Single Low-Density Lipoprotein Apheresis Does Not Improve Vascular Endothelial Function in Chronically Treated...

Area of Science:

• Cardiovascular Medicine
• Metabolic Disorders
• Vascular Biology

Background:

• Hypercholesterolemia poses significant cardiovascular risk.
• Vascular endothelial function (VEF) is crucial for cardiovascular health.
• LDL apheresis is a treatment for severe hypercholesterolemia.

Purpose of the Study:

• To evaluate the immediate effects of a single LDL apheresis session on VEF.
• To assess changes in oxidative stress and nitric oxide (NO) metabolism markers post-apheresis.
• To investigate these effects in patients receiving chronic hypercholesterolemia treatment.

Main Methods:

• Measured brachial artery flow-mediated dilation (FMD) as an indicator of VEF.
• Assessed plasma lipids, vitamin E (α- and γ-tocopherol), malondialdehyde (MDA), nitro-γ-tocopherol (NGT), arginine (ARG), and asymmetric dimethylarginine (ADMA).
• Measurements were taken before and at multiple time points after LDL apheresis in 5 hypercholesterolemic patients.

Main Results:

• LDL apheresis significantly reduced total and LDL cholesterol by 61% and 70%, respectively.
• No significant changes were observed in VEF (FMD), oxidative stress (MDA), or NO regulators (ARG, ADMA).
• Plasma levels of vitamin E and NGT decreased significantly post-apheresis, with some reduction persisting for up to 3 days.

Conclusions:

• Acute reduction of LDL cholesterol via apheresis does not acutely improve VEF in treated hypercholesterolemic patients.
• The procedure does not appear to alter oxidative stress or nitric oxide homeostasis.
• Significant reductions in vitamin E and NGT suggest their removal during apheresis.