Blood yield stress in systemic sclerosis.
Blood is a weak percolating physical gel at low shear rates, in which clusters of aggregates can be reversibly disaggregated or formed again. This phenomenon is of potential importance in the microvascular pathophysiology of ischemic and vasospastic disorders such as systemic sclerosis. The aim of this work was to determine blood yield stress using low-shear-rate rheometry with a homemade roughened Couette device in 10 patients with systemic sclerosis compared with 10 healthy controls. Biochemical plasmatic parameters were assessed independently. Results showed a significantly increased stress (+56%, P < 0.05 at 60% hematocrit) for scleroderma patients. The best biochemical predictor for yield stress was the ratio of albumin to globulins; 69% of its variance was explained by plasmatic factors (albumin, fibrinogen, and globulins) in scleroderma patients and 23.4% in healthy controls. Additional microscopic observations showed different microstructures. These results support the hypothesis of an abnormal red blood cell organization process in scleroderma patients that could be partly responsible for the severity of ischemic complications of the disease.