Araştırma Makalesi
Yıl 2025,
Cilt: 15 Sayı: 1, 80 - 87, 30.04.2025
Öz
Kaynakça
- 1. Tomkiewicz EM, Kline JA. Concise Review of the Clinical Approach to the Exclusion and Diagnosis of Pulmonary Embolism in 2020. J Emerg Nurs. 2020;46(4):527–38.
- 2. Konstantinides S V. Diagnosis of pulmonary embolism: progress after many years. The Lancet. 2017;390(10091):210–1.
- 3. Righini M, Le Gal G, Bounameaux H. Venous thromboembolism diagnosis: Unresolved issues. Thromb Haemost. 2015;113(6):1184–92.
- 4. Righini M, Robert-Ebadi H, Le Gal G. Diagnosis of acute pulmonary embolism. Journal of Thrombosis and Haemostasis. 2017;15(7):1251–61.
- 5. Cohen AT, Dobromirski M, Gurwith MMP. Managing pulmonary embolism from presentation to extended treatment. Thromb Res. 2014;133(2):139–48.
- 6. Stoltz JF, Donner M. New trends in clinical hemorheology:an introduction to the concept of the hemorheological profile. Schweiz Med Wochenschr Suppl. 1991;43:41–9.
- 7. Xiong X, Li T, Yu S, Cheng B. Association Between Red Blood Cell Indices and Preoperative Deep Vein Thrombosis in Patients Undergoing Total Joint Arthroplasty: A Retrospective Study. Clinical and Applied Thrombosis/Hemostasis. 2022;28.
- 8. Baskurt OK, Meiselman HJ. Blood Rheology and Hemodynamics. Semin Thromb Hemost. 2003;29(5):435–50.
- 9. Vayá A, Suescun M. Hemorheological parameters as independent predictors of venous thromboembolism. ClinHemorheol Microcirc. 2013 [cited. 2025;53(1-2):131–41.
- 10. Lowe GDO, Rumley A, Whincup PH, Danesh J. Hemostatic and rheological variables and risk of cardiovascular disease. Semin Vasc Med. 2002;2(4):429–39.
- 11. De Simone G, Devereux RB, Chien S, Alderman MH, Atlas SA, Laragh JH. Relation of blood viscosity to demographic and physiologic variables and to cardiovascular risk factors in apparently normal adults. Circulation. 1990;81(1):107–17.
- 12. Van Belle A, Büller HR, Huisman MV, Huisman PM, Kaasjager K, Kamphuisen PW, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA. 2006;295(2):172–9.
- 13. Righini M, Van Es J, Den Exter PL, Roy PM, Verschuren F, Ghuysen A, et al. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: The ADJUST-PE study. JAMA. 2014;311(11):1117–24.
- 14. Van der Hulle T, den Exter PL, Erkens PGM, van Es J, Mos ICM, ten Cate H, et al. Variable D-dimer thresholds for diagnosis of clinically suspected acute pulmonary embolism. Journal of Thrombosis and Haemostasis. 2013;11(11):1986–92.
- 15. Raja AS, Greenberg JO, Qaseem A, Denberg TD, Fitterman N, Schuur JD. Evaluation of patients with suspected acute pulmonary embolism: Best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2015;163(9):701–11.
- 16. van der Hulle T, Cheung WY, Kooij S, Beenen LFM, van Bemmel T, van Es J, et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study) : a prospective, multicentre, cohort study. Lancet. 2017;390(10091):289–97.
- 17. Nwose EU. Cardiovascular risk assessment and support techniques. Whole blood viscosity assessment issues I. Extrapolation chart and reference values. N Am J Med Sci. 2010;2(4):165–9.
- 18. Pop GAM, Duncker DJ, Gardien M, Vranckx P, Versluis S, Hasan D, et al. The clinical significance of whole blood viscosity in (cardio) vascular medicine. Neth Heart J. 2002;10(12):512–6.
- 19. Uzunget SB, Sahin KE. Another possible determinant for ischemic stroke with nonvalvular atrial fibrillation other than conventional oral anticoagulant treatment: The relationship between whole blood viscosity and stroke. J Stroke Cerebrovasc Dis. 2022;31(9).
- 20. Cetin EHO, Cetin MS, Canpolat U, Aydin S, Aras D, Topaloglu S, et al. Prognostic significance of whole blood viscosity estimated by de Simone’s formula in ST-elevation myocardial infarction. Biomark Med. 2016;10(5):495–511.
- 21. Atici AG, Kayhan S, Aydin D, Yilmaz YA. Plasma viscosity levels in pulmonary thromboembolism. Clin Hemorheol Microcirc. 2013;55(3):313–20.
- 22. Carlisi M, Presti R Lo, Mancuso S, Siragusa S, Caimi G. Thrombotic Risk and Calculated Whole Blood Viscosity in a Cohort of Patients With New Diagnosis of Multiple Myeloma. Clin Appl Thromb Hemost. 2024;30.
- 23. Abul Y, Karakurt S, Ozben B, Toprak A, Celikel T. C-reactive protein in acute pulmonary embolism. Journal of Investigative Medicine. 2011;59(1):8–14.
- 24. Afzal A, Noor HA, Gill SA, Brawncr C, Stein PD. Leukocytosis in acute pulmonary embolism. Chest. 1999;115(5):1329–32.
- 25. Köse N, Yıldırım T, Akın F, Yıldırım SE, Altun İ. Prognostic role of NLR, PLR, and LMR in patients with pulmonary embolism. Bosn J Basic Med Sci. 2020;20(2):248–53.
- 26. Salinger-Martinovic S, Dimitrijevic Z, Stanojevic D, Momčilović S, Kostic T, Koracevic G, et al. Renal dysfunction as intrahospital prognostic indicator in acute pulmonary embolism. Int J Cardiol. 2020;302:143–9.
Blood Viscosity and the Other Laboratory Parameters as Diagnostic Determinants of Pulmonary Embolism
Öz
Aim:
Pulmonary embolism (PE) is a significant cardiovascular condition and a leading cause of mortality worldwide. Diagnosing PE remains challenging due to nonspecific symptoms and limited accessible laboratory tests beyond D-dimer. This retrospective study aimed to evaluate the predictive properties of blood parameters, particularly whole blood viscosity (WBV), for early PE diagnosis.
Materials and Methods:
The study included 72 patients with acute PE and 72 age- and sex-matched controls. Data regarding past illnesses, blood tests, and basic echocardiography findings of all patients obtained. WBV was assessed at low shear rate (LSR) and high shear rate (HSR) using established formulas incorporating hematocrit and total plasma protein.
Results:
Significant differences were observed in various laboratory parameters between the groups. WBV at both LSR and HSR was significantly higher in the PE group compared to controls (p < 0.005). ROC analysis demonstrated strong diagnostic capability for WBV, with high specificity and positive predictive value. The optimal cut-off values for WBV at LSR and HSR were ≥4.20 and ≥27.22, respectively. Correlation analyses revealed a significant positive relationship between WBV and pulmonary arterial pressure.
Conclusions:
The findings suggest that WBV, which can be calculated using routine laboratory parameters, holds potential as a diagnostic tool for PE. Integrating WBV assessment could enhance the accuracy and efficiency of PE diagnosis, potentially reducing the need for invasive or radiation-exposing procedures. Further research is necessary to validate these findings in larger populations and establish standardized cut-off values for clinical application.
Anahtar Kelimeler
Blood viscosity Pulmonary embolism Venous thromboembolism Hypercoagulability Shear rate
Kaynakça
- 1. Tomkiewicz EM, Kline JA. Concise Review of the Clinical Approach to the Exclusion and Diagnosis of Pulmonary Embolism in 2020. J Emerg Nurs. 2020;46(4):527–38.
- 2. Konstantinides S V. Diagnosis of pulmonary embolism: progress after many years. The Lancet. 2017;390(10091):210–1.
- 3. Righini M, Le Gal G, Bounameaux H. Venous thromboembolism diagnosis: Unresolved issues. Thromb Haemost. 2015;113(6):1184–92.
- 4. Righini M, Robert-Ebadi H, Le Gal G. Diagnosis of acute pulmonary embolism. Journal of Thrombosis and Haemostasis. 2017;15(7):1251–61.
- 5. Cohen AT, Dobromirski M, Gurwith MMP. Managing pulmonary embolism from presentation to extended treatment. Thromb Res. 2014;133(2):139–48.
- 6. Stoltz JF, Donner M. New trends in clinical hemorheology:an introduction to the concept of the hemorheological profile. Schweiz Med Wochenschr Suppl. 1991;43:41–9.
- 7. Xiong X, Li T, Yu S, Cheng B. Association Between Red Blood Cell Indices and Preoperative Deep Vein Thrombosis in Patients Undergoing Total Joint Arthroplasty: A Retrospective Study. Clinical and Applied Thrombosis/Hemostasis. 2022;28.
- 8. Baskurt OK, Meiselman HJ. Blood Rheology and Hemodynamics. Semin Thromb Hemost. 2003;29(5):435–50.
- 9. Vayá A, Suescun M. Hemorheological parameters as independent predictors of venous thromboembolism. ClinHemorheol Microcirc. 2013 [cited. 2025;53(1-2):131–41.
- 10. Lowe GDO, Rumley A, Whincup PH, Danesh J. Hemostatic and rheological variables and risk of cardiovascular disease. Semin Vasc Med. 2002;2(4):429–39.
- 11. De Simone G, Devereux RB, Chien S, Alderman MH, Atlas SA, Laragh JH. Relation of blood viscosity to demographic and physiologic variables and to cardiovascular risk factors in apparently normal adults. Circulation. 1990;81(1):107–17.
- 12. Van Belle A, Büller HR, Huisman MV, Huisman PM, Kaasjager K, Kamphuisen PW, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA. 2006;295(2):172–9.
- 13. Righini M, Van Es J, Den Exter PL, Roy PM, Verschuren F, Ghuysen A, et al. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: The ADJUST-PE study. JAMA. 2014;311(11):1117–24.
- 14. Van der Hulle T, den Exter PL, Erkens PGM, van Es J, Mos ICM, ten Cate H, et al. Variable D-dimer thresholds for diagnosis of clinically suspected acute pulmonary embolism. Journal of Thrombosis and Haemostasis. 2013;11(11):1986–92.
- 15. Raja AS, Greenberg JO, Qaseem A, Denberg TD, Fitterman N, Schuur JD. Evaluation of patients with suspected acute pulmonary embolism: Best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2015;163(9):701–11.
- 16. van der Hulle T, Cheung WY, Kooij S, Beenen LFM, van Bemmel T, van Es J, et al. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study) : a prospective, multicentre, cohort study. Lancet. 2017;390(10091):289–97.
- 17. Nwose EU. Cardiovascular risk assessment and support techniques. Whole blood viscosity assessment issues I. Extrapolation chart and reference values. N Am J Med Sci. 2010;2(4):165–9.
- 18. Pop GAM, Duncker DJ, Gardien M, Vranckx P, Versluis S, Hasan D, et al. The clinical significance of whole blood viscosity in (cardio) vascular medicine. Neth Heart J. 2002;10(12):512–6.
- 19. Uzunget SB, Sahin KE. Another possible determinant for ischemic stroke with nonvalvular atrial fibrillation other than conventional oral anticoagulant treatment: The relationship between whole blood viscosity and stroke. J Stroke Cerebrovasc Dis. 2022;31(9).
- 20. Cetin EHO, Cetin MS, Canpolat U, Aydin S, Aras D, Topaloglu S, et al. Prognostic significance of whole blood viscosity estimated by de Simone’s formula in ST-elevation myocardial infarction. Biomark Med. 2016;10(5):495–511.
- 21. Atici AG, Kayhan S, Aydin D, Yilmaz YA. Plasma viscosity levels in pulmonary thromboembolism. Clin Hemorheol Microcirc. 2013;55(3):313–20.
- 22. Carlisi M, Presti R Lo, Mancuso S, Siragusa S, Caimi G. Thrombotic Risk and Calculated Whole Blood Viscosity in a Cohort of Patients With New Diagnosis of Multiple Myeloma. Clin Appl Thromb Hemost. 2024;30.
- 23. Abul Y, Karakurt S, Ozben B, Toprak A, Celikel T. C-reactive protein in acute pulmonary embolism. Journal of Investigative Medicine. 2011;59(1):8–14.
- 24. Afzal A, Noor HA, Gill SA, Brawncr C, Stein PD. Leukocytosis in acute pulmonary embolism. Chest. 1999;115(5):1329–32.
- 25. Köse N, Yıldırım T, Akın F, Yıldırım SE, Altun İ. Prognostic role of NLR, PLR, and LMR in patients with pulmonary embolism. Bosn J Basic Med Sci. 2020;20(2):248–53.
- 26. Salinger-Martinovic S, Dimitrijevic Z, Stanojevic D, Momčilović S, Kostic T, Koracevic G, et al. Renal dysfunction as intrahospital prognostic indicator in acute pulmonary embolism. Int J Cardiol. 2020;302:143–9.
Toplam 26 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2025 |
| Gönderilme Tarihi | 9 Ocak 2025 |
| Kabul Tarihi | 18 Şubat 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 15 Sayı: 1 |
