title: Gel point and fractal microstructure of incipient blood clots are significant new markers of hemostasis for healthy and anticoagulated blood.
abstract: Here we report the first application of a fractal analysis of the viscoelastic properties of incipient blood clots. We sought to ascertain whether the incipient clot's fractal dimension, D(f,) could be used as a functional biomarker of hemostasis. The incipient clot is formed at the gel point (GP) of coagulating blood, the GP demarcating a functional change from viscoelastic liquid to a viscoelastic solid. Incipient clots formed in whole healthy blood show a clearly defined value of D(f) within a narrow range that represents an index of clotting in health, where D(f) = 1.74 (± 0.07). A significant relationship is found between the incipient clot formation time, T(GP), and the activated partial thromboplastin time, whereas the association of D(f) with the microstructural characteristics of the incipient clot is supported by its significant correlation with fibrinogen. Our study reveals that unfractionated heparin not only prolongs the onset of clot formation but has a significant effect on its fractal microstructure. A progressive increase in unfractionated heparin concentration results in a linear decrease in D(f) and a corresponding prolongation in T(GP). The results represent a new, quantitative measure of clot quality derived from measurements on whole blood samples.
authors.affiliation: School of Medicine, Swansea University, Swansea, United Kingdom. P.A.Evans@swansea.ac.uk
authors.forename: Phillip A
authors.initials: PA
authors.lastname: Evans
authors.forename: Karl
authors.initials: K
authors.lastname: Hawkins
authors.forename: Roger H K
authors.initials: RH
authors.lastname: Morris
authors.forename: Naresh
authors.initials: N
authors.lastname: Thirumalai
authors.forename: Roger
authors.initials: R
authors.lastname: Munro
authors.forename: Lisa
authors.initials: L
authors.lastname: Wakeman
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Lawrence
authors.forename: P Rhodri
authors.initials: PR
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology; D001777:Blood Coagulation / Q000187:drug effects; D001778:Blood Coagulation Disorders / Q000175:diagnosis*; D001809:Blood Viscosity / Q000187:drug effects; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D018056:Hemorheology / Q000187:drug effects; D006487:Hemostasis / Q000187:drug effects; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013916:Thrombelastography / Q000379:methods; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D005340:Fibrinogen; D006493:Heparin