Single LDL Apheresis Improves Endothelium-Dependent Vasodilatation in Hypercholesterolemic Humans

Author:

Tamai Osamu1,Matsuoka Hidehiro1,Itabe Hiroyuki1,Wada Yoshifumi1,Kohno Keisuke1,Imaizumi Tsutomu1

Affiliation:

1. the Department of Internal Medicine III (O.T., H.M., Y.W., K.K., T.I.), Kurume University School of Medicine, Fukuoka, Japan, and the Department of Microbiology and Molecular Pathology, Faculty of Pharmaceutical Sciences, Teikyo University, Kanagawa, Japan (H.I.).

Abstract

Background Although long-term lipid-lowering therapy improves endothelium-dependent vasodilatation in humans, it remains unknown whether the short-term removal of LDL per se ameliorates endothelial dysfunction. Methods and Results To examine the effects of a single session of LDL apheresis on endothelial function in patients with hypercholesterolemia, we measured forearm blood flow (FBF) by strain-gauge plethysmography before and after single LDL apheresis while infusing acetylcholine (ACh; 4 to 24 μg/min) and sodium nitroprusside (SNP; 0.2 to 1.2 μg/min). The single session of LDL apheresis reduced total LDL (from 142.2±15.0 to 32.6±5.0 mg/mL, P <.0005) and oxidized LDL (from 111.6±22.8 to 30.0±5.4 ng/mL, P <.005). Although ACh and SNP increased FBF dose-dependently before and after LDL apheresis, the endothelium-dependent vasodilatation responses to ACh were significantly augmented ( P <.01) after the single session of LDL apheresis without changes in the endothelium-independent vasodilatation responses to SNP. The plasma levels of total and oxidized LDL correlated with the degree of ACh-induced vasodilatation. Furthermore, the local production of nitrate/nitrite, metabolites of NO, during ACh infusion was significantly ( P <.05) augmented by LDL apheresis, and there was a significant correlation between the degree of ACh-induced vasodilatation and the production in nitrate/nitrite ( r =.99, P <.0005). Conclusions We demonstrated that even a single session of LDL apheresis with the reduction of total LDL and oxidized LDL improved endothelial function. Our results suggest that total LDL and/or oxidized LDL may directly impair endothelial function in the human forearm vessel.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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