Relationship Between Whole Blood Viscosity and Lower Extremity Peripheral Artery Disease Severity

Year 2021, Volume: 5 Issue: 1, 66 - 74, 23.04.2021

Mustafa Yenerçağ Uğur Arslan Metin Çoksevim Seçkin Dereli Mustafa Doğduş Güney Erdoğan

https://doi.org/10.30565/medalanya.828026

Abstract

Aim: Increased blood viscosity (BV) has good correlaton with lower extremity peripheral artery disease (LEAD). However, the relationship between BV and peripheral arterial disease (PAD) severity has not been studied adequately so far. The aim of the present study was to assess the relationship between whole blood viscosity (WBV) and LEAD severity.

Methods: The study included 240 consecutive patients with suspected PAD who had lower extremity peripheral angiography between March 2016 and March 2020. A Transatlantic İntersociety Consensus II (TASC II) A-B lesion was defined as simple LEAD, and a TASC II C-D lesion was defined as prevalent and complex LEAD. Symptom severity of all patients were categorized from 0 to 6 according to Rutherford classification. WBV was assessed using a validated calculation formula derived from hematocrit and total plasma protein levels, both at low (LSR) and high (HSR) shear rate.

Results: TASC II C-D group presented significantly higher WBV values both at LSR (40.2 ± 9.5 vs. 46.5 ± 13.2; p < 0.001) and HSR (15.9 ± 0.5 vs. 16.5 ± 0,7; p < 0.001). In ROC analysis, a cut-off value of 16.1 WBV at HSR had 73.4% sensitivity and 68.0% specificity for predicting TASC II C-D (AUC: 76.2%, p < 0.001) and a cut-off value of 42.9 WBV at LSR had 73.4% sensitivity and 66.6% specificity for predicting TASC II C-D (AUC: 74.2%, p < 0.001). In multivariate analysis, both high WBV at LSR (OR: 2.121, 95% CI: 1.079 – 3.164, p < 0.001) and high WBV at HSR (OR: 2.737, 95% CI: 1.671 – 4.483, p < 0.001) were independent predictors for TASC II C-D. There was a significant positive correlation between WBV at LSR and Rutherford symptom category (0-6) (r = 0.412, p <0.001) and WBV at HSR and Rutherford symptom category (0-6) (r = 0.402, p <0.001).

Conclusion: Our data suggests that; increased WBV values may be associated with TASC II C-D lesions, which indicated more prevalent and complex LEAD. Also WBV values positively correlated with Rutherford symptom severity.

Keywords

Blood viscosity, peripheral arter disease,, lower extremity,

Tam Kan Akışkanlığı ile Alt Ekstremite Periferik Arter Hastalığı Şiddeti Arasındaki İlişki

Abstract

Amaç: Artmış kan viskozitesinin (BV) alt ekstremite periferik arter hastalığı (LEAD) ile iyi korelasyonu vardır. Ancak, BV ve peripherik arter hastalığı (PAD) şiddeti arasındaki ilişki şu ana kadar yeterince çalışılmamıştır. Bu çalışmanın amacı, tam kan viskozitesi (WBV) ve LEAD şiddeti arasındaki ilişkiyi değerlendirmektir.

Yöntem: Çalışmaya Mart 2016 ile Mart 2020 tarihleri arasında alt ekstremite periferik anjiyografisi yapılan ve PAD şüphesi olan 240 ardışık hasta dahil edildi. Transatlantic Intersociety Consensus II (TASC II) A-B lezyonu basit LEAD olarak, TASC II C-D lezyonu yaygın ve karmaşık LEAD olarak tanımlandı. Tüm hastaların semptom şiddeti Rutherford sınıflandırmasına göre 0 ile 6 arasında kategorize edildi. WBV, hem düşük (LSR) hem de yüksek (HSR) kayma hızında hematokrit ve toplam plazma protein seviyelerinden türetilen doğrulanmış bir hesaplama formülü kullanılarak değerlendirildi.

Bulgular: TASC II C-D grubu hem LSR'de (40.2 ± 9.5'e karşı 46.5 ± 13.2; p <0.001) hem de HSR'de (15.9 ± 0.5'e karşı 16.5 ± 0,7; p <0.001) anlamlı olarak daha yüksek WBV değerleri gösterdi. ROC analizinde, HSR'de 16,1 WBV'lik bir kesme değeri TASC II C-D'yi tahmin etmek için% 73,4 duyarlılık ve% 68,0 özgüllük (AUC: % 76,2, p <0,001) ve LSR'de 42,9 WBV kesme değeri 73,4'tür. TASC II C-D'yi tahmin etmek için% duyarlılık ve% 66.6 özgüllük (AUC: % 74.2, p <0.001). Çok değişkenli analizde, hem LSR'de yüksek WBV (OR: 2.121, % 95 CI: 1.079 - 3.164, p <0.001) hem de HSR'de yüksek WBV (OR: 2.737, % 95 CI: 1.671 - 4.483, p <0.001) TASC II C-D için bağımsız prediktördü. LSR'deki WBV ile HSR’deki WBV değerleri Rutherford semptom kategorisi ile (0-6) anlamlı pozitif korelasyon gösterdi (r = 0.412, p <0.001; r = 0.402, p <0.001, sırasıyla).

Sonuç: Verilerimiz gösteriyor ki; artmış WBV değerleri, daha yaygın ve karmaşık LEAD'i gösteren TASC II C-D lezyonları ile ilişkili olabilir. Ayrıca WBV değerleri, Rutherford semptom şiddeti ile pozitif korelasyon gösterdi.

Keywords

Kan viskozitesi, periferik arter hastalığı, alt ekstremite,

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