Abstract
BackgroundIncreased level of blood viscosity, which is one of the major factors that determine blood rheology, has been reported as a risk factor or predictor for cerebrovascular events. We investigated how blood viscosity is associated with acute stroke and chronic radiological manifestations of cerebral small vessel disease, and how blood viscosity changes after stroke.MethodsWe prospectively enrolled consecutive patients with acute ischemic stroke. Whole blood viscosities at a low or high shear rate were measured using a scanning capillary tube viscometer, and were referred to as diastolic blood viscosity (DBV) and systolic blood viscosity (SBV), respectively. Correlations between blood viscosity and acute stroke etiology or chronic radiological manifestations of cerebral small vessel disease were investigated. The temporal profiles of blood viscosity at the onset of stroke and follow-up at 1 and 5 weeks were investigated.ResultsOf the 127 patients admitted with acute ischemic stroke, 63 patients were included in the final analyses. DBV at the onset of stroke was significantly higher in small artery occlusion (SAO) stroke than in other stroke subtypes (p = 0.037). DBV showed a significant positive correlation with the number of chronic lacunes (r = 0.274, p = 0.030). The temporal profiles of DBV in SAO stroke showed a transient decrease due to the hydration therapy after 1 week and recurrent elevation at 5 week follow-up (p = 0.009).ConclusionsOur study suggests that elevated DBV may play a role in the development of acute and chronic manifestations of cerebral small vessel disease. The recurring elevation of DBV in SAO stroke indicates that sufficient hydration and additional therapeutic interventions targeting blood viscosity may be needed in patients with SAO stroke.
Highlights
Increased level of blood viscosity, which is one of the major factors that determine blood rheology, has been reported as a risk factor or predictor for cerebrovascular events
For the first two questions, we investigated which stroke subtype at the onset of index stroke and which chronic radiological manifestations, including white matter hyperintensities, lacunes, and microbleeds, are correlated with blood viscosity in patients with acute ischemic stroke
Patient enrollment Of the 127 consecutive patients with acute ischemic stroke admitted during the study period from July 2013 to February 2014, samples for blood viscosity measurement were obtained from 70 patients (Fig. 1)
Summary
Increased level of blood viscosity, which is one of the major factors that determine blood rheology, has been reported as a risk factor or predictor for cerebrovascular events. Whole blood viscosity, and plasma viscosity, which are major factors that determine blood rheology, have been reported as risk factors or predictors for various cardio- or cerebrovascular events [1,2,3,4,5,6,7,8,9,10,11]. A comparable microvascular dysfunction in the brain may be chronic cerebral ischemia due to cerebral small vessel disease [17, 18]. Radiological manifestations, such as white matter hyperintensities, lacunes, and microbleeds, are known consequences of impaired microvascular perfusion in the brain and chronic radiological markers for cerebral small vessel disease [19, 20]
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