Lipid-apheresis improves microcirculation of the upper limbs

Area of Science:

• Cardiovascular Medicine
• Hematology
• Medical Technology

Background:

• Lipid apheresis (LA) is a medical procedure aimed at removing lipids from the blood.
• While LA is known to affect systemic circulation, its impact on peripheral microcirculation remains under-investigated.
• Understanding LA's effects on microcirculation is crucial for optimizing treatment strategies.

Purpose of the Study:

• To investigate the effects of weekly lipid apheresis (LA) on upper limb peripheral microcirculation.
• To assess changes in blood flow, vasomotor function, and erythrocyte aggregation.
• To evaluate the impact of LA on vasoactive mediators and blood viscosity markers.

Main Methods:

• Capillary microscopy was used to analyze blood flow, capillary perfusion, and erythrocyte aggregation in 22 patients before and after LA.
• Photoplethysmography and laser Doppler anemometry assessed capillary blood flow under various stress conditions.
• Blood levels of vasoactive mediators (epinephrine, norepinephrine, endothelin-1, ANP, ADMA) and proteins (total protein, fibrinogen) were measured.

Main Results:

• Lipid apheresis significantly increased blood flow and the number of perfused capillaries, alongside improved erythrocyte aggregation.
• Laser Doppler anemometry indicated increased flow primarily in superficial capillaries.
• LA significantly reduced levels of epinephrine, atrial natriuretic peptide (ANP), asymmetrical dimethyl-arginine (ADMA), and fibrinogen.

Conclusions:

• Weekly lipid apheresis improves upper limb microcirculation.
• Observed improvements may stem from reduced vasoconstrictors, enhanced vasomotor function, and decreased blood viscosity or erythrocyte aggregation.
• LA demonstrates potential benefits for peripheral microvascular health.