TY - JOUR
T1 - Correction of erythrocyte shape abnormalities in familial hypercholesterolemia after LDL-apheresis
T2 - Does it influence cerebral hemodynamics?
AU - Iannuzzi, Arcangelo
AU - Bianciardi, Giorgio
AU - Faccenda, Fulvio
AU - Gnasso, Agostino
AU - Scarpato, Nicola
AU - Marino, Lucrezia Di
AU - Iaccarino, Guido
AU - Simoes, Cristobao
AU - Sacchi, Giovanni
AU - Weber, Elisabetta
PY - 1997
Y1 - 1997
N2 - It is well known that red blood cells incubated in low-density lipoprotein (LDL)-rich medium show shape abnormalities that revert to normal after reincubation in normal plasma. Patients with homozygous familial hypercholesterolemia (HFH) have an increased percentage of abnormally-shaped erythrocytes (mostly stomatocytes, knisocytes, and crenated cells) compared to normocholesterolemic controls: 7.73 ± 0.96 versus 3.52 ± 0.52 (mean ± SEM; P = 0.001). To confirm the role of high LDL concentration in inducing red cell shape abnormalities we determined the percentage of abnormally shaped erythrocytes in seven HFH patients 1 day after the procedure of LDL-apheresis with a 40% cholesterol decrease. A reduction in kniscocytes, stomatocytes, and crenated cells was observed in the patients treated by LDL-apheresis (P <0.01). To investigate the possible benefit of a reduction in erythrocyte shape abnormality on cerebral hemodynamics, cerebral flow velocity, as evaluated by transcranial Doppler, was evaluated concommitanlly and found to be remarkably increased after apheresis (P <0.01). No significant change in hematocrit, plasma viscosity, blood viscosity, mean pressure, or cardiac output was detected, 1 day after apheresis. An inverse correlation was demonstrated (r = 0.55; P = 0.04) between changes in the percentage of knisocytes + stomatocytes + crenated cells and percent changes in middle cerebral artery peak systolic velocity. The correction of erythrocyte shape abnormalities after LDL-apheresis might be related to dramatic changes in plasma phospholipid concentration and proportion occurring after this procedure in HFH patients. The reduction of erythrocyte shape abnormalities could contribute, together with other hemorheological factors, to the improvement of cerebral hemodynamics after LDL-apheresis.
AB - It is well known that red blood cells incubated in low-density lipoprotein (LDL)-rich medium show shape abnormalities that revert to normal after reincubation in normal plasma. Patients with homozygous familial hypercholesterolemia (HFH) have an increased percentage of abnormally-shaped erythrocytes (mostly stomatocytes, knisocytes, and crenated cells) compared to normocholesterolemic controls: 7.73 ± 0.96 versus 3.52 ± 0.52 (mean ± SEM; P = 0.001). To confirm the role of high LDL concentration in inducing red cell shape abnormalities we determined the percentage of abnormally shaped erythrocytes in seven HFH patients 1 day after the procedure of LDL-apheresis with a 40% cholesterol decrease. A reduction in kniscocytes, stomatocytes, and crenated cells was observed in the patients treated by LDL-apheresis (P <0.01). To investigate the possible benefit of a reduction in erythrocyte shape abnormality on cerebral hemodynamics, cerebral flow velocity, as evaluated by transcranial Doppler, was evaluated concommitanlly and found to be remarkably increased after apheresis (P <0.01). No significant change in hematocrit, plasma viscosity, blood viscosity, mean pressure, or cardiac output was detected, 1 day after apheresis. An inverse correlation was demonstrated (r = 0.55; P = 0.04) between changes in the percentage of knisocytes + stomatocytes + crenated cells and percent changes in middle cerebral artery peak systolic velocity. The correction of erythrocyte shape abnormalities after LDL-apheresis might be related to dramatic changes in plasma phospholipid concentration and proportion occurring after this procedure in HFH patients. The reduction of erythrocyte shape abnormalities could contribute, together with other hemorheological factors, to the improvement of cerebral hemodynamics after LDL-apheresis.
KW - Blood component removal
KW - Cerebral flow velocity
KW - Cholesterol
KW - Erythrocyte shape
KW - Familial hypercholesterolemia
KW - LDL-apheresis
KW - Transcranial Doppler
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M3 - Article
C2 - 9846809
AN - SCOPUS:13144255676
VL - 12
SP - 234
EP - 240
JO - Heart and Vessels
JF - Heart and Vessels
SN - 0910-8327
IS - 5
ER -