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Journal Article Review Epublish 82 citations

PubMed: 35874542 DOI: 10.3389/fphys.2022.906768

Physical Properties of Blood and their Relationship to Clinical Conditions.

Front Physiol 13:906768

Authors: Tamas Alexy, Jon Detterich, Philippe Connes, Kalman Toth, Elie Nader, Peter Kenyeres, Jose Arriola-Montenegro, Pinar Ulker, Michael J Simmonds

Affiliations

  • Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, United States.
  • Department of Pediatrics, Division of Cardiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
  • Laboratory LIBM EA7424, Vascular Biology and Red Blood Cell Team, University of Lyon, Lyon, France.
  • First Department of Medicine, Division of Cardiology, Medical School, University of Pecs, Pecs, Hungary.
  • Department of Physiology, Akdeniz University, Faculty of Medicine, Antalya, Turkey.
  • Biorheology Research Laboratory, Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.

Abstract

It has been long known that blood health heavily influences optimal physiological function. Abnormalities affecting the physical properties of blood have been implicated in the pathogenesis of various disorders, although the exact mechanistic links between hemorheology and clinical disease manifestations remain poorly understood. Often overlooked in current medical practice, perhaps due to the promises offered in the molecular and genetic era, the physical properties of blood which remain a valuable and definitive indicator of circulatory health and disease. Bridging this gap, the current manuscript provides an introduction to hemorheology. It reviews the properties that dictate bulk and microcirculatory flow by systematically dissecting the biomechanics that determine the non-Newtonian behavior of blood. Specifically, the impact of hematocrit, the mechanical properties and tendency of red blood cells to aggregate, and various plasma factors on blood viscosity will be examined. Subsequently, the manner in which the physical properties of blood influence hemodynamics in health and disease is discussed. Special attention is given to disorders such as sickle cell disease, emphasizing the clinical impact of severely abnormal blood rheology. This review expands into concepts that are highly topical; the relation between mechanical stress and intracellular homeostasis is examined through a contemporary cell-signaling lens. Indeed, accumulating evidence demonstrates that nitric oxide is not only transported by erythrocytes, but is locally produced by mechanically-sensitive enzymes, which appears to have intracellular and potentially extracellular effects. Finally, given the importance of shear forces in the developing field of mechanical circulatory support, we review the role of blood rheology in temporary and durable mechanical circulatory support devices, an increasingly utilized method of life support. This review thus provides a comprehensive overview for interested trainees, scientists, and clinicians.

MeSH

Cells, Blood Viscosity, Erythrocytes, Blood, Rheology, Hemorheology, Medical Devices, Mechanical Circulatory Support

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