Document Detail


Improvement of endothelium-dependent coronary vasodilation after a single LDL apheresis in patients with hypercholesterolemia.
MedLine Citation:
PMID:  15095396     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to determine whether a single LDL apheresis would improve impaired endothelium-dependent dilation of the coronary artery in patients with hypercholesterolemia. Hypercholesterolemia is associated with impaired endothelial function, and human studies using cholesterol-lowering drugs indicate that endothelial function in the coronary arteries improves with reduction of serum LDL cholesterol over 6 to 12 months. The internal diameter of the left coronary artery and the coronary blood flow were measured by intracoronary Doppler-wire measurement and quantitative angiography before and immediately after a single LDL apheresis in a population of 15 patients with familial hypercholesterolemia. Endothelium-dependent vasodilation was assessed by intracoronary infusion of acetylcholine (1, 10, and 50 microg/min), and endothelium-independent vasodilation was assessed by intracoronary bolus infusion of isosorbide dinitrate (2.5 mg) or papaverine (10 mg). A single 3-hour LDL apheresis reduced serum LDL cholesterol by an average of 86.6 +/- 1.7%. After the LDL apheresis, the changes in the coronary artery diameter and coronary blood flow in response to an infusion of 50 microg/min of acetylcholine increased significantly compared to the pre-apheresis values (from -19.7 +/- 4.8 to -2.9 +/- 3.0% [P < 0.01] and from 80.7 +/- 27.6 to 155.3 +/- 23.5% [P < 0.01], respectively). The LDL apheresis did not significantly change the response of either parameter to infusion with isosorbide dinitrate or papaverine. The endothelial function of the epicardial coronary artery and the coronary microvasculature improved in hypercholesterolemic patients after only a single LDL apheresis, a procedure that markedly reduces the serum level of LDL cholesterol.
Authors:
Keiichi Igarashi; Masahiro Tsuji; Masaharu Nishimura; Masashi Horimoto
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical apheresis     Volume:  19     ISSN:  0733-2459     ISO Abbreviation:  J Clin Apher     Publication Date:  2004  
Date Detail:
Created Date:  2004-04-19     Completed Date:  2004-12-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8216305     Medline TA:  J Clin Apher     Country:  United States    
Other Details:
Languages:  eng     Pagination:  11-6     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Wiley-Liss, Inc.
Affiliation:
Division of Cardiology, Hokkaido Hospital for Social Health Insurance, Sapporo, Japan. igarashi@kd6.so-net.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Acetylcholine / pharmacology
Adult
Blood Component Removal*
Cholesterol, LDL* / blood
Coronary Circulation
Coronary Disease / etiology,  therapy*
Coronary Vessels / physiopathology
Endothelium, Vascular / physiopathology
Family Health
Female
Humans
Hypercholesterolemia / therapy*
Lipids / blood
Male
Middle Aged
Treatment Outcome
Vasodilation / drug effects
Chemical
Reg. No./Substance:
0/Cholesterol, LDL; 0/Lipids; 51-84-3/Acetylcholine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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