Standardization for obtaining blood viscosity: A systematic review

Effectiveness and Safety of Fufang Danshen Dripping Pill (Cardiotonic Pill) on Blood Viscosity and Hemorheological Factors for Cardiovascular Event Prevention in Patients with Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis

Background and Objectives: Diabetes can cause various vascular complications. The Compounded Danshen-Dripping-Pill (CDDP) is widely used in China. This study aimed to analyze the effectiveness and safety of CDDP in the blood viscosity (BV) with type 2 diabetes mellitus (T2DM). Materials and Methods: We conducted a systematic search of seven databases from their inception to July 2022 for randomized controlled trials that used CDDP to treat T2DM. To evaluate BV, we measured low shear rate (LSR), high shear rate (HSR), and plasma viscosity (PV). Homocysteine and adiponectin levels were also assessed as factors that could affect BV. Results: We included 18 studies and 1532 patients with T2DM. Meta-analysis revealed that CDDP significantly reduced LSR (mean difference [MD] -2.74, 95% confidence interval [CI] -3.77 to -1.72), HSR (MD -0.86, 95% CI -1.08 to -0.63), and PV (MD -0.37, 95% CI -0.54 to -0.19) compared to controls. CDDP also reduced homocysteine (MD -8.32, 95% CI -9.05 to -7.58), and increased plasma adiponectin (MD 2.72, 95% CI 2.13 to 3.32). Adverse events were reported less frequently in the treatment groups than in controls. Conclusions: CDDP is effective in reducing BV on T2DM. However, due to the poor design and quality of the included studies, high-quality, well-designed studies are required in the future.

Interdependence of Rheological and Biochemical Parameters of Blood in a Group of Patients with Clinically Silent Multifocal Vascular Cerebral Lesions

BACKGROUND

Hemorheology is a field of science which often becomes interesting to researchers studying impairments related to blood flow disturbances. Clinically silent vascular cerebral lesions (CSVCLs) are considered a problem of great importance in neurology.

OBJECTIVE

This work aimed to analyze the interdependencies of the rheological and biochemical parameters of the blood.

METHODS

The group of patients included persons with clinically silent multifocal vascular cerebral lesions diagnosed using neuroimaging. The control group had no symptoms in the central nervous system (CNS). We analyzed hemorheological profiles in 69 patients with CSVCLs diagnosed via magnetic resonance imaging (MR) or 64-row computer tomography measurements. Rheological data were acquired using a rotary-oscillating rheometer, the Contraves LS-40, an instrument dedicated to blood viscosity measurements. For each sample, the hematocrit value was measured using the standard method. Analysis of erythrocytes' aggregability and deformability was performed using the rheological model of Quemada. Biochemical tests of blood were also performed.

RESULTS

The results of rheological and biochemical studies were compared with those obtained in the control group. Special attention was paid to the correlation analysis of rheological and biochemical parameters.

CONCLUSIONS

Such correlations were found, e.g., between the red cells' deformability and the fibrinogen level. The results improve our understanding of blood flow hemodynamics by analyzing the shear-dependent behavior of the aggregation and deformability of red blood cells.

A local-saturation-and-delay MRI method for evaluation of red blood cells aggregation in vivo for tumor-bearing or drug-used rats

Hyperviscosity syndrome (HVS) is a combination of clinical signs and symptoms related to increased blood viscosity. HVS can increase the thrombotic risk by causing a major disturbance to the blood flow, which is usually found in the advanced stages of the tumor. Moreover, some of the drugs used in chemotherapy, such as 5-fluorouracil and erythropoietin, are also capable of causing HVS through their respective pathways. Clinically, the viscosity of a patient's blood sample is measured by a rotary rheometer to estimate the risk of hyperviscosity syndrome. However, the measurement of blood viscosity in vitro is easily affected by storage time, storage environment, and anticoagulants. In addition, the fluid conditions in the rheometer are quite different from those in natural blood vessels, making this method inappropriate for evaluating blood viscosity and its effects in vivo under physiological condition. Herein, we presented a novel magnetic resonance imaging method called local-saturation-and-delay imaging (LSDI). The radial distributions of flow velocity measured by LSDI are consistent with the Ultrasonic (US) method (Spearman correlation coefficient r = 0.990). But the result of LSDI is more stable than US (p < 0.0001). With the LSDI method, we can directly measure the radial distribution of diastolic flow velocity, and further use these data to calculate the whole blood relative viscosity (WBRV) and erythrocyte aggregation trend. It was a strong correlation between the results measured by LSDI and rotary rheometer in the group of rats given erythropoietin. Furthermore, experimental results in glioma rats indicate that LSDI is equivalent to a rheometer as a method for predicting the risk of hyperviscosity syndrome. Therefore, LSDI, as a non-invasive method, can effectively follow the changes in WBRV in rats and avoid the effect of blood sampling during the experiment on the results. In conclusion, LSDI is expected to become a novel method for real-time in vivo recognition of the cancer progression and the influence of drugs on blood viscosity and RBC aggregation.

Exact Association Between Preoperative Blood Viscosity and Postoperative Deep Venous Thrombosis Risk in Knee Osteoarthritis Patients: A 10-Year Retrospective Study

Several lines of evidence have suggested a sustainable relationship between blood viscosity (BV) and deep vein thrombosis (DVT). But there was a lack of data on the association of preoperative BV and postoperative acute DVT. For patients who accepted total knee arthroplasty (TKA) caused by primary knee osteoarthritis (KOA), this study tried to investigate whether preoperative BV relevant parameters might affect DVT risk following TKA. We reviewed a total of 750 consecutive KOA patients treated by unilateral TKA in our hospital from March 2010 to May 2020. All patients undergoing TKA were routinely examined by the color Doppler ultrasound on the third postoperative day and were assigned into DVT and non-DVT groups. Statistical comparisons of BV relevant parameters which mainly including whole BV (low, midst, and high shear rates), plasma viscosity, whole blood reductive viscosity (BRV; low, midst, and high shear rates) were made comprehensively. It could be found that low whole BRV (low shear rate) before TKA was significantly related to postoperative DVT risk in all patients, especially in female patients after stratifying by gender (p < .05). Our results implied that low whole BRV might be a remarkable risk factor of DVT in primary KOA patients after TKA. Timely and effective DVT prophylaxis for these patients is much required.