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(Hypertension. 2007;49:902.)
© 2007 American Heart Association, Inc.

Original Articles

In Vivo Shear Stress Determines Circulating Levels of Endothelial Microparticles in End-Stage Renal Disease

Chantal M. Boulanger; Nicolas Amabile; Alain P. Guérin; Bruno Pannier; Aurélie S. Leroyer; Ziad Mallat; Clément Nguyen; Alain Tedgui; Gérard M. London

From the INSERM Cardiovascular Research Center (C.M.B., N.A., A.S.L., C.N., Z.M., A.T.), Hôpital Lariboisière, Paris, France; and the Hôpital F.H. Manhès (A.P.G., B.P., G.M.L.), Fleury-Mérogis, France.

Correspondence to Chantal M. Boulanger, INSERM Unit 689, 41 bd de la Chapelle, 75475 Paris Cedex 10, France. E-mail chantal.boulanger{at}larib.inserm.fr

Shear stress is a major determinant of endothelial apoptosis, but its role in the in vivo release of shed membrane microparticles by endothelial cells remains unknown. Thus, we sought to evaluate the possible relationship between circulating endothelial microparticle levels and laminar shear stress in end-stage renal disease patients with high cardiovascular risk, whose levels of endothelial microparticles are elevated. In 34 hemodialyzed patients, we analyzed the relationships between brachial artery and aortic shear stress and circulating microparticles levels. Only endothelial microparticles were inversely correlated with laminar shear stress values (P<0.0001) or its components shear rate and whole blood viscosity, independent of age or arterial blood pressure. Changes in hematocrit resulting from hemodialysis-induced hemoconcentration or erythropoietin anemia improvement induced a significant increase in whole blood viscosity and shear stress and were associated with a significant decrease in endothelial microparticles with a significant and inverse correlation with changes in hematocrit/hemoglobin or laminar shear stress. These results demonstrate that, in end-stage renal disease patients, laminar shear stress is an important determinant of plasma levels of endothelial microparticles. Anemia as an important determinant of whole blood viscosity and shear stress, contributes to endothelial apoptosis, and could play an indirect role in the pathogenesis of accelerated arteriosclerosis in this high-risk population.

Key Words: microparticles • ESRD • endothelium • whole blood viscosity • shear stress • hemodialysis

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