title: Regional cerebral blood flow in familial hypercholesterolemia.
abstract: OBJECTIVE
  Although epidemiologic investigations are trying to clarify the role of plasma lipid concentrations (primarily cholesterol and its subfractions) as risk factors for both ischemic and hemorrhagic stroke, little information is available regarding the effect of sustained hypercholesterolemia on cerebral perfusion.
  
  
  METHODS
  Regional cerebral blood flow (CBF) was measured by the 133Xe inhalation method in 25 heterozygous patients (four untreated) affected with familial hypercholesterolemia. In 15 patients regional CBF was repeated 20 minutes after intravenous administration of acetazolamide (10 mg/kg body wt) to evaluate cerebrovascular reactivity. Correlations among cerebral perfusion data, present or pretreatment plasma lipid concentrations, and certain other clinical features were assessed by ANOVA.
  
  
  RESULTS
  Both basal regional CBF and cerebrovascular reactivity were normal in the vast majority of patients compared with age- and sex-matched normal control subjects. CBF was significantly dependent on pretreatment low-density lipoprotein cholesterol (LDL-C) concentration (P = .005) and the presence of symptomatic ischemic heart disease (P = .015). CBF was only slightly dependent on age (P = .05) and was not dependent on either lipoprotein(a) or present LDL-C concentration. CBF did not differ between treated and untreated patients, and the perfusional increase induced by acetazolamide was not related to any other variable.
  
  
  CONCLUSIONS
  Cerebral perfusion and cerebrovascular reactivity were maintained within the normal range despite long-lasting, severe hypercholesterolemia, even if a somewhat lower CBF was found in those patients with the highest LDL-C pretreatment levels. These results are in accord with the epidemiologic data that implicate hypercholesterolemia as a minor risk factor, if a risk factor at all, for intracranial atherosclerosis and ischemic stroke.
authors.affiliation: Department of Motor Science (Neurophysiopathology), University of Genova, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rodriguez
authors.forename: S
authors.initials: S
authors.lastname: Bertolini
authors.forename: F
authors.initials: F
authors.lastname: Nobili
authors.forename: A
authors.initials: A
authors.lastname: Arrigo
authors.forename: P
authors.initials: P
authors.lastname: Masturzo
authors.forename: N
authors.initials: N
authors.lastname: Elicio
authors.forename: M
authors.initials: M
authors.lastname: Gambaro
authors.forename: G
authors.initials: G
authors.lastname: Rosadini
mesh_terms: D000086:Acetazolamide / Q000494:pharmacology; D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000503:physiopathology; D011877:Radionuclide Imaging; D012039:Regional Blood Flow; D014661:Vasoconstriction / Q000187:drug effects
chemical_list: D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D000086:Acetazolamide