D. Pieragalli

Allopurinol prevents ischaemia-dependent haemorheological changes

SummaryPre-treatment with allopurinol is able markedly to attenuate the deterioration in blood viscosity (BV) and whole blood filterability (WBF) that occurs after ischaemia during exercise. It also reduces the exercise-induced increase in serum oxidase activity, although this action is slightly less effective in peripheral obliterative arterial disease (POAD) patients.Conversely, allopurinol is completely ineffective in modifying haemorheological parameters in vitro, and it does not affect superoxide anion generation or enzyme release from neutrophils stimulated in vitro with formyl-methionyl-leucyl-phenylalanine (FMLP).It is suggested that allopurinol may attenuate changes in BV and WBF by affecting xanthine-oxidase-dependent free radical formation in tissues.

Effect on rheological and some peripheral haemodynamic parameters of defibrotide in POAD patients

Received 1.12.1986; Accepted 19.1.1987 by Editor T. DiPerri) In ten POAD patients, 800 mg. of Defibrotide (polideoxynucleotide extracted from mammalian lung, with antitrombotic and fibrinolytic activity) were infused i.v. Blood and plasma viscosity, haematocrit, blood filterability and fibrinogen concentration were controlled, in basal conditions and after one hour from the end of infusion. Haemodynamic parameters: rest flow, peak flow, time to peak flow, half time and total time of reactive hyperemia by means of strain gauge pletismography, were controlled at lower limbs before infusion and after 1 h., 2 h., 6 h., from the end of infusion. The present investigation showed an improvement of rheological parameters and a decrease of total time and half time of reactive hyperemia. These data demonstrate a rheological activity of Defibrotide as well as the fibrinolytic one.

Influence of Non-Selective and Selective Beta Adrenoceptor Blockade on Isoxsuprine-Dependent Hemodynamic and Rheologic Changes

The infusion of isoxsuprine was followed by an increase of heart rate and calf blood flow and by a decrease of arterial diastolic pressure and blood viscosity both in normal controls and patients with peripheral obstructive arterial disease. The pre-treatment with a non-selective beta adrenoceptor blocker (propranolol) canceled all the isoxsuprine-dependent changes, while the pre-treatment with a selective beta adrenoceptor blocker (metoprolol) abolished only tachycardia and did not influence the increase of calf blood flow and the decrease of blood viscosity. These findings indicate the different role of vascular beta receptors in the regulation of muscular blood flow and suggest the pharmacologic possibility to unmask the beta2-dependent vaso dilation.

Takayasu's arteritis: case report of a patient with recurrent subclavian steal syndrome

Takayasu’s arteritis is a chronic inflammatory disease of unknown origin in which cell-mediated inflammation involves large arteries progressing from the adventitia to the intima, until the lumen of the vessel is narrowed. Here we report a case of a 48-year-old female patient who was diagnosed with Takayasu’s arteritis 6 years ago. At that time, because of severe involvement of both the right and left carotid arteries, she underwent application of a Hemashield vascular prosthesis, including the ascending aorta, left common carotid artery, and right common carotid artery. Due to the fact that there were also bilateral subclavian artery stenoses, the application of the prosthesis induced bilateral subclavian steal syndrome. This year she developed stenosis of the prosthesis and the bilateral subclavian steal syndrome disappeared until she underwent percutaneous transluminal angioplasty, which restored cerebral flow through the carotid arteries after which the subclavian steal syndrome reappeared.

Takayasu’s Arteritis: The “Macaroni Sign”

A 24-year-old woman presented with sudden paresis of the right hemisoma. Systolic blood pressure in the left arm was 80 mm Hg and in the right arm was 110 mm Hg. The laboratory data showed systemic inflammation (erythrocyte sedimentation rate: 47 mm/h; C-reactive protein, 3.57 mg/dL). Echo-color Doppler …A 24-year-old woman presented with sudden paresis of the right hemisoma. Systolic blood pressure in the left arm was 80 mm Hg and in the right arm was 110 mm Hg. The laboratory data showed systemic inflammation (erythrocyte sedimentation rate: 47 mm/h; C-reactive protein, 3.57 mg/dL). Echo-color Doppler …

CIRCADIAN VARIATION OF PLATELET AGGREGATION AND BLOOD RHEOLOGY

Many vascular pathologies have been reported to follow a diurnal rhythm (AMI, angina, stroke, sudden cardiac death, pulmonary thromboembolism) with a peak in the early morning. Aim of the study was to evaluate the existence of a diurnal rhythm of platelet aggregability and blood rheology. The study was carried out in 12 subjects; blood withdrawings were performed every 3 hour for 24 hours and in each blood sample platelet aggregation (on PRP and on washed platelets) and haemorheological parameters (blood viscosity, blood filterability, haematocrit and fibrinogen) were measured. Moreover systolic and diastolic blood pressure was recorded by dynamiC monitoring. The results show that a circadian rhythm of the above mentioned parameters does exists. Even if our data do not prove a strict correlation between these parameters and the incidence of the vascular pathology, it could be interesting to keep in mind the existence of a temporal parallelism when starting preventive therapy.

Takayasu’s Arteritis

A 24-year-old woman presented with sudden paresis of the right hemisoma. Systolic blood pressure in the left arm was 80 mm Hg and in the right arm was 110 mm Hg. The laboratory data showed systemic inflammation (erythrocyte sedimentation rate: 47 mm/h; C-reactive protein, 3.57 mg/dL). Echo-color Doppler …A 24-year-old woman presented with sudden paresis of the right hemisoma. Systolic blood pressure in the left arm was 80 mm Hg and in the right arm was 110 mm Hg. The laboratory data showed systemic inflammation (erythrocyte sedimentation rate: 47 mm/h; C-reactive protein, 3.57 mg/dL). Echo-color Doppler …

Haemorheological changes after thrombolytic treatment with Streptokinase in acute myocardial infarction

Ischaemic heart disease and its various clinical manifestations, whether acute or chronic, are shown to be characterized by hyperviscosity syndrome, more evident in the acute than in the chronic phase. In the present study the effect of i.v. Streptokinase (SK) treatment in 13 patients affected by AMI was evaluted; the haemorheological parameters (blood and plasma viscosity, blood filterability, fibrinogen and haematocrit) were measured in basal conditions, at the end of the infusion and 24 hours later. The patients showed high blood and plasma viscosity and low blood filterability in basal conditions. A decrease of blood and plasma viscosity with reduction of fibrinogen was observed at the end of the infusion, associated with an improvement in blood filterability. After 24 hours the haemorheological parameters showed a trend towards basal values without reaching them. On the contrary, 13 patients with AMI who could not undertake SK treatment showed an increase of blood and plasma viscosity and a reduction of blood filterability at the 8th hour lasting until the 24th hour. The haemorheological improvement observed in. patients treated with SK may be correlated to the fibrinogenolytic activity of the drug; the results of the present study support the hypothesis that SK may be a useful tool in AMI manegement.

Wirkungen einer einmaligen intravenösen Dosis von Nicergolin auf hämorheologische und hämodynamische Parameter bei peripheren Gefäßerkrankungen

Periphere obliterierende arterielle Erkrankungen (im weiteren Text als POAD—peripheral obliterative disease —abgekurzt) sind pathophysiologisch durch eine Reduktion der nutritiven Durchblutung gekennzeichnet, die durch arteriosklerotische Stenosen oder Verschlusse der grosen oder mittleren Beinarterien hervorgerufen wird.