Related Experiment Video
Updated: Mar 12, 2026
Optical Coherence Tomography Based Biomechanical Fluid-Structure Interaction Analysis of Coronary Atherosclerosis Progression
Published on: January 15, 2022
The Association between Whole Blood Viscosity and Coronary Collateral Circulation in Patients with Chronic Total
Mehmet Serkan Cetin1, Elif Hande Ozcan Cetin1, Kevser Gülcihan Balcı1
1Department of Cardiology, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey.
Insights
Whole blood viscosity (WBV) is an underappreciated predictor of poor coronary collateral circulation (CCC). Higher WBV is linked to impaired CCC development, impacting myocardial blood supply in patients with chronic total occlusions.
Area of Science:
- Cardiology
- Vascular Biology
- Hemodynamics
Background:
- Coronary collateral circulation (CCC) acts as an intrinsic bypass, supplying blood to ischemic heart muscle.
- Factors influencing CCC are complex, with whole blood viscosity (WBV) being an understudied element.
- WBV, calculable from hematocrit and plasma protein, relates to cardiovascular disease risk.
Purpose of the Study:
- To investigate the association between WBV and CCC in patients with coronary chronic total occlusions.
- To determine if WBV is an independent predictor of poor collateralization.
Main Methods:
- Study included 371 patients with at least one chronic total coronary artery occlusion.
- Patients were categorized into good CCC (Rentrop grade 2-3, n=197) and poor CCC (Rentrop grade 0-1, n=174) groups.
- WBV was calculated for low-shear rate (LSR) and high-shear rate (HSR).
Main Results:
- Patients with poor CCC exhibited significantly higher WBV at both LSR and HSR compared to the good CCC group.
- A significant negative correlation was observed between CCC grade and WBV for both LSR and HSR.
- Multivariate analysis confirmed WBV at both shear rates as independent risk factors for poor CCC.
Conclusions:
- Whole blood viscosity is an overlooked predictor of inadequate coronary collateralization.
- Elevated WBV may impair microvascular perfusion and angiogenesis, hindering CCC development.
- WBV assessment could offer insights into collateral function in coronary artery disease.
Background And Objectives:
Coronary collateral circulation (CCC) has been attributed as inborn bypass mechanisms supporting ischemic myocardium. Various factors have been postulated in CCC. Whole blood viscosity (WBV) has been an underappreciated entity despite close relationships between multiple cardiovascular diseases. WBV can be calculated with a validated equation from hematocrit and total plasma protein levels for a low and high shear rate. On the grounds, we aimed to evaluate the association between WBV and CCC in patients with chronic total occlusion.
Subjects And Methods:
A total of 371 patients diagnosed as having at least one major, chronic total occluded coronary artery were included. 197 patients with good CCC (Rentrop 2 and 3) composed the patient group. The poor collateral group consisted of 174 patients (Rentrop grade 0 and 1).
Results:
Patients with poor CCC had higher WBV values for a low-shear rate (LSR) (69.5±8.7 vs. 60.1±9.8, p<0.001) and high-shear rate (HSR) (17.0±2.0 vs. 16.4±1.8, p<0.001) than the good collateral group. Correlation analysis demonstrated a significant negative correlation between the grade of CCC and WBV for LSR (β=0.597, p<0.001) and HSR (β=0.494, p<0.001). WBV for LSR (β=0.476, p<0.001) and HSR (β=0.407, p<0.001) had a significant correlation with the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score. A multivariate analysis showed that the WBV for both shear rates were independent risk factors of poor CCC (WBV at LSR, OR: 1.362 CI 95%: 1.095-1.741 p<0.001 and WBV at HSR, 1.251 CI 95%: 1.180-1.347 p<0.001).
Conclusion:
WBV has been demonstrated as the overlooked predictor of poor coronary collateralization. WBV seemed to be associated with microvascular perfusion and angiogenesis process impairing CCC development.
More Related Videos
09:36A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
Published on: August 12, 2025
08:42Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Related Concept Videos
01:26Coronary Artery Disease II: Pathophysiology
01:20Vascular Resistance
The primary determinants of vascular resistance are vessel diameter, blood viscosity, and vessel length. Among these, vessel diameter plays the most significant role due to the fourth power relationship described by...
01:30Acute Coronary Syndrome III: Diagnostic Studies