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LDL apheresis improves deranged cardiovagal modulation in hypercholesterolemic patients
Manja Reimann1, Ulrich Julius, Kristin Haink
1Autonomic and Neuroendocrinological Laboratory, Department of Neurology, University Hospital Carl Gustav Carus, Dresden University of Technology, Germany. manjareimann@uniklinikum-dresden.de
Atherosclerosis
|August 17, 2010
Summary
Hypercholesterolemic patients undergoing LDL apheresis show autonomic dysfunction. A single LDL apheresis session improved heart rate modulation, suggesting a beneficial effect on cardiovascular autonomic control.
Area of Science:
- Cardiology
- Autonomic Neuroscience
Background:
- Hypotensive episodes are common adverse effects of LDL apheresis.
- Autonomic cardiovascular control is crucial for maintaining blood pressure homeostasis.
Purpose of the Study:
- To evaluate the impact of LDL apheresis on autonomic cardiovascular control.
- To compare autonomic function in hypercholesterolemic patients before and after LDL apheresis with a control group.
Main Methods:
- Continuous monitoring of blood pressure, ECG, and respiration during autonomic testing in 21 hypercholesterolemic patients and 22 controls.
- Assessment of baroreflex sensitivity and heart rate variability using spectral analysis.
- Cardiovascular autonomic testing included metronomic breathing, Valsalva maneuver, and head-up tilt.
Main Results:
- Hypercholesterolemic patients exhibited reduced baroreflex sensitivity and impaired heart rate variability at rest.
- Autonomic testing revealed inadequate baroreflex activation in patients before apheresis.
- Following LDL apheresis, parasympathetic response improved, and sympathetic outflow decreased, though baroreflex sensitivity remained low.
Conclusions:
- Hypercholesterolemic patients on LDL apheresis display significant autonomic dysfunction.
- A single LDL apheresis session does not cause sympathetic overactivation.
- LDL apheresis can improve impaired cardiovagal heart rate modulation in hypercholesterolemia.
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