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(Circulation. 1997;95:76-82.)
© 1997 American Heart Association, Inc.


Articles

Single LDL Apheresis Improves Endothelium-Dependent Vasodilatation in Hypercholesterolemic Humans

Osamu Tamai, MD; Hidehiro Matsuoka, MD, PhD; Hiroyuki Itabe, PhD; Yoshifumi Wada, MD; Keisuke Kohno, MD; Tsutomu Imaizumi, MD, PhD

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.).

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.


Key Words: acetylcholine • arteriosclerosis • blood flow • endothelium-derived factors • lipoproteins




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J Am Coll CardiolHome page
J. M. Mostaza, M. V. Gomez, F. Gallardo, M. L. Salazar, R. Martin-Jadraque, L. Plaza-Celemin, I. Gonzalez-Maqueda, and L. Martin-Jadraque
Cholesterol reduction improves myocardial perfusion abnormalities in patients with coronary artery disease and average cholesterol levels
J. Am. Coll. Cardiol., January 1, 2000; 35(1): 76 - 82.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
D. Hahnel, J. Thiery, T. Brosche, and B. Engelmann
Role of Plasmalogens in the Enhanced Resistance of LDL to Copper-Induced Oxidation After LDL Apheresis
Arterioscler Thromb Vasc Biol, October 1, 1999; 19(10): 2431 - 2438.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
T. J. Anderson
Assessment and treatment of endothelial dysfunction in humans
J. Am. Coll. Cardiol., September 1, 1999; 34(3): 631 - 638.
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StrokeHome page
T. K. Pfefferkorn, H.-P. Knuppel, B. R. Jaeger, J. Thiery, and G. F. Hamann
Increased Cerebral CO2 Reactivity After Heparin-Mediated Extracorporal LDL Precipitation (HELP) in Patients With Coronary Heart Disease and Hyperlipidemia
Stroke, September 1, 1999; 30 (9): e1802 - 1806.
[Abstract] [Full Text] [PDF]


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Cardiovasc ResHome page
A. M Dart and J. P.F Chin-Dusting
Lipids and the endothelium
Cardiovasc Res, August 1, 1999; 43(2): 308 - 322.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
H. W. Wilmink, J. D. Banga, M. Hijmering, W. D. Erkelens, E. S. G. Stroes, and T. J. Rabelink
Effect of angiotensin-converting enzyme inhibition and angiotensin II type 1 receptor antagonism on postprandial endothelial function
J. Am. Coll. Cardiol., July 1, 1999; 34(1): 140 - 145.
[Abstract] [Full Text] [PDF]


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CirculationHome page
D. Waters
Cholesterol Lowering : Should It Continue to Be the Last Thing We Do?
Circulation, June 29, 1999; 99(25): 3215 - 3217.
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CirculationHome page
J. Dupuis, J.-C. Tardif, P. Cernacek, and P. Theroux
Cholesterol Reduction Rapidly Improves Endothelial Function After Acute Coronary Syndromes : The RECIFE (Reduction of Cholesterol in Ischemia and Function of the Endothelium) Trial
Circulation, June 29, 1999; 99(25): 3227 - 3233.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
T. V. Lewis, A. M. Dart, and J. P. F. Chin-Dusting
Endothelium-dependent relaxation by acetylcholine is impaired in hypertriglyceridemic humans with normal levels of plasma LDL cholesterol
J. Am. Coll. Cardiol., March 1, 1999; 33(3): 805 - 812.
[Abstract] [Full Text] [PDF]


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CirculationHome page
M. Guethlin, A. M. Kasel, K. Coppenrath, S. Ziegler, W. Delius, and M. Schwaiger
Delayed Response of Myocardial Flow Reserve to Lipid-Lowering Therapy With Fluvastatin
Circulation, February 2, 1999; 99(4): 475 - 481.
[Abstract] [Full Text] [PDF]


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HypertensionHome page
Y. Higashi, S. Sasaki, N. Sasaki, K. Nakagawa, T. Ueda, A. Yoshimizu, S. Kurisu, H. Matsuura, G. Kajiyama, and T. Oshima
Daily Aerobic Exercise Improves Reactive Hyperemia in Patients With Essential Hypertension
Hypertension, January 1, 1999; 33(1): 591 - 597.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
U. Laufs and J. K. Liao
Post-transcriptional Regulation of Endothelial Nitric Oxide Synthase mRNA Stability by Rho GTPase
J. Biol. Chem., September 11, 1998; 273(37): 24266 - 24271.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
T. Neunteufl, K. Kostner, R. Katzenschlager, M. Zehetgruber, G. Maurer, and F. Weidinger
Additional benefit of vitamin E supplementation to simvastatin therapy on vasoreactivity of the brachial artery of hypercholesterolemic men
J. Am. Coll. Cardiol., September 1, 1998; 32(3): 711 - 716.
[Abstract] [Full Text] [PDF]


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ANGIOLOGYHome page
R. W. Kalmansohn, D. L. Schiff, and R. B. Kalmansohn
Present Status of HMG Reductase Inhibitors in Treatment of Dyslipidemia
Angiology, September 1, 1998; 49(9): 801 - 805.
[Abstract] [PDF]


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CirculationHome page
R. A. Vogel and M. C. Corretti
Estrogens, Progestins, and Heart Disease : Can Endothelial Function Divine the Benefit?
Circulation, April 7, 1998; 97(13): 1223 - 1226.
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CirculationHome page
U. Laufs, V. La Fata, J. Plutzky, and J. K. Liao
Upregulation of Endothelial Nitric Oxide Synthase by HMG CoA Reductase Inhibitors
Circulation, March 31, 1998; 97(12): 1129 - 1135.
[Abstract] [Full Text] [PDF]


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ANGIOLOGYHome page
S. Mii, A. Mori, H. Sakata, M. Nakayama, and H. Tsuruta
LDL Apheresis for Arteriosclerosis Obliterans with Occluded Bypass Graft: Change in Prostacyclin and Effect on Ischemic Symptoms
Angiology, March 1, 1998; 49(3): 175 - 180.
[Abstract] [PDF]


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J. Pharmacol. Exp. Ther.Home page
L. Zhao and R. L. Tackett
Oxidized Low-Density Lipoprotein Inhibits Acetylcholine-Induced Vasorelaxation and Increases 5-HT-Induced Vasoconstriction in Isolated Human Saphenous Vein
J. Pharmacol. Exp. Ther., February 1, 1998; 284(2): 637 - 643.
[Abstract] [Full Text]


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Cardiovasc ResHome page
E. Stroes, T. de Bruin, H. de Valk, W. Erkelens, J.-D. Banga, H. van Rijn, H. Koomans, and T. Rabelink
NO activity in familial combined hyperlipidemia: potential role of cholesterol remnants
Cardiovasc Res, December 1, 1997; 36(3): 445 - 452.
[Abstract] [Full Text] [PDF]


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StrokeHome page
N. Delanty and C. J. Vaughan
Vascular Effects of Statins in Stroke
Stroke, November 1, 1997; 28(11): 2315 - 2320.
[Abstract] [Full Text]


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CirculationHome page
A. P. Selwyn, S. Kinlay, P. Libby, and P. Ganz
Atherogenic Lipids, Vascular Dysfunction, and Clinical Signs of Ischemic Heart Disease
Circulation, January 7, 1997; 95(1): 5 - 7.
[Full Text]