Int J Angiol 2021; 30(02): 117-121
DOI: 10.1055/s-0040-1720968
Original Article

Relationship between Whole Blood Viscosity and Lesion Severity in Coronary Artery Disease

1   Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
,
Oğuzhan Birdal
1   Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
› Author Affiliations

Abstract

Objective This article investigates the relationship of fractional flow reserve (FFR) with whole blood viscosity (WBV) in patients who were diagnosed with chronic coronary syndrome and significant stenosis in the major coronary arteries and underwent the measurement of FFR.

Material and Method In the FFR measurements performed to evaluate the severity of coronary artery stenosis, 160 patients were included in the study and divided into two groups as follows: 80 with significant stenosis and 80 with nonsignificant stenosis. WBVs at low shear rate (LSR) and high shear rate (HSR) were compared between the patients in the significant and nonsignificant coronary artery stenosis groups.

Results In the group with FFR < 0.80 and significant coronary artery stenosis, WBV was significantly higher compared with the group with nonsignificant coronary artery stenosis in terms of both HSR (19.33 ± 0.84) and LSR (81.19 ± 14.20) (p < 0.001). In the multivariate logistic regression analysis, HSR and LSR were independent predictors of significant coronary artery stenosis (HSR: odds ratio: 1.67, 95% confidence interval: 1.17–2.64; LSR: odds ratio: 2.46, 95% confidence interval: 2.19–2.78). In the receiver operating characteristic (ROC) curve analysis, when the cutoff value of WBV at LSR was taken as 79.23, it had 58.42% sensitivity and 62.13% specificity for the prediction of significant coronary artery stenosis (area under the ROC curve: 0.628, p < 0.001).

Conclusion WBV, an inexpensive biomarker that can be easily calculated prior to coronary angiography, was higher in patients with functionally severe coronary artery stenosis, and thus could be a useful marker in predicting the hemodynamic severity of coronary artery stenosis in patients with chronic coronary syndrome.



Publication History

Article published online:
19 January 2021

© 2021. International College of Angiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Knuuti J, Wijns W, Saraste A. et al. ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 2020; 41: 407-477
  • 2 Dattilo PB, Prasad A, Honeycutt E, Wang TY, Messenger JC. Contemporary patterns of fractional flow reserve and intravascular ultrasound use among patients undergoing percutaneous coronary intervention in the United States: insights from the National Cardiovascular Data Registry. J Am Coll Cardiol 2012; 60 (22) 2337-2339
  • 3 Christou MA, Siontis GC, Katritsis DG, Ioannidis JP. Meta-analysis of fractional flow reserve versus quantitative coronary angiography and noninvasive imaging for evaluation of myocardial ischemia. Am J Cardiol 2007; 99 (04) 450-456
  • 4 Pijls NHJ, De Bruyne B. Pitfalls in coronary pressure measurements. In: Coronary Pressure. Dortrecht: Kluwer Academic Publishers; 1997: 49-79
  • 5 Pijls NH, De Bruyne B, Peels K. et al. Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med 1996; 334 (26) 1703-1708
  • 6 Hutchison KJ, Karpinski E. In vivo demonstration of flow recirculation and turbulence downstream of graded stenoses in canine arteries. J Biomech 1985; 18 (04) 285-296
  • 7 Schmid-Schönbein H. Microrheology of erythrocytes, blood viscosity, and the distribution of blood flow in the microcirculation. Int Rev Physiol 1976; 9: 1-62
  • 8 Mchedlishvili G. Disturbed blood flow structuring as critical factor of hemorheological disorders in microcirculation. Clin Hemorheol Microcirc 1998; 19 (04) 315-325
  • 9 Cowan AQ, Cho DJ, Rosenson RS. Importance of blood rheology in the pathophysiology of atherothrombosis. Cardiovasc Drugs Ther 2012; 26 (04) 339-348
  • 10 de Simone G, Devereux RB, Chien S, Alderman MH, Atlas SA, Laragh JH. Relation of blood viscosity to demographic and physiologic variables and to cardiovascular risk factors in apparently normal adults. Circulation 1990; 81 (01) 107-117
  • 11 Kensey KR, Cho YI, Chang M. Effects of whole blood viscosity on atherogenesis. J Invasive Cardiol 1997; 9 (01) 17-24
  • 12 Lowe GD, Lee AJ, Rumley A, Price JF, Fowkes FG. Blood viscosity and risk of cardiovascular events: the Edinburgh Artery Study. Br J Haematol 1997; 96 (01) 168-173
  • 13 Li B, Li X. A liquid-solid coupling hemodynamic model with microcirculation load. Appl Sci (Basel) 2016; 6 (01) 28
  • 14 Wongpraparut N, Yalamanchili V, Pasnoori V. et al. Thirty-month outcome after fractional flow reserve-guided versus conventional multivessel percutaneous coronary intervention. Am J Cardiol 2005; 96 (07) 877-884