title: Elevated blood viscosity is associated with cerebral small vessel disease in patients with acute ischemic stroke.
abstract: BACKGROUND
  Increased level of blood viscosity, which is one of the major factors that determine blood rheology, has been reported as a risk factor or predictor for cerebrovascular events. We investigated how blood viscosity is associated with acute stroke and chronic radiological manifestations of cerebral small vessel disease, and how blood viscosity changes after stroke.
  
  
  METHODS
  We prospectively enrolled consecutive patients with acute ischemic stroke. Whole blood viscosities at a low or high shear rate were measured using a scanning capillary tube viscometer, and were referred to as diastolic blood viscosity (DBV) and systolic blood viscosity (SBV), respectively. Correlations between blood viscosity and acute stroke etiology or chronic radiological manifestations of cerebral small vessel disease were investigated. The temporal profiles of blood viscosity at the onset of stroke and follow-up at 1 and 5 weeks were investigated.
  
  
  RESULTS
  Of the 127 patients admitted with acute ischemic stroke, 63 patients were included in the final analyses. DBV at the onset of stroke was significantly higher in small artery occlusion (SAO) stroke than in other stroke subtypes (p = 0.037). DBV showed a significant positive correlation with the number of chronic lacunes (r = 0.274, p = 0.030). The temporal profiles of DBV in SAO stroke showed a transient decrease due to the hydration therapy after 1 week and recurrent elevation at 5 week follow-up (p = 0.009).
  
  
  CONCLUSIONS
  Our study suggests that elevated DBV may play a role in the development of acute and chronic manifestations of cerebral small vessel disease. The recurring elevation of DBV in SAO stroke indicates that sufficient hydration and additional therapeutic interventions targeting blood viscosity may be needed in patients with SAO stroke.
authors.affiliation: Department of Neurology, Research Institute of Medical Science, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Neurology, Research Institute of Medical Science, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
authors.forename: Jeong Hee
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Neurology, Research Institute of Medical Science, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
authors.forename: Joon Hwa
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
authors.forename: Yeo-Min
authors.initials: YM
authors.lastname: Yun
authors.affiliation: Department of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Dong-Hee
authors.initials: DH
authors.lastname: Choi
authors.affiliation: Department of Neurology, Research Institute of Medical Science, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea. hykimmd@gmail.com.
authors.forename: Hahn Young
authors.initials: HY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001809:Blood Viscosity; D059345:Cerebral Small Vessel Diseases / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000097:blood*
keywords: Blood viscosity; Ischemic stroke; Lacunes; Small artery occlusion; Small vessel disease