Intentional Hemodilution, Biblthca Haemat., Νο. 41 ed. by K. MESSIER and H. SCHIrn-SCHbNBEIN, pp. 133-139 (Karger, Basel 1975)
Effect of Stress and Anxiety on Thrombus Formation and Blood Viscosity Factors LEOPOLD DINTENFASS and IMRE ZADOR Haemorheology Unit and Medical Research, KMI, Sydney Hospital, Sydney
Introduction The fact that stress and anxiety might play a very important role in the etiology of cardiovascular disorders and episodes (including a `sudden death' syndrome) is widely believed but not entirely accepted due to lack of objective and instrumental evidence. It is likely that the `missing link' between emotional stress and cardiovascular disorders is blood viscosity or, more correctly, blood viscosity factors. These would include blood viscosity, plasma viscosity, haematocrit, aggregation of red cells, internal viscosity and deformability of red cells, aggregation of platelets, propensity for formation of thrombi and microemboli (as measured by variablefrequency thromboviscometer [VFTV] methods, and including apparent viscosity of artificial thrombi, their rates of formation and degradation) [DINTENFASS, 1971]. It does appear that an elevation of blood viscosity factors in chronic anxiety [and according to other authors, i.e. STILL, 1960, in acute anxiety] might provide the necessary mechanism, both physiological and objective, to provide evidence that anxiety is paralleled by interference with tissue perfusion. Methods
Downloaded by: Université de Paris 193.51.85.197 - 1/25/2020 7:00:14 AM
52 patients suffering from `endogenous' depressive and schizoid anxiety were studied. One-half of them was female. They ranged in age from 22 to 58 years. Clinical diagnosis and psychological score index were used to differentiate between depressive and schizoid anxiety. This index is based on Lassa [1970], and includes
134
DJNTENFASS/ZADOR
grading for mood, psychomotor activity, performance and anxiety level, the total possible scores being from 4 to 16. Blood viscosity factors studied included blood viscosity (measured by means of the rotational rhombospheroid viscometer), plasma viscosity (determined by means of the Coulter Automatic Capillary Viscometer), apparent viscosity of artificial thrombi (formed and evaluated in the VFTV, at mean shear rates of 26.8 and 80 sec) and aggregation of red cells (estimated from the erythrocyte sedimentation rates defined in Westergren tubes on EDTA blood, corrected for plasma viscosity and adjusted to haematocrit of 300/o). All these tests were reviewed by DINTENFAS5 [1971], but the more detailed methods were described [DINTENFASS, 1969, 1974; DsiTairAss and Sτawnι~r, 1968; DΙΝΤΕΝFΑss and MF-TON, 1973]. Blood samples were obtained by clean venipuncture, using disposable plastic syringes and needles. One millilitre of blood was used immediately in the VFTV for formation and determination of artificial red/white thrombus, 1 ml was placed in ice for second determination, and an other part of the blood was anti-coagulated with sequestrene (EDTA) for viscosity and sedimentation tests. Fibrinogen was determined by the RATN0FF and Mnizia [1951] method.
Results Results are contained in tables I and II. Α comparison of patients' data and data of normals (non-smokers only) indicates that the following factors are elevated in patients: plasma viscosity (p
Effect of Stress and Anxiety on Thrombus Formation and Blood Viscosity Factors LEOPOLD DINTENFASS and IMRE ZADOR Haemorheology Unit and Medical Research, KMI, Sydney Hospital, Sydney
Introduction The fact that stress and anxiety might play a very important role in the etiology of cardiovascular disorders and episodes (including a `sudden death' syndrome) is widely believed but not entirely accepted due to lack of objective and instrumental evidence. It is likely that the `missing link' between emotional stress and cardiovascular disorders is blood viscosity or, more correctly, blood viscosity factors. These would include blood viscosity, plasma viscosity, haematocrit, aggregation of red cells, internal viscosity and deformability of red cells, aggregation of platelets, propensity for formation of thrombi and microemboli (as measured by variablefrequency thromboviscometer [VFTV] methods, and including apparent viscosity of artificial thrombi, their rates of formation and degradation) [DINTENFASS, 1971]. It does appear that an elevation of blood viscosity factors in chronic anxiety [and according to other authors, i.e. STILL, 1960, in acute anxiety] might provide the necessary mechanism, both physiological and objective, to provide evidence that anxiety is paralleled by interference with tissue perfusion. Methods
Downloaded by: Université de Paris 193.51.85.197 - 1/25/2020 7:00:14 AM
52 patients suffering from `endogenous' depressive and schizoid anxiety were studied. One-half of them was female. They ranged in age from 22 to 58 years. Clinical diagnosis and psychological score index were used to differentiate between depressive and schizoid anxiety. This index is based on Lassa [1970], and includes
134
DJNTENFASS/ZADOR
grading for mood, psychomotor activity, performance and anxiety level, the total possible scores being from 4 to 16. Blood viscosity factors studied included blood viscosity (measured by means of the rotational rhombospheroid viscometer), plasma viscosity (determined by means of the Coulter Automatic Capillary Viscometer), apparent viscosity of artificial thrombi (formed and evaluated in the VFTV, at mean shear rates of 26.8 and 80 sec) and aggregation of red cells (estimated from the erythrocyte sedimentation rates defined in Westergren tubes on EDTA blood, corrected for plasma viscosity and adjusted to haematocrit of 300/o). All these tests were reviewed by DINTENFAS5 [1971], but the more detailed methods were described [DINTENFASS, 1969, 1974; DsiTairAss and Sτawnι~r, 1968; DΙΝΤΕΝFΑss and MF-TON, 1973]. Blood samples were obtained by clean venipuncture, using disposable plastic syringes and needles. One millilitre of blood was used immediately in the VFTV for formation and determination of artificial red/white thrombus, 1 ml was placed in ice for second determination, and an other part of the blood was anti-coagulated with sequestrene (EDTA) for viscosity and sedimentation tests. Fibrinogen was determined by the RATN0FF and Mnizia [1951] method.
Results Results are contained in tables I and II. Α comparison of patients' data and data of normals (non-smokers only) indicates that the following factors are elevated in patients: plasma viscosity (p
