The Impact of Erythrocytes Injury on Blood Flow in Bionic Arteriole with Stenosis Segment

Donghai Li,Qingyu Wu,Jia Man,Haosheng Chen,Yu Zhang,Mingkui Zhang,Yuanyuan Chen,Guiling Li

doi:10.3390/pr7060372

Donghai Li, Qingyu Wu + Show 6 more

Open Access

https://doi.org/10.3390/pr7060372

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Abstract

Ventricular assist device (VAD) implantation is an effective treatment for patients with end-stage heart failure. However, patients who undergo long-term application of VADs experience a series of VAD-related adverse effects including pump thrombosis, which is induced by rotate impeller-caused blood cell injury and hemolysis. Blood cell trauma-related flow patterns are the key mechanism for understanding thrombus formation. In this study, we established a new method to evaluate the blood cell damage and investigate the real-time characteristics of blood flow patterns in vitro using rheometer and bionic microfluidic devices. The variation of plasma free hemoglobin (PFH) and lactic dehydrogenase (LDH) in the rheometer test showed that high shear stress was the main factor causing erythrocyte membrane injury, while the long-term exposure of high shear stress further aggravated this trauma. Following this rheometer test, the damaged erythrocytes were collected and injected into a bionic microfluidic device. The captured images of bionic microfluidic device tests showed that with the increase of shear stress suffered by the erythrocyte, the migration rate of damaged erythrocyte in bionic microchannel significantly decreased and, meanwhile, aggregation of erythrocyte was clearly observed. Our results indicate that mechanical shear stress caused by erythrocyte injury leads to thrombus formulation and adhesion in arterioles.

Highlights

The concept of mechanical circulatory support (MCS) was developed rapidly to resolve the shortage of donor hearts for heart transplantation and the sustained increase of heart failure (HF)mobility and mortality
Among these Ventricular assist device (VAD)-related complications, thrombosis is concerning as a multifactorial complication which is related to other adverse events, such as hemolysis, stroke and bleeding, and can induce rapid clinical deterioration [11]
The variation of plasma free hemoglobin (PFH) concentration under different shear stress and exposure time in rheometers showed that the long exposure time in high shear stress environments would induce more damage of erythrocytes

Summary

Introduction

The concept of mechanical circulatory support (MCS) was developed rapidly to resolve the shortage of donor hearts for heart transplantation and the sustained increase of heart failure (HF)mobility and mortality. Various in vitro test methods and devices have been applied to monitor and evaluate blood clotting and platelet function to avoid thrombosis, such as assays for bleeding time, activated clotting time (ACT), activated partial thromboplastin time (APTT), thromboelastography, and platelet aggregometry. All of these parameters are tested under static or irrelevant flow conditions, which fail to incorporate the true flow pattern and status in blood vessels. There is an urgent demand for a new method to investigate the real-time thrombus formation process and evaluate the relationship with the assessment of the blood cell damage in the region of VAD application

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