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Published on: May 28, 2019
Haemorheological factors and myocardial reperfusion in patients with ST-elevation myocardial infarction undergoing
Jarosław Wasilewski1, Bolesław Turczyński, Ludmiła Słowińska
1III Katedra i Oddział Kliniczny Kardiologii, Slaskie Centrum Chorób Serca, ul Szpitalna 2, 41-800 Zabrze. jaroslaw-wasilewski@wp.pl
Insights
Blood viscosity and red blood cell properties significantly impact myocardial reperfusion after artery opening. Impaired blood flow and red blood cell aggregation are linked to the no-reperfusion phenomenon in heart attack patients.
Area of Science:
- Cardiology
- Haemorheology
- Biomedical Engineering
Background:
- The no-reperfusion phenomenon, where myocardial perfusion doesn't improve despite artery patency, affects many patients.
- While myocardial structural changes are known factors, the role of haemorheological parameters in microvascular resistance remains understudied.
Purpose of the Study:
- To investigate the relationship between blood viscosity, plasma viscosity, red blood cell aggregation, and red blood cell deformability.
- To determine the impact of these haemorheological factors on myocardial reperfusion after opening the infarct-related artery (IRA).
Main Methods:
- Analysis of 23 myocardial infarction patients undergoing primary coronary angioplasty with TIMI grade 3 flow.
- Assessment of blood and plasma viscosity using a Brookfield rotation viscometer.
- Measurement of red blood cell aggregation and deformability using a Laser Optical Rotational Cell Analyzer (LORCA).
Main Results:
- Patients experiencing no-reperfusion exhibited significantly higher blood and plasma viscosity (14% and 10.5% higher, respectively).
- The no-reperfusion group showed significantly lower red blood cell deformability and higher red blood cell aggregation.
- Aggregation halftime was also significantly shorter in the no-reperfusion group.
Conclusions:
- Haemorheological disturbances, including altered blood viscosity and red blood cell properties, are significant contributors to the no-reperfusion phenomenon.
- These findings highlight the importance of haemorheological assessment in managing patients with myocardial infarction.
Introduction:
The no-reperfusion phenomenon occurs in a considerable number of patients despite restoration of the infarct-related artery (IRA) patency. Factors responsible for this phenomenon include myocardial structural changes, whereas haemorheological parameters that significantly contribute to microvascular resistance, have not been studied so far.
Aim:
To determine the possible relationship between blood and plasma viscosity, red blood cell aggregation and their deformability, and myocardial reperfusion following effective mechanical intervention of IRA.
Methods:
The analysis included 23 patients with myocardial infarction treated with primary coronary angioplasty with resultant TIMI (Thrombolysis in Myocardial Infarction) grade 3 flow. Myocardial reperfusion was found effective if myocardial perfusion grade (MPG) was 3. Blood and plasma viscosity were assessed using a Brookfield rotation viscometer. Red blood cell aggregation and deformability were measured with a Laser Optical Rotational Cell Analyzer (LORCA). Patients were divided into two groups with respect to obtained MPG: reperfusion group (14 subjects) and no-reperfusion group (9 patients).
Results:
Corrected whole blood viscosity and plasma viscosity were significantly higher in the no-reperfusion group and exceeded the values obtained in the reperfused patients by 14% (p <0.05) and 10.5% (p <0.01), respectively. Red blood cell deformability index at shear stress ranging from 1.75 Pa to 60.03 Pa was significantly lower in the no-reperfusion group. Red blood cell aggregation index was significantly higher (by 14.3%, p <0.05), whereas aggregation halftime was significantly shorter (by 58%, p <0.05) in the no-reperfusion group.
Conclusions:
Our results indicate that haemorheological disturbances may be an important factor contributing to no-reperfusion after effective mechanical opening of IRA.
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