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High-Density Lipoprotein-Specific Phospholipid Efflux Assay
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A single lipid apheresis does not modulate pulse wave reflection in hypercholesterolemic patients.
J Passauer1, K Herbrig, S Fischer
1Division of Nephrology, Department of Internal Medicine III, University Hospital Carl Gustav Carus at the Technische Universität, Dresden, Germany. passauer@rcs.urz.tu-dresden.de
Atherosclerosis. Supplements
|February 5, 2010
Summary
Lipid apheresis (LA) significantly reduces LDL-cholesterol but does not alter arterial stiffness or pulse wave reflection in patients with severe hypercholesterolemia. Further research is needed to understand long-term cardiovascular impacts.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Vascular Biology
Background:
- Lipid apheresis (LA) improves life expectancy in patients with severe hypercholesterolemia and cardiovascular events.
- LA treatment demonstrably enhances endothelial and micro-vascular function.
- The impact of LA on arterial stiffness and pulse wave reflection remains uninvestigated.
Purpose of the Study:
- To investigate the effects of a single lipid apheresis session on arterial stiffness and pulse wave reflection.
- To determine if LA-induced microvascular improvements influence central hemodynamic parameters.
Main Methods:
- Twenty patients undergoing regular LA (immunoadsorption, lipid filtration, or direct lipid adsorption) were studied.
- Applanation tonometry (SphygmoCor) measured central systolic pressure (CSP), central pulse pressure (CPP), augmentation index (AIX), and pulse wave velocity (PWV).
- Hemodynamic parameters were assessed before and after a single LA treatment session.
Main Results:
- LDL-cholesterol levels decreased significantly post-LA (3.5+/-0.9 to 0.9+/-0.3 mmol/L).
- Peripheral blood pressure and heart rate remained unchanged.
- CSP, CPP, AIX, and PWV showed no significant alterations after LA, irrespective of the apheresis method used.
Conclusions:
- A single session of lipid apheresis does not measurably affect pulse wave reflection or arterial stiffness parameters.
- Observed improvements in microvascular function following LA are not directly linked to changes in central hemodynamics.
- Long-term studies are necessary to fully elucidate the cardiovascular implications of lipid apheresis.
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