A single lipid apheresis does not modulate pulse wave reflection in hypercholesterolemic patients

Abstract: Background: Lipid apheresis (LA) is instituted to increase life expectancy in patients with previous cardiovascular events and severe and otherwise untreatable hypercholesterolemia. Studies have demonstrated that even a single LA markedly improves endothelial and micro-vascular function in patients. It is unknown whether these changes also impact pulse wave reflection and established parameters of arterial stiffness. Methods: In 20 patients on regular LA (8 treated by immunoadsorption, 7 by lipid filtration, 5 by direct adsorption of lipids) we measured peripheral blood pressure, heart rate, central systolic pressure (CSP), central pulse pressure (CPP), augmentation index (AIX) and pulse wave velocity by applanation tonometry (SphygmoCor, Atcor Medical) before and after a single treatment. Results: Peripheral blood pressure and heart rate were comparable pre- and post treatment. CSP, CPP, AIX and PWV did not significantly change during LA independent of treatment modality although LDL-cholesterol levels were markedly reduced (in average from 3.5±0.9 to 0.9±0.3 mmol/L). Conclusion: The well-documented effects of a single LA on microvascular function are not associated with measurable changes in pulse wave reflection. Future studies are required in order to evaluate long-term effects of LA in this context. [Copyright &y& Elsevier]