driven PPG signal model

This article discusses the origin of PPG signals. Two plausible hypotheses are analyzed: the volumetric hypothesis and a model wherein the PPG is driven by the RBC aggregation process. To verify the model predictions, the PPG signals at the fingertip were measured. External pressure was applied to the fingertip, presumably reducing the blood flow. The results expressed in terms of gamma, used in pulse-oximetry, agree with the aggregation model. In addition, the oscillometric signal and the PPG signal amplitude were simultaneously measured in the fingertip. All of the experimental results favor the proposed aggregation mechanism as responsible the PPG signal.

Individual cell motion in healthy human skin microvasculature by reflectance confocal video microscopy

OBJECTIVE

To describe upper dermal microvasculature of healthy human skin in terms of density and size of cutaneous blood vessels, leukocyte velocity, and leukocyte interactions with the endothelium.

METHODS

We used a reflectance confocal microscope, the VivaScope 1500, to acquire videos of individual cell motion.

RESULTS

We found no rolling leukocytes in the upper microvasculature of ten healthy subjects. We observed "paused" leukocytes, that is, leukocytes that temporarily stop, coinciding with the simultaneous stopping of the rest of the blood flow. We imaged more paused (median: 1.0 per subject) and adherent (1.5) leukocytes in the forearm than in the chest (median 0 paused and 0 adherent per subject) per 5 minutes of videos per body site. Leukocytes were paused for a median of 7 seconds in the forearm and 3 seconds in the chest, and we found no correlation between this parameter and the blood vessel or leukocyte size. We visualized blood flow change direction. Flowing leukocyte velocities followed a lognormal distribution and were on average higher in the chest (117 µm/s) than in the forearm (66 µm/s).

CONCLUSION

The proposed method and reported values in healthy skin provide new insights into intact human skin microcirculation.

A Review on Microvascular Hemodynamics: The Control of Blood Flow Distribution and Tissue Oxygenation

The microcirculation is a complex network of vessels ranging from as large as 100 μm to as small as 5 μm. This complex network is responsible for the regulation of oxygen to the surrounding tissues and ensures metabolite washout. With a more complete understanding of the microcirculation's physiologic and pathologic tendencies, engineers can create new solutions to combat blood pathologies and shock-related diseases. Over the last number of decades a grown interest in the microcirculation has resulted in the development of fundamental techniques to quantify the microvasculature flow and the release of oxygen to tissues.

Compact system for in situ laser Doppler velocimetry of blood flow

This work describes the implementation of a compact system allowing measurement of blood flow velocity using laser Doppler velocimetry in situ. The compact setup uses an optical fiber acting as an emitter and receptor of the signal. The signal is then recovered by a photodiode and processed using a spectrum analyzer. The prototype was successfully tested to measure microbead suspension and whole blood flow velocities in a fluidic chip. Fibers with hemispherical lenses with three different radius of curvature were investigated. This simple yet precise setup would enable the insertion of the fiber via a medical catheter to monitor blood flow velocity in non superficial vessels where previous reported techniques cannot be implemented.

Effect of fractional blood flow on plasma skimming in the microvasculature

Although redistribution of red blood cells at bifurcated vessels is highly dependent on flow rate, it is still challenging to quantitatively express the dependence of flow rate in plasma skimming due to nonlinear cellular interactions. We suggest a plasma skimming model that can involve the effect of fractional blood flow at each bifurcation point. To validate the model, it is compared with in vivo data at single bifurcation points, as well as microvascular network systems. In the simulation results, the exponential decay of the plasma skimming parameter M along fractional flow rate shows the best performance in both cases.

Superficial femoral artery endothelial responses to a short-term altered shear rate intervention in healthy men

In animal and in-vitro models, increased oscillatory shear stress characterized by increased retrograde shear-rate (SR) is associated with acutely decreased endothelial cell function. While previous research suggests a possible detrimental role of elevated retrograde SR on endothelial-function in the brachial artery in humans, little research has been conducted examining arteries in the leg. Examinations of altered shear pattern in the superficial femoral artery (SFA) are important, as this vessel is both prone to atherosclerosis and leg exercise is a common form of activity in humans. Seven healthy men participated; bilateral endothelial-function was assessed via flow-mediated-dilation (FMD) before and after 30-minute unilateral inflations of a thigh blood pressure cuff to either 75 mmHg or 100 mmHg on two separate visits. Inflation of the cuff induced increases in maximum anterograde (p<0.05), maximum retrograde (p<0.01), and oscillatory shear index (OSI) (p<0.001) in the cuffed leg at both inflation pressures. At 100 mmHg the increases in SR were larger in the retrograde than the anterograde direction evidenced by a decrease in mean SR (p<0.01). There was an acute decrease in relative FMD in the cuffed leg alone following inflation to both pressures. These results indicate that in the SFA, altered SR profiles incorporating increased retrograde and OSI influence the attenuation in FMD after a 30-minute unilateral thigh-cuff inflation intervention. Novel information highlighting the importance of OSI calculations and assessments of flow profiles add to current body of knowledge regarding the influence of changes in SR patterns on FMD. Findings from the current study may provide additional insight when designing strategies to combat impaired vascular function in the lower extremity where blood vessels are more prone to atherosclerosis in comparison to the upper extremity.

A simple "streak length method" for quantifying and characterizing red blood cell velocity profiles and blood flow in rat skeletal muscle arterioles

OBJECTIVES

To develop a valid experimental method for quantifying blood flow in continuously branching skeletal muscle arterioles, and to derive an empirical relationship between velocity ratio (V(Max)/V(Mean)) and arteriolar diameter.

METHODS

We evaluated arteriolar trees using IVVM of rat gluteus maximus muscle and developed a method to acquire single fluorescent-labeled RBC velocities across arteriolar lumens to create velocity profiles. These data were used to calculate the blood flow for 37 vessel segments (diameters: 21-115 μm).

RESULTS

Mass balance at arteriolar bifurcations had 0.6 ± 3.2% error. Velocity ratios ranged from 1.35 to 1.98 and were positively correlated with diameter (p < 0.0001), and V(RBC) profiles were blunted with decreasing diameter.

CONCLUSIONS

We present a means for quantifying blood flow in continuously branching skeletal muscle arterioles. Further, we provide an equation for calculating velocity ratios based on arteriolar diameter, which may be used by others for blood flow calculations.

Image-based vessel-by-vessel analysis for red blood cell and plasma dynamics with automatic segmentation

The aim of the present study was to test the hypothesis that vascular tones of cortical surface and parenchymal blood flow can be dissociated depending on the perturbation. To this end, a novel image-based analytical method for quantitatively measuring vessel diameters and flow dynamics was developed. The algorithm relies on the spatiotemporal coherence of the pixel intensity changes induced by the transit of the fluorescent signals measured using confocal laser scanning fluorescent microscopy in the rat cerebral cortex. A cocktail of fluorescently labeled red blood cell (RBC) and plasma agents was administered to simultaneously compare RBC and plasma dynamics in the same vascular networks. The time to fluorescent signal appearance and the width of the fluorescent signal were measured in each segment and compared between sodium nitroprusside-induced global and sensory stimulation-induced local perturbation conditions. We observed that infusion of sodium nitroprusside induced significant vasodilation in the surface artery, particularly in the small arteries (1.8-fold increase). Vasodilation induced by sensory stimulation was observed to depend on vessel size, but significant changes were only detected for the small arteries and veins. Measurements of the time to venous appearance revealed that appearance time was extended by sodium nitroprusside, but shortened during forepaw stimulation, relative to the control condition. Both perturbations provoked the largest changes between the small artery and vein segments, indicating that the changes in the appearance time originate from blood passage through parenchymal microcirculation. These findings support the hypothesis that cortical surface vascular tone and parenchymal blood flow are individually coordinated.

Anterograde and retrograde blood velocity profiles in the intact human cardiovascular system

Current assessments of the effects of shear patterns on vascular function assume that a parabolic velocity profile is always present. Any substantial deviation in the profile away from this may result in misinterpretation of the importance that shear patterns have on vascular function. The present investigation tested the hypothesis that anterograde and retrograde blood flow would have a parabolic velocity profile at rest, during cold pressor test and exercise. Eight healthy subjects completed a cold pressor test and a graded knee-extension exercise test. Doppler ultrasound was used to determine time-averaged mean velocity (V(mean)) and time-averaged peak velocity (V(peak)) for both anterograde and retrograde flow in the femoral artery (FA) and brachial artery (BA). The V(mean)/V(peak) ratio was used to interpret the shape of the blood velocity profile (parabolic, V(mean)/V(peak) = 0.5; plug-like, V(mean)/V(peak) = 1.0). At rest, BA and FA V(mean)/V(peak) ratios of anterograde and retrograde flow were not significantly different from 0.5. During cold pressor test, anterograde V(mean)/V(peak) in the BA (0.56 ± 0.02) and FA (0.58 ± 0.03) were significantly greater than 0.5. During peak exercise, the V(mean)/V(peak) ratio of anterograde flow in the FA (0.53 ± 0.04) was not significantly different from 0.5. In all conditions, the retrograde V(mean)/V(peak) ratio was lower than anterograde. These data demonstrate that blood flow through two different conduit arteries during two different physiological stressors maintains a velocity profile that resembles a slightly blunted parabolic velocity profile.

Micro-Particle Image Velocimetry (microPIV): recent developments, applications, and guidelines

In this review we discuss the state of the art of the optical whole-field velocity measurement technique micro-scale Particle Image Velocimetry (microPIV). microPIV is a useful tool for fundamental research of microfluidics as well as for the detailed characterization and optimization of microfluidic applications in life science, lab-on-a-chip, biomedical research, micro chemical engineering, analytical chemistry and other related fields of research. An in depth description of the microPIV method is presented and compared to other flow visualization and measurement methods. An overview of the most relevant applications is given on the topics of near-wall flow, electrokinetic flow, biological flow, mixing, two-phase flow, turbulence transition and complex fluid dynamic problems. Current trends and applications are critically reviewed. Guidelines for the implementation and application are also discussed.

Improved instrumentation for blood flow velocity measurements in the microcirculation of small animals

Microcirculation is the generic name of vessels with internal diameter less than 100 microm of the circulatory system, whose main functions are tissue nutrition and oxygen supply. In microcirculatory studies, it is important to know the amount of oxyhemoglobin present in the blood and how fast it is moving. The present work describes improvements introduced in a classical hardware-based instrument that has usually been used to monitor blood flow velocity in the microcirculation of small animals. It consists of a virtual instrument that can be easily incorporated into existing hardware-based systems, contributing to reduce operator related biases and allowing digital processing and storage. The design and calibration of the modified instrument are described as well as in vitro and in vivo results obtained with electrical models and small animals, respectively. Results obtained in in vivo studies showed that this new system is able to detect a small reduction in blood flow velocity comparing arteries and arterioles (p <0.002) and a further reduction in capillaries (p<0.0001). A significant increase in velocity comparing capillaries and venules (p <0.001) and venules and veins (p <0.001) was also observed. These results are in close agreement with biophysical principles. Moreover, the improvements introduced in the device allowed us to clearly observe changes in blood flow introduced by a pharmacological intervention, suggesting that the system has enough temporal resolution to track these microcirculatory events. These results were also in close conformity to physiology, confirming the high scientific potential of the modified system and indicating that this instrument can also be useful for pharmacological evaluations.

Integrated photothermal flow cytometry in vivo

The capability of integrated flow cytometry to detect, in real time, moving cells in their natural states in vivo is demonstrated in a study of circulating red and white blood cells in lymph and blood flow of rat mesentery. This system combines dual pump-probe photothermal (PT) techniques, such as PT imaging, the PT thermolens method, and PT velocimetry, with high-resolution (up to 0.3 microm), high-speed (up to 1000 fps) transmission digital microscopy (TDM) and fluorescence imaging. All PT techniques are based on irradiation of cells in rat mesenteric microvessels with a spectrally tunable laser pulse (420 to 570 nm, 8 ns, 0.1 to 300 microJ) and on detection of temperature-dependent variations of the refractive index with a second continuous probe laser beam (633 nm, 1.4 mW). We focus on intravital monitoring of the integral PT response from single, moving, unlabeled cells (from 100 to 500 cells in one measurement). Potential in vivo applications of this new optical tool, called PT flow cytometry (PTFC), are discussed, including identification of selected cells with differences in natural absorptive properties and sizes, determination of laser-induced cell damage, estimation of flow velocity, and monitoring of circulating cells labeled with PT probes.

Relationship between erythrocyte aggregate size and flow rate in skeletal muscle venules

In previous studies we showed that intravenous infusion of Dextran 500 in the rat causes blunting of the velocity profile of red blood cells in venules at low shear rates. To determine whether this blunting is associated with the formation of red blood cell aggregates, we measured the length and width of particles in the venular flow stream at systemic hematocrits up to 20% with a high-speed video camera and a new image analysis technique. Data were obtained at various shear rates under normal (nonaggregating) conditions as well as after infusion of Dextran 500. Under normal conditions, particle length (parallel to the vessel axis) was 6.5 +/- 2.7 microm and width (perpendicular to the axis) was 6.1 +/- 1.7 microm, in agreement with published dimensions of individual red blood cells for this species. After Dextran 500 infusion, particle length and width increased significantly to 8.7 +/- 5.1 and 10.4 +/- 4.4 microm, respectively. Particle dimensions were greater in the central region of the flow stream for both normal and dextran-treated blood and increased at low flow rates with dextran-treated blood. This study provides direct confirmation of aggregate formation at low shear in venules with high-molecular-weight dextran as well as an estimate of aggregate size and range.

Velocity pulse measurements in the mesenteric arterioles of rabbits

The axial red blood cell velocity pulse was quantified throughout its period by a high-speed video microscopy method, using images of erythrocytes moving near the microvessel axis. In 10 mesenteric precapillary arterioles (8 to 12 microm in diameter) from six rabbits, axial velocities ranged from 0.46 (the minimum of all the end diastolic values) to 4.8 mm s(-1) (the maximum of all the peak systolic values). With the velocity pulse shape properly quantified, a correct estimation of the average velocity over time can be made and hence, appropriate quantification of blood flow. Average velocity ranged between 1.14 mm s(-1) (8 microm arterioles) and 1.98 mm s(-1) (9 microm arterioles). Also, with the velocity pulse shape known, an estimation of the magnitude of the pulsation can be made by introducing Pourcelot's resistive index (RI) in the microvascular haemodynamics (diameter less than 15 microm). The results of this study reveal that RI in the precapillary arterioles is quite high ranging between 0.56 (8 microm arterioles) and 0.74 (12 microm arterioles). Observing the velocity pulse diagrams in different diameters, quantitative information is obtained for the first time on how the velocity pulse shape flattens as it proceeds to the capillary bed.

Effect of aggregation and shear rate on the dispersion of red blood cells flowing in venules

Previous in vitro studies of blood flow in small glass tubes have shown that red blood cells exhibit significant erratic deviations in the radial position in the laminar flow regime. The purpose of the present study was to assess the magnitude of this variability and that of velocity in vivo and the effect of red blood cell aggregation and shear rate upon them. With the use of a gated image intensifier and fluorescently labeled red blood cells in tracer quantities, we obtained multiple measurements of red blood cell radial and longitudinal positions at time intervals as short as 5 ms within single venous microvessels (diameter range 45-75 microm) of the rat spinotrapezius muscle. For nonaggregating red blood cells in the velocity range of 0.3-14 mm/s, the mean coefficient of variation of velocity was 16.9 +/- 10.5% and the SD of the radial position was 1.98 +/- 0.98 microm. Both quantities were inversely related to shear rate, and the former was significantly lowered on induction of red blood cell aggregation by the addition of Dextran 500 to the blood. The shear-induced random movements observed in this study may increase the radial transport of particles and solutes within the bloodstream by orders of magnitude.

Surface-dependent coagulation enzymes. Flow kinetics of factor Xa generation on live cell membranes

The initial surface reactions of the extrinsic coagulation pathway on live cell membranes were examined under flow conditions. Generation of activated coagulation factor X (fXa) was measured on spherical monolayers of epithelial cells with a total surface area of 41-47 cm(2) expressing tissue factor (TF) at >25 fmol/cm(2). Concentrations of reactants and product were monitored as a function of time with radiolabeled proteins and a chromogenic substrate at resolutions of 2-8 s. At physiological concentrations of fVIIa and fX, the reaction rate was 3.05 +/- 0.75 fmol fXa/s/cm(2), independent of flux, and 10 times slower than that expected for collision-limited reactions. Rates were also independent of surface fVIIa concentrations within the range 0.6-25 fmol/cm(2). The transit time of fX activated on the reaction chamber was prolonged relative to transit times of nonreacting tracers or preformed fXa. Membrane reactions were modeled using a set of nonlinear kinetic equations and a lagged normal density curve to track the expected surface concentration of reactants for various hypothetical reaction mechanisms. The experimental results were theoretically predicted only when the models used a slow intermediate reaction step, consistent with surface diffusion. These results provide evidence that the transfer of substrate within the membrane is rate-limiting in the kinetic mechanisms leading to initiation of blood coagulation by the TF pathway.

Effect of erythrocyte aggregation on velocity profiles in venules

A recent whole organ study in cat skeletal muscle showed that the increase in venous resistance seen at reduced arterial pressures is nearly abolished when the muscle is perfused with a nonaggregating red blood cell suspension. To explore a possible underlying mechanism, we tested the hypothesis that red blood cell aggregation alters flow patterns in vivo and leads to blunted red blood cell velocity profiles at reduced shear rates. With the use of fluorescently labeled red blood cells in tracer quantities and a video system equipped with a gated image intensifier, we obtained velocity profiles in venous microvessels (45-75 microm) of rat spinotrapezius muscle at centerline velocities between 0.3 and 14 mm/s (pseudoshear rates 3-120 s(-1)) under normal (nonaggregating) conditions and after induction of red blood cell aggregation with Dextran 500. Profiles are nearly parabolic (Poiseuille flow) over this flow rate range in the absence of aggregation. When aggregation is present, profiles are parabolic at high shear rates and become significantly blunted at pseudoshear rates of 40 s(-1) and below. These results indicate a possible mechanism for increased venous resistance at reduced flows.

Elevation of oxygen release by nitroglycerin without an increase in blood flow in the hepatic microcirculation

The effect of nitroglycerin on oxygen (O2) release in the microcirculation was investigated by examining single, unbranched hepatic sinusoids of rats using dual-spot microspectroscopy. Nitroglycerin significantly increased O2 release from erythrocytes flowing in the sinusoids. Differences in O2 saturation of hemoglobin per unit length of the sinusoid were significantly enhanced, while there were no significant changes in erythrocyte velocity, hemoglobin concentration or oxyhemoglobin flow into the sinusoids, or in regional hepatic blood flow measured with a laser tissue blood flow meter. No change was noted for hepatic O2 consumption measured in isolated liver perfused with hemoglobin-free oxygenated buffer. Isosorbide dinitrate showed a similar but slower effect. These findings suggest that nitroglycerin and isosorbide dinitrate enhance O2 release from erythrocytes without significantly increasing tissue blood flow.

Variation in the velocity, deformation, and adhesion energy density of leukocytes rolling within venules

Leukocyte rolling along the endothelium in inflammation is caused by continuous formation and breakage of bonds between selectin adhesion molecules and their ligands. We investigated trauma-induced leukocyte rolling in venules (diameter, 23 to 58 microns; wall shear stress, 1.2 to 35 dyne/cm2) of the exteriorized rat mesentery using high-resolution intravital microscopy. While rolling, the leukocytes deformed into a tear-droplike shape. Deformation continued to increase with shear stress up to the highest values observed (35 dyne/cm2). Successive leukocytes had similar rolling velocities at the same axial positions along each vessel, suggesting that heterogeneity of endothelial adhesiveness is responsible for velocity variation. Adhesion energy density varied inversely with instantaneous rolling velocity and directly with instantaneous deformation. Adhesion energy density reached a maximum of 0.36 dyne/cm, similar to values found for lymphocyte function-associated antigen-1-dependent adhesion of stimulated T cells to isolated intercellular adhesion molecule-1. We conclude that selectin-mediated adhesion during rolling produces adhesion energy densities comparable to those observed for integrin-mediated adhesion events in other experimental systems.

Relation between air-filled albumin microbubble and red blood cell rheology in the human myocardium. Influence of echocardiographic systems and chest wall attenuation

BACKGROUND

We have previously shown that the intravascular rheology of sonicated air-filled albumin microbubbles is similar to that of red blood cells (RBCs) and that their myocardial transit rate is also similar to that of RBCs in the beating canine heart. In the present study, we tested the hypothesis that the myocardial transit rates of these microbubbles reflect those of RBCs in humans at different coronary flow rates.

METHODS AND RESULTS

RBC and microbubble transit rates were measured in 17 patients undergoing coronary angiography: in 8, measurements were made only at rest, whereas in 9, they were performed both at rest and during a pacing-induced increase in coronary blood flow. A gamma-variate function was used to derive mean RBC and microbubble transit rates from the time-activity and time-intensity plots after the left main injection of RBCs and microbubbles, respectively. There was linear correlation between the myocardial transit rates with both tracers with the slope of the correlation determined by the specific echocardiographic system that was used. Microbubble transit rate consistently overestimated RBC transit rate due to artificial narrowing of the time-intensity curves caused by chest wall attenuation of the echocardiographic signal, which was confirmed through in vitro experiments.

CONCLUSIONS

There is close correlation between air-filled albumin microbubbles and RBC rheology in the human myocardium. The use of these microbubbles in the cardiac catheterization laboratory could, therefore, provide further insights into myocardial blood flow/myocardial blood volume relations in humans.

Role of erythrocytes in leukocyte-endothelial interactions: mathematical model and experimental validation

The binding of circulating cells to the vascular wall is a central process in inflammation, metastasis, and therapeutic cell delivery. Previous in vitro studies have identified the adhesion molecules on various circulating cells and the endothelium that govern the process under static conditions. Other studies have attempted to simulate in vivo conditions by subjecting adherent cells to shear stress as they interact with the endothelial cells in vitro. These experiments are generally performed with the cells suspended in Newtonian solutions. However, in vivo conditions are more complex because of the non-Newtonian flow of blood, which is a suspension consisting of 20-40% erythrocytes by volume. The forces imparted by the erythrocytes in the flow can contribute to the process of cell adhesion. A number of experimental and theoretical studies have suggested that the rheology of blood can influence the binding of circulating leukocytes by increasing the normal and axial forces on leukocytes or the frequency of their collision with the vessel wall, but there have been no systematic investigations of these phenomena to date. The present study quantifies the contribution of red blood cells (RBCs) in cell capture and adhesion to endothelial monolayers using a combination of mathematical modeling and in vitro studies. Mathematical modeling of the flow experiments suggested a physical mechanism involving RBC-induced leukocyte dispersion and/or increased normal adhesive contact. Flow chamber studies performed with and without RBCs in the suspending medium showed increases in wall collision and binding frequencies, and a decrease in rolling velocity in the presence of erythrocytes. Increased fluid viscosity alone did not influence the binding frequency, and the differences could not be attributed to large near-wall excesses of the lymphocytes. The results indicate that RBCs aid in the transport and initial engagement of lymphocytes to the vascular wall, modifying the existing paradigm for immune cell surveillance of the vascular endothelium by adding the erythrocyte as an essential contributor to this process.

In vivo myocardial kinetics of air-filled albumin microbubbles during myocardial contrast echocardiography. Comparison with radiolabeled red blood cells

Myocardial contrast echocardiography (MCE) is a new technique for assessing myocardial perfusion that uses intracoronary injections of microbubbles of air. Because these microbubbles have a mean diameter of 4.3 +/- 0.3 microns and an intravascular rheology similar to that of red blood cells (RBCs), we hypothesized that their mean myocardial transit rates recorded on echocardiography would provide an estimation of regional myocardial blood flow in the in vivo beating heart. Accordingly, blood flow to the left anterior descending coronary artery (LAD) of 12 open-chest anesthetized dogs (group I) was adjusted to 4 to 6 flows (total of 60 flows), and microbubbles and radiolabeled RBCs were injected into the LAD in a random order at each stage. The mean myocardial RBC transit rates were measured by fitting a gamma-variate function to time-activity plots generated by placing a miniature CsI2 probe over the anterior surface of the heart, and the mean myocardial microbubble transit rates were measured from time-intensity plots derived from off-line analysis of MCE images obtained during the injection of microbubbles. An excellent correlation was noted between flow (measured with an extracorporeal electromagnetic flow probe) and mean myocardial RBC transit rate (y = 2.83 x 10(-3)x + 0.01, r = .96, SEE = 0.02, P < .001). A close correlation was also noted between mean RBC and microbubble myocardial transit rates (y = 1.01x + 0.01, r = .89, SEE = 0.02, P < .001). Despite its theoretical advantages, a lagged normal density function did not provide a better fit to the MCE data than the gamma-variate function.(ABSTRACT TRUNCATED AT 250 WORDS)

Platelet-activating factor acetylhydrolase in red cell membranes. Does decreased activity impair erythrocyte deformability in ischemic stroke patients?

BACKGROUND AND PURPOSE

Platelet-activating factor acetylhydrolase hydrolyzes platelet-activating factor (1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine). It also hydrolyzes oxidized derivatives of phosphatidylcholine that have a short-chain acyl residue at the sn-2 position. This enzyme may act mainly in the degradation of oxidized phospholipids and may play a role in maintaining erythrocyte deformability. Therefore, we assessed the activity of red cell membrane platelet-activating factor acetylhydrolase in patients with ischemic stroke and studied the relation of the enzyme activity to red cell deformability.

METHODS

Enzyme activity was measured in the detergent extract of red cell membranes from 38 patients with cerebral thrombosis and 38 age-matched healthy volunteers. Red cell filterability, an index of red cell deformability, was also measured.

RESULTS

The enzyme activity in patients and control subjects was 100 +/- 74 and 148 +/- 128 nmol/g protein per minute (2.68 +/- 2.11 and 3.79 +/- 2.46 pmol/10(9) cells per minute) (mean +/- SD), respectively, and the difference was significant (p < 0.05 by the Mann-Whitney U test, two-sided test). Enzyme activity was correlated positively with red cell filterability in the patients (n = 20, r = 0.565, p < 0.01).

CONCLUSIONS

Red blood cells from stroke patients have lower levels of platelet-activating factor acetylhydrolase activity when compared with those from healthy subjects. This may result in the accumulation of oxidized lipids in the cell membrane and lead to impaired red cell deformability in patients with cerebral thrombosis.

Participation of serum albumin and LDL-cholesterol in impaired blood cell-filterability affected by white blood cells in patients with cerebral thrombosis

We examined the effect of white blood cells (WBCs) on the red blood cell (RBC)-filterability, and the influence of plasma components on their interaction of their microcirculatory behaviour in cerebral thrombosis patients. Subjects studied were 20 patients with a history of cerebral thrombosis (60 +/- 4.7 years old) (mean +/- SD) and 28 healthy controls (59 +/- 5.4 years old). Filterability indices of RBC suspension (RFI) and suspension with RBCs plus WBCs (RWFI) were measured by the method of Nuclepore filtration. The values of RFI in patients and controls were 0.44 +/- 0.12 and 0.56 +/- 0.16 ml min-1 (mean +/- SD), and RWFIs were 0.33 +/- 0.092 and 0.40 +/- 0.11 ml min-1, respectively. The differences in both of these values between patients and controls were significant (p < or = 0.01 for RFI and p < or = 0.05 for RWFI, based on Student's t test, respectively). Both RFI and RWFI in bed-ridden patients were lower than those in the more active counterparts (p < or = 0.05, based on Student's t test). In patients, RFI and RWFI correlated positively with serum albumin (r = +0.515, p < 0.05; r = +0.533, p < 0.05, based on Student's t test, respectively). The net lowering effect of WBCs on RFI (RFI-RWFI) correlated positively with serum LDL-cholesterol in patients (r = +0.574, p < 0.01, based on Student's t test). WBCs play a significant role in reducing RFI, and its effect is related to the pathemas of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Validation and reproducibility of bidirectional laser Doppler velocimetry for the measurement of retinal blood flow

Bidirectional laser Doppler velocimetry (BLDV) for the measurement of retinal blood flow was validated in six anaesthetised minipigs, by comparing BLDV derived results with those obtained using radioactively labelled microspheres (RLM). The mean velocity of blood (Vmean) was calculated from the maximum red blood cell velocity measured by BLDV. Volumetric flow rate was determined from Vmean and vessel diameter, measure from monochromatic fundus photographs. Total retinal blood flow (TRBF) was calculated by summating flow values obtained for each retinal vein draining into the optic disc. A significant correlation was found between the TRBF results obtained by the two techniques (r = 0.99, p less than 0.001). The BLDV results were between 3-35 microliters/min lower than the corresponding RLM results (p = 0.05). Values of 57 +/- 24 microliters/min and 76 +/- 34 microliters/min were obtained for TRBF using the BLDV and RLM techniques respectively. Reproducibility studies with BLDV were also performed in six anaesthetised pigs over three hours and in six normal human volunteers over two hours and two weeks. No significant difference between measurements was found with time. Ninety five percent confidence limits of +/- 9.8% for the six pigs and +/- 8.9% for the six human volunteers were found for measurements on the same day and at two weeks. We conclude that with a sample size of six, changes in flow of approximately 20% can be detected using BLDV and monochromatic fundus photography.

The accuracy of pulse oximetry at two haematocrit levels

The object of this study was to investigate the influence of haematocrit on the accuracy of pulse oximetry. Seven Swedish land race rabbits were studied. The oxygen saturation of haemoglobin was decreased step-wise using increasing fractions of nitrogen to the inspiratory gas. One pulse oximeter probe was attached on the front leg and another probe directly over the common carotid artery. The pulse oximeter readings (SpO2) were compared with simultaneous oxygen saturation analysis (SaO2) by a haemoximeter. The pulse oximeter measurements were performed at the haematocrit levels of approximately 40% and 11%, respectively. We found a good correlation between SpO2 and SaO2 in a wide range of the oxygen saturation, i.e. SaO2 26-100%. After haemodilution the correlation was improved in the range 86-100%, but not in the range 26-85%. No correlation between SpO2 and SaO2 was found when the sensor was attached directly over the artery during normal haematocrit levels. After haemodilution a better correlation was however obtained. These results indicate that the accuracy of pulse oximetry is dependent on the haematocrit level.

A method for measuring the rate of oxygen release from single microvessels

A system determining the rate of oxygen release from erythrocytes flowing in single microvessels was constructed with an inverted microscope by connecting 1) a scanning/grating spectrophotometer equipped with a photon-counting detector through a thin light guide, to obtain the visible absorption spectrum of a spot (5 microns in diameter) focused on a microvessel, 2) two photomultipliers (connected to a microcomputer via an analog-to-digital converter) through two light guides, to determine the flow velocity of erythrocytes by calculating the cross correlation between the light-intensity changes of two spots (3 microns in diameter, 5 microns apart from each other) focused on the microvessel, and 3) an image processor through a video camera, to estimate the diameter of microvessel from the digitized video images. The rate of oxygen release from single microvessels 7-25 microns in diameter in rat mesentery was measured under the superfusion of deoxygenated solution: 1) The maximal rate was obtained in capillaries, and the rate in arterial microvessels was larger than that in venous microvessels, when similar diameters were compared. 2) The rate was maximum at pH 7.0-7.2, and it decreased in more acidic and alkaline pH values. 3) The rate decreased with a decrease in temperature. The reliability of the measurement using the present apparatus was tested in detail.

Measurement of cochlear blood flow: intravital fluorescence microscopy

A technique is described for directly observing in vivo cochlear microvasculature in the gerbil for physiologic and experimentally induced changes in vessel diameter and blood flow velocity. Measurements are made from computer processed video images of surgically exposed microvessels. These images are obtained using intravital fluorescence microscopy (IFM) with epi-illumination. The Mongolian gerbil is an ideal animal model for circulatory studies of the inner ear. It has a stable heart rate and blood pressure under urethane/alpha-chloralose anesthesia and its cochlea is surgically accessible. A window is created over the feeding artery (anterior inferior cerebellar artery) and over the stria vascularis of the second turn of the cochlea, atraumatically exposing radiating arterioles and strial capillaries. Our system of IFM provides images that are videorecorded, digitally analyzed with a computer image processor, and enhanced according to the type of measurement desired. Velocity measurements are obtained by tracking plasma gaps or single fluorescent labeled red blood cells through successive frames of the videorecorded images. This experimental technique allows us to analyze circulatory responsiveness to a variety of vasoactive drugs administered regionally to the cochlea in concentrations not affecting systemic circulation.

The behavior of sonicated albumin microbubbles within the microcirculation: a basis for their use during myocardial contrast echocardiography

The purpose of this study was to determine whether the behavior of sonicated albumin microbubbles accurately mimics red blood cell flow in the microcirculation and is thus consistent with their use as in vivo tracers of red blood cell flow during myocardial contrast echocardiography. Accordingly, microbubbles prepared from fluorescein-conjugated albumin and fluorescently labeled red blood cells were injected intravascularly in eight golden hamsters. Their intravascular distribution, velocities, arteriolar-to-venular transit and flux ratios at branch points were determined in the microcirculation of the cheek pouch. Albumin microbubbles (mean diameter, 4.9 +/- 3.6 microns) and red blood cells displayed a similar frequency of distribution across the arteriolar lumen (33% in the central 20% of the arterioles), and their arteriolar velocities were also similar (2.5 +/- 0.7 mm/sec and 2.3 +/- 0.7 mm/sec,p = NS). The mean velocities of microbubbles correlated well with those of red blood cells at baseline and after adenosine application (r = 0.97 and r = 0.89, respectively), as did the calculated maximum velocity (r = 0.98 and r = 0.80, baseline and adenosine, respectively). The velocity profiles across the lumen of the vessels for albumin microbubbles and red blood cells were similar at baseline and after adenosine-induced velocity changes. The flux ratios at branch points also correlated well (r = 0.92, p less than 0.001). Arteriolar-to-venular transit times of albumin microbubbles were similar to those of red blood cells in vessels ranging in size from 22 microns to 45 microns. We conclude that the behavior of albumin microbubbles in the microcirculation mimics that of red blood cells and supports their use as intravascular tracers of red blood cell flow during myocardial contrast echocardiography.

Red cell distribution at microvascular bifurcations

The distribution of red cell and blood volume flow was studied at 65 arteriolar bifurcations in the rat mesentery. Hematocrit and flow velocity were measured simultaneously in all three vessel segments constituting a bifurcation. Blood flow distribution was manipulated by irreversibly occluding downstream side branches of one of the daughter vessels. The dependence of fractional red cell volume flow on fractional blood flow was described using a three-parameter (X0, B, A) logit function. The critical volume flow fraction below which only plasma enters a downstream branch (X0), the nonlinearity of the relation between red cell and blood volume flow (B), and the asymmetry of that relation which is described by the parameter A decrease with increasing diameter of the vessel feeding the bifurcation. At diameters above 30 microns, phase separation is very limited. In addition, the nonlinearity parameter B decreases with decreasing hematocrit in the feeding vessel. The asymmetry parameter A strongly depends on the diameter ratio between the two daughter branches: For a given fractional blood flow, the smaller branch receives more red cells than the larger branch. Using a model for plasma skimming based on the assumption of a planar separating surface, the shape of the radial hematocrit profile in the feeding vessel has been calculated. The model predicts a decrease in local hematocrit from the vessel axis toward the wall with a distinct marginal zone free from cell centers. With increasing vessel diameter the hematocrit profile becomes more blunted while the width of the marginal zone increases.

Increase in capillary blood flow and relative haematocrit in rabbit skeletal muscle following acute normovolaemic anaemia

The effect of acute normovolaemic haemodilution on microvascular red blood cell flow was studied by intravital microscopy in the tenuissimus muscle of the rabbit. Blood was substituted isovolaemically with equal volumes of a 6% solution of dextran 70 (MW 70,000). The systemic haematocrit (Hsys) decreased from 36 +/- 4% (mean +/- SD) to 17 +/- 2%. Following haemodilution capillary haematocrit (Hcap), as measured by video densitometric methods, decreased by 20 +/- 9%. The reduction of Hcap was significantly smaller than that of Hsys, and Hcap normalized with respect to Hsys increased from 0.39 +/- 0.07 in the control situation to 0.62 +/- 0.18 after haemodilution. Red blood cell velocity (vrbc) increased by 45 +/- 20% and compensated for the decrease in Hcap in such a way that the red blood cell flux, calculated from vrbc and Hcap, remained unchanged. Measurements of volume flow in the feeding arterioles in the muscle revealed a fractional redistribution of blood flow in favour of the muscle capillaries following haemodilution at the expense of vessels in adjacent connective tissue supplied by the same arterioles. This fractional flow redistribution was likely the basis for the relative increase in capillary haematocrit seen after haemodilution. The present data demonstrate that an acute reduction of the systemic haematocrit is compensated for in an active regulating vascular bed by a proportionally smaller decrease in capillary haematocrit and by an increased capillary red cell velocity. Microvascular haematocrit was found not to be a constant fraction of the systemic value, which supports the view of capillary haematocrit as a 'controlled' physiological variable.

Mathematical modelling of oxygen supply and oxygenation in tumor tissues: prognostic, therapeutic, and experimental implications

Radiation response of some tumors is dependent on the oxygenation of the tumor tissue. To improve tissue oxygenation, attempts to increase a reduced hemoglobin concentration or to shift the dissociation curve of hemoglobin have been made. The aim of this paper is to estimate the influence of such measures on the volume of radiobiologically hypoxic tissue by means of a mathematical model. In addition, the influence of blood velocity and metabolic status of tumor tissues on tissue oxygenation is evaluated. The calculations show a strong influence on hypoxic tissue volume over a modest range of variation of physiological parameters, especially when interactions of several parameters may occur.

Haematocrit distribution in rabbit tenuissimus muscle

Low values of mean capillary haematocrit have been reported in many tissues including skeletal muscle. The present study was undertaken to analyse haematocrit distribution in the transverse and terminal arterioles, capillaries and venules of the rabbit tenuissimus muscle preparation. Tube haematocrit, i.e. the volume fraction of red cells, in muscle capillaries (n = 85) was found to be 39% of systematic haematocrit Hsys. In part, this haematocrit reduction is due to the Fahraeus effect. Corresponding capillary discharge haematocrit HD was 56% of Hsys. Tenuissimus muscle capillaries are fed by terminal arterioles originating from transverse arterioles. The latter extend into and supply adjacent connective tissue septa in addition to the muscle tissue proper. In transverse arterioles leaving the muscle to enter the connective tissue, HD was found to be 127% of Hsys (n = 18), and in collecting venules at the muscle edge HD was 129% of Hsys (n = 18). These findings indicate that the connective tissue microcirculation represents a functional red-cell shunt in resting tenuissimus muscle. Since only about 20% of the inflow to the preparation passes through the connective tissue, this shunting is not sufficient to satisfy conservation of red-cell mass. In addition, it is likely that the observed low capillary haematocrit is in part due to a positive correlation between blood-flow velocity and HD in capillaries originating from individual terminal arterioles. This phenomenon is called the network Fahraeus effect.

Hematocrit in cerebral capillaries and veins under control and ischemic conditions

Red blood cell concentration and hematocrit were assessed in the blood flowing in the capillaries of rabbit cerebral cortex (in unstained histologic sections prepared after in situ fixation of the tissue) and in the blood samples taken from the respective veins using direct, quantitative techniques. The values appeared to be significantly higher in veins than in capillaries under control conditions. With the development of cerebral ischemia, when the blood flow in the cortex was reduced to almost half of the control level, red cell concentration and hematocrit in the blood were found to decrease markedly both in the capillaries and veins of the brain, while in the femoral veins of the same animals the values remained essentially unchanged.

Exposure of platelet binding sites in von Willebrand factor by adsorption onto polystyrene latex particles

Von Willebrand factor molecules are flexible linear polymers composed of repeating protomeric polypeptide subunits. In the process of primary hemostasis, von Willebrand factor promotes platelet adhesion and platelet plug formation at the site of vascular injury. This biologic activity is apparently related to the multimeric size of von Willebrand factor. We simulated von Willebrand factor binding to the subendothelial surface by adsorbing purified human von Willebrand factor onto polystyrene latex particles of two different diameters, i.e., 0.312 micron and 2.02 micron. The rate and extent of 125I-labeled von Willebrand factor binding to polystyrene was similar with both size classes of latex particles. The von Willebrand factor-coated latex beads of 2.02 micron diameter, in contrast to the smaller size, induced rapid agglutination of formalin-fixed human platelets in the absence of any other aggregating agent. Von Willebrand factor was also adsorbed from human plasma onto latex particles coated with anti-von Willebrand factor antibodies. Again, only the large beads, carrying the von Willebrand factor-antibody complex, induced agglutination of fixed platelets. Shear stress promoted the rate of von Willebrand factor adsorption to latex particles. Our results suggest that adsorption to surface exposes binding sites in human von Willebrand factor for platelets.

Velocity profiles of blood platelets and red blood cells flowing in arterioles of the rabbit mesentery

Velocity profiles were determined in rabbit mesenteric arterioles (diameter 17-32 micron). A good spatial resolution was obtained by using the blood platelets as small and natural markers of flow, providing for the first time in vivo detailed, quantitative information about the shape of the velocity profiles in microvessels. In some experiments red blood cell velocity profiles were recorded as well. Easy detection of the cells of interest could be achieved by labelling them selectively with a fluorescent dye and visualizing them by intravital fluorescence video microscopy, using flashed illumination. Pairs of flashes were given with a short, preset time interval between both flashes, yielding in one TV picture two images of the same cell displaced over a certain distance for the given time interval. Velocity and mean radial position of cells, flowing within an optical section around the median plane of the vessel, were determined. The shape of the velocity profiles of platelets and red blood cells was similar. The profiles were flattened as compared to a parabola, both in systole and diastole. Vessel diameter did not change measurably during the cardiac cycle. As an index of the degree of blunting of the profiles, the ratio of the maximal and mean velocity of the profile was used, which is 2 for a parabola and 1 for complete plug flow. The index ranged from 1.39 to 1.54 (median 1.50), and increased with vessel diameter. Calculations showed that the blunting of the profiles cannot be explained by an influence of the finite depth of the optical section.

Estimation of red cell flow microvessels: consequences of the Baker-Wayland spatial averaging model

The dual sensor cross-correlation method of H. Wayland and P.C. Johnson [1967), J. Appl. Physiol. 22, 333-337) has become a standard technique for determining the velocity of red blood cells (RBCs) in glass tubes and blood vessels. M. Baker and H. Wayland [1974), Microvasc. Res. 7, 131-143) found that under a variety of conditions the ratio of dual sensor velocity at the centerline of a glass tube to the blood velocity averaged over the lumen was close to 1.6. They provided an explanation of this factor based on spatial averaging of RBC velocity vertically through the tube as well as laterally across the face of the sensor. Their spatial averaging model could also account for the apparent blunting of RBC velocity profiles determined with the dual sensor technique. We used Baker and Wayland's spatial averaging model to calculate how the above velocity ratio depends on sensor size. A nonlinear relation between the velocity ratio and sensor size was found such that the velocity ratio varied from 1.6 to 1.33 as the ratio of sensor width to vessel or tube diameter was varied from 0 to 1. These results also hold for vessels or tubes of elliptic cross section. Some investigators have found that the velocity of red cells near the walls of blood vessels can be a substantial fraction of centerline velocity which suggests that RBC velocity distributions can be blunter than a Poiseuille distribution. We repeated the above calculation for blunted parabolic profiles and we found that the velocity ratio ranged from 1 for plug flow to 1.6 for Poiseuille flow. These calculations show that reliable estimates of RBC flow from dual sensor centerline velocity measurements require one to take into account the relative size of the sensor and blood vessel diameter as well as the bluntness of the RBC velocity distribution.

Studies on regional cerebral haematocrit and blood flow in patients with cerebral tumours using positron emission tomography

Regional cerebral haematocrit has been measured in seven patients with brain tumours, and in one normal subject, using positron emission tomography (PET). Red cell and plasma volumes of distribution were assessed using 11CO and [methyl-11C]albumin, respectively. Haematocrit values were compared with values of regional cerebral blood flow (rCBF) measured using steady-state inhalation of C15O2. Only two of the seven cerebral tumours studied showed any increase in uptake of [methyl-11C]albumin over 45 min. Values of r, the regional ratio of cerebral small-to-large vessel haematocrit, varied from 0.52 to 0.84 for the seven tumours studied. No correlation between r and tumour blood flow was observed. The normal subject yielded an r value of 0.69 for the mean whole brain small-to-large vessel haematocrit ratio. No significant difference between gray and white matter r values was found. The contralateral hemispheres of the seven tumour patients studied yielded an overall mean r value of 0.71 +/- 0.05. We conclude that it is reasonable to assume an r value of 0.7 in tomographic calculations of regional cerebral blood volume (rCBV) from red cell or plasma volumes of distribution in normal brain. Such an assumption for tumours, however, may lead to errors of 35% in estimated rCBV.