Microvascular and Hemorheological disorders during ischemic heart disease

18T. Urdulashvili, M. Mantskava,
N. Momtselidze, N. Narsia,
G. Mchedlishvili.


Scientific –Practical Journal ISSN 1512-1291.
Cardilogy and Internal Medicine XXIN4 (VIII) 2004, 9-15.


Significance of the hemorheological disorders in development of acute vascular syndromes is presenltky well known, but their role in pathogenesis of chronic ischemic heart disease is not yet sufficiently analyzed. Aim of the present study was investigation of the relationship between the hemorheological, vascular and hemodynamic factors during the ischemic heart disease.

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We investigated 64 patients with ischemic heart disease of functional classes I-IV with and without heart failure. For evaluation of the hemorheological disorders we investigated the most significant symptom, the erythrocyte aggregability, with the Georgian technique” that provided us with direct and quantitative data. In the some patients we investigated the tone of the resistance arteries with an original non-invasive technique. Based on measurement of[/su_animate]

the flow velocity in a radial artery with a Doppler technique under the condition of a control and of a standardized postischemic hyperemia. Two dimensional echocardiograph was performed with a sector scanner (mysono-201. Medison. SK ECG by standart leads and blood pressure was measured in all patients.

We found that the erythrocyte aggregability increased almost twice in investigated patients as compared to the healthy control group. This symptom was found positively correlated with severity of the disease. The most pronounced hemorheological disorders were in the patients with heart failure. As to the arteriolar resistance index. It was increased only in 45 per cent of all the investigated patients and no significant difference between the patients with the heart failure and without it was found. There was a negative relationship between erythrocyte aggregability (EA) and the ejection fraction of the left ventricle and positive correlation between EA and left ventricle hypertrophy (p<0.01)
We concluded that the blood rheological disorders represent themselves a factor that plays the significant role in pathogenesis of the ischemic heart disease. They are predictors of the disease and not only risk factors as it is generally believed. Measurement and correction of these disturbances in early stages should have a high clinical significance.
Pro. Georgian Acad. Csi. Biol. Ser.A 2003, vol29, N5-6, p. 653-657         ISSN-0321-1665


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