[Rheology and occlusive arterial disease of the legs]. 1996

C Dupuy-Fons, and J F Brun, and I Quere, and L Bardet, and C Janbon
Service de Médecine Interne B, Hôpital Saint-Eloi, Montpellier.

Peripheral occlusive arterial disease (P.O.A.D.) is one of the situations in which hemorheological abnormalities are usually described. However the clinical relevance of hemorheological measurements in angiologic practice remains to be defined. The aim of the study was to investigate whether hemorheological disturbances are associated with alterations in oxygen diffusion and prognosis of the arterial disease. Three groups of patients were included in this work. First, a study was realized on 160 nondiabetic P.O.A.D patients (suffering from intermittent claudication to critical limb ischemia) in order to evaluate the possible influence of hemorheological disturbances on oxygen diffusion in distal tissue. A control group of 30 subjects matched for age and sex was also studied. A second study was performed on 80 diabetic P.O.A.D. patients (stage III and IV of Leriche and Fontaine classification) to determinate if hemorheological parameters could be considered as prognostic factors in the P.O.A.D. course. Hemorheological parameters were determined on different devices: red blood cell (RBC) aggregation by Myrenne aggregometer, blood and plasma viscosities by MT 90 falling ball viscometer. Transcutaneous oxygen pressure was measured by Radiometer TCM2 oxygen monitor. Several rheological parameters of non diabetic patients suffering from P.O.A.D. were significantly higher than those of control group subjects : blood viscosity (p < 0.05), plasma viscosity (p < 0.001), erythrocyte rigidity index (p < 0.01) and fibrinogen level (p < 0.0001). In the nondiabetic patients TcPO2 was negatively correlated with RBC aggregation, erythrocyte rigidity index and hematocrit /viscosity ratio. The diabetic patients who needed major amputation (above or below knee) presented significantly increased hemorheological parameters (blood viscosity, RBC aggregation, RBC rigidity index, hematocrit/viscosity ratio, fibrinogen level) compared to diabetic who had not been major amputated (no amputation or only toes' amputation). Our finding suggests that hemorheological factors (1) may influence oxygen transfer to distal tissues by maldistribution of blood flow and (2) may have prognostic significance in chronic peripheral occlusive arterial disease.

UI MeSH Term Description Entries
D007866 Leg The inferior part of the lower extremity between the KNEE and the ANKLE. Legs
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D001809 Blood Viscosity The internal resistance of the BLOOD to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as SICKLE CELL ANEMIA and POLYCYTHEMIA. Blood Viscosities,Viscosities, Blood,Viscosity, Blood
D003925 Diabetic Angiopathies VASCULAR DISEASES that are associated with DIABETES MELLITUS. Diabetic Vascular Complications,Diabetic Vascular Diseases,Microangiopathy, Diabetic,Angiopathies, Diabetic,Angiopathy, Diabetic,Diabetic Angiopathy,Diabetic Microangiopathies,Diabetic Microangiopathy,Diabetic Vascular Complication,Diabetic Vascular Disease,Microangiopathies, Diabetic,Vascular Complication, Diabetic,Vascular Complications, Diabetic,Vascular Disease, Diabetic,Vascular Diseases, Diabetic
D004058 Diffusion The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space. Diffusion, especially FACILITATED DIFFUSION, is a major mechanism of BIOLOGICAL TRANSPORT. Diffusions
D005260 Female Females

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