Hemorheology and vascular reactivity in patients with diabetes mellitus type 2.

The study aimed to investigate the hemorheological parameters in patients with diabetes mellitus type 2 and to estimate their relationship with the cerebral and cutaneous blood flow and their responses to postural changes. The basic hemorheological constituents: hematocrit (Ht), fibrinogen (Fib), whole blood (WBV) and plasma viscosity (PV) were examined in 20 patients with diabetes mellitus type 2 and in 10 healthy age and sex matched controls. Blood flow velocity in the middle cerebral artery (MCA) was measured by transcranial Doppler monitoring at rest and during 5-min head-up tilt. Also laser Doppler-recorded tiptoe skin blood flow was investigated and venoarteriolar reflex perfusion responses to postural impact was monitored. Significant increase of Fib and WBV at shear rates of 0.0237 s(-1) to 128.5 s(-1) in the patients in comparison to controls was found. The postural challenge caused decrease of the cerebral blood flow velocity and increase of the resistance index (RI) in the diabetic patients. The initial mean skin perfusion values of the tiptoes and the venoarteriolar constriction response indices were significantly higher in the diabetes group. In the patients with diabetes mellitus type 2 the increased blood viscosity values were associated with impaired cerebrovascular and peripheral vascular responces.

Hemorheology and heart rate variability in patients with diabetes mellitus type 2.

Our study aimed to investigate the relationship between hemorheological parameters and heart rate variability (HRV) in patients with diabetes mellitus type 2. Hemorheological variables, including hematocrit (Ht), fibrinogen (Fib), whole blood (WBV) and plasma viscosity (PV) at shear rates of 0.0237 s(-1) to 128.5 s(-1) were examined in 20 patients with diabetes mellitus type 2 and in 10 control subjects. They all underwent non-invasive short-term monitoring of heart rate at rest and after passive head-up tilt. Measurement of the R-R intervals and calculation of the time domain parameters and the power spectral data were performed by our softwear, using fast Fourier transformation. Significant increase of Fib and WBV in the patients in comparison to controls was found within the range of shear rates 0.0237 s(-1) to 128.5 s(-1). In the diabetic patients parallel decrease of the total power (TP), the low frequency spectral power (LF) and of the mean RR and mild increase of the low frequency-high frequency ratio (LF/HF) at rest were established. This tendency was kept after the passive tilt. In patients with diabetes mellitus type 2 the increased blood viscosity was associated with reduced HRV.

Common carotid artery hemodynamic factors in patients with cerebral infarctions.

The aim of the study was to investigate the changes of the common carotid local hemodynamic factors like wall shear stress and tensile forces in 16 patients with chronic unilateral cerebral infarctions (CUCI), 58 patients with risk factors (RF) for cerebrovascular disease (CVD) and 25 healthy control subjects. The blood flow velocities (BFV), the internal diameters (D) and the vessel wall intima-media thickness (IMT) in the common carotid arteries (CCA) were recorded with color duplex sonography. Systolic (SBP) and diastolic (DBP) blood pressure were measured and mean blood pressure (MBP) was calculated by the formula of Wiggers. Whole blood viscosity (WBV) at the shear rate of 94.5 s-1 was measured on the day of the Doppler ultrasound examination with a rotational viscometer Contraves Low Shear 30. Wall shear stress (WSS), the circumferential wall tension (T) and the tensile stress tau were calculated. The main RF in the patients' groups were hypertension and hyperlipidemia. The SBP, WBV and IMT were significantly increased in the patients with UCI and RF for CVD in comparison to controls. Lower systolic WSS and tau and higher T were established in the patients with UCI. The IMT correlated with WSS and tau. The study confirms the complex influence of the changes in WBV and blood pressure for the development of carotid atherosclerosis.

Hemorheological parameters in correlation with the risk factors for carotid atherosclerosis.

The study aimed to follow the relationship between some hemorheological variables and the main risk factors (RF) for carotid atherosclerosis (CA). Carotid atherosclerosis was evaluated by color duplex sonography of the carotid arteries in 18 patients with RF for CA, 31 patients with transient ischemic attacks (TIAs), 21 patients with chronic unilateral cerebral infarctions (UCI) and 11 healthy subjects without RF for CA. The examined hemorheological variables were whole blood and plasma viscosity, hematocrit and fibrinogen. They were correlated with intima-media thickness (IMT) of the common carotid and the internal carotid arteries and with other main RF for CA: hypertension, diabetes mellitus, coronary heart disease, and hyperlipidemia. The hemorheological investigation showed an increase in blood and plasma viscosity at different shear rates and it was more expressed in the group with UCI. The neurosonographic investigation revealed an increase in the IMT and carotid artery stenoses in the patients' groups with CVD. These were also more frequent in the patients with UCI. Different correlations were established between the hemorheological parameters, the IMT of the carotid arteries and other RF for CA. In the group with UCI, the hematocrit and the whole blood viscosity correlated significantly with the IMT, arterial blood pressure and cholesterol values. These data confirm the influence of the hemorheological parameters on carotid blood vessel walls and on blood flow in patients with CVD.