Relationship between blood viscosity and infarct size in patients with ST-segment elevation myocardial infarction
Emanuele Cecchi1, Agatina Alessandriello Liotta, Anna Maria Gori
1Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
Insights
High blood viscosity is linked to larger heart attack size in STEMI patients post-PCI. This finding suggests viscosity may worsen myocardial perfusion and offers potential for new therapeutic strategies.
Area of Science:
- Cardiology
- Hemodynamics
- Biomedical Engineering
Background:
- Previous research linked hemorheological alterations to acute myocardial infarction.
- Hematological components play a role in microvascular flow dynamics.
Purpose of the Study:
- To assess the association between blood viscosity and infarct size in ST-segment elevation myocardial infarction (STEMI) patients.
- To correlate blood viscosity with myocardial damage markers like peak creatine kinase (CK) and cardiac Troponin I (cTnI) post-primary percutaneous coronary intervention (PCI).
Main Methods:
- 197 STEMI patients undergoing PCI were studied.
- Whole blood viscosity (at low and high shear rates) and plasma viscosity were measured.
- Erythrocyte deformability was assessed.
Main Results:
- Significant correlations were found between infarct size markers (CK, cTnI) and hemorheological variables.
- Leukocytes and whole blood viscosity (at 0.512 s(-1) and 94.5 s(-1)) were independently associated with infarct size after adjusting for confounders.
Conclusions:
- Blood viscosity is independently associated with infarct size in STEMI patients post-PCI.
- Increased blood viscosity may exacerbate myocardial damage by impairing perfusion in low-flow states.
- Measuring whole blood viscosity could identify patients who might benefit from novel therapeutic interventions.
Background:
Previous studies explored the association between hemorheological alterations and acute myocardial infarction, pointing out the role of hematological components on microvascular flow. The aim of this study was to evaluate the association between blood viscosity and infarct size, estimated by creatine kinase (CK) peak activity and cardiac Troponin I (cTnI) peak concentration in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (PCI).
Methods:
The study population included 197 patients with diagnosis of STEMI undergoing PCI. Hemorheological studies were performed by assessing whole blood viscosity (measured at shear rates of 0.512 s(-1) and 94.5 s(-1)) and plasma viscosity using the Rotational Viscosimeter LS 30 and erythrocyte deformability index by Myrenne filtrometer.
Results:
Significant correlations between CK peak activity, cTnI peak concentration, left ventricular ejection fraction and hemorheological variables were observed. At linear regression analysis (adjusted for age, gender, traditional cardiovascular risk factors, renal dysfunction, timeliness of reperfusion, pre-PCI TIMI flow, infarct location, multivessel disease and previous coronary artery disease) leukocytes and whole blood viscosity at 0.512 s(-1) and 94.5 s(-1) were independently and positively associated with infarct size.
Conclusions:
These results demonstrate a significant and independent association between hemorheology and infarct size in STEMI patients after PCI suggesting that blood viscosity, in a condition of low flow, might worsen myocardial perfusion leading to an increased infarct size. The measurement of whole blood viscosity in STEMI patients could help to identify those who may benefit from new therapeutic strategies.
