title: Lipid apheresis: oxidative stress, rheology, and vasodilatation.
abstract: In the treatment of homozygous and therapy-resistant hypercholesterolemia, lipid apheresis enables not only low density lipoprotein (LDL) cholesterol to be lowered by approximately 60%, but also oxidative stress factors to be influenced and adhesion molecules reduced. This was investigated in a group of 12 patients using the heparin-induced extracorporeal LDL precipitation (H.E.L.P.) procedure.A significant lowering of LDL cholesterol and fibrinogen leads to an improvement in rheology and endothelial function, detectable and measurable within approximately 20 h by assessing minimum coronary resistance using positron emission tomography (PET) performed in 35 patients. This effect is detectable even after the first lipid apheresis session (H.E.L.P. procedure), documented in 12 patients.Lipid apheresis appears to be the most effective procedure in the treatment of elevated lipoprotein(a) [Lp(a)]. A chosen group of nine patients with selective elevated Lp(a) illustrated both the influence on endothelial dysfunction, in the shape of sharply increased minimum coronary resistance, and the reduction through lipid apheresis, indicating that Lp(a) seems to exert a similar effect on the vascular wall and vascular function as LDL cholesterol.
authors.affiliation: Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany. kpmellwig@hdz-nrw.de
authors.forename: K-P
authors.initials: KP
authors.lastname: Mellwig
authors.forename: E
authors.initials: E
authors.lastname: Pulawski
authors.forename: D
authors.initials: D
authors.lastname: Horstkotte
authors.forename: F
authors.initials: F
authors.lastname: van Buuren
mesh_terms: D000328:Adult; D000368:Aged; D001781:Blood Component Removal / Q000379:methods*; D011232:Chemical Precipitation; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000628:therapy*; D005112:Extracorporeal Circulation / Q000379:methods; D005260:Female; D006493:Heparin / Q000737:chemistry; D006801:Humans; D006937:Hypercholesterolemia / Q000503:physiopathology / Q000628:therapy; D006938:Hyperlipoproteinemia Type II / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D049268:Positron-Emission Tomography; D012212:Rheology; D016896:Treatment Outcome; D014655:Vascular Resistance; D014664:Vasodilation
chemical_list: D008078:Cholesterol, LDL; D006493:Heparin