Haemorheological Proælein Chronic Venous Insufæciency

Abstract

Background: In recent years, pathophysiological studies and treatment approaches of chronic venous insufficiency (CVI) have focused on haemorheology. Objective: To analyse erythrocyte aggregation (EA) and blood viscosity (BV) in mild and severe stages of CVI. Methods: In 147 patients (three severity stages), EA was measured with a photometric aggregometer, and BV with a cone-plate viscosimeter. Patients with concomitant pathologies affecting haemorheology were excluded. Results: EA was higher in patients (mean EA 10M: 16.4 vs 14.5 control), increasing progressively with the evolution of CVI ( p<0.001). Greatest differences were found for stage III (mean EA 10M: 17.6) vs stage II (15.7) and stage 0 (14.5) respectively ( p<0.001), but rheological abnormalities exist in early grades (I: 16.7) ( p<0.01). Fibrinogen and age had a strong influence on EA ( p<0.003 and p<0.001 respectively). When a covariance analysis avoided their effect, significant global differences between CVI groups persisted. BV at high shear rate was increased at advanced stages (III: mean 3.3 centipoise (cp); I: 3.1 cp) ( p<0.05). Conclusions: We found progressive impairment of the haemorheological profile with the worsening stages of CVI, related to age, severity stage and fibrinogen. Rheological impairment is likely to play a part in the pathophysiology of CVI, and perhaps may be useful in its management.