open access

Vol 65, No 7 (2007)
Other
Published online: 2007-07-24
Submitted: 2012-12-28
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Original article
Haemorheological factors and myocardial reperfusion in patients with ST-elevation myocardial infarction undergoing primary coronary intervention

Jarosław Wasilewski, Bolesław Turczyński, Ludmiła Słowińska, Violetta Kowalik, Tadeusz Osadnik, Lech Poloński
Kardiol Pol 2007;65(7):778-785.

open access

Vol 65, No 7 (2007)
Other
Published online: 2007-07-24
Submitted: 2012-12-28

Abstract


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.

Abstract


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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Keywords

haemorheological factors; STEMI; PCI; no-reflow

About this article
Title

Original article
Haemorheological factors and myocardial reperfusion in patients with ST-elevation myocardial infarction undergoing primary coronary intervention

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 7 (2007)

Pages

778-785

Published online

2007-07-24

Bibliographic record

Kardiol Pol 2007;65(7):778-785.

Keywords

haemorheological factors
STEMI
PCI
no-reflow

Authors

Jarosław Wasilewski
Bolesław Turczyński
Ludmiła Słowińska
Violetta Kowalik
Tadeusz Osadnik
Lech Poloński

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