Abstract

Research Article

The Impact of a Single Apheretic Procedure on Endothelial Function Assessed by Peripheral Arterial Tonometry and Endothelial Progenitor Cells

Gabriele Cioni*, Francesca Cesari, Rossella Marcucci, Anna Maria Gori, Lucia Mannini, Agatina Alessandrello Liotta, Elena Sticchi, Ilaria Romagnuolo, Rosanna Abbate and Giovanna D’Alessandri

Published: 22 February, 2017 | Volume 1 - Issue 1 | Pages: 001-007

Introduction: Endothelial progenitor cells (EPC) are involved in vascular repair and proliferation, contributing to the long-term outcomes of apheretic treatment. Aim of this study was to investigate the relationships between endothelial function, assessed by levels of bone marrow-derived progenitor cells and endothelial response to hyperaemia, and clinical and biohumoral parameters in high vascular risk patients before, immediately after, 24-hours and 72 hours after a single lipid apheresis procedure.

Material and Methods: We evaluated lipid profile, endothelial function and endothelial progenitor cells before (T0), immediately after (T1), 24h after (T2) and 72h after (T3) a lipoprotein apheresis procedure, in 8 consecutive patients [Sex: 62.5% M; Age; 63.29(12), mean, (range) years] with a personal history of acute coronary syndrome, symptomatic peripheral arterial disease and elevated plasma levels of lipoprotein (a) [Lp(a)]. Patients were on regularly weekly or biweekly lipoprotein apheresis, and they were treated with the FDA-approved Heparin-induced Extracorporeal LDL Precipitation (H.E.L.P.) (Plasmat Futura, B.Braun, Melsungen, Germany) technique. PAT values were expressed as the natural logarithm (Ln-RHI, normal values≥0.4) of the reactive hyperaemia index (RHI), which is the parameter automatically calculated by the device.

Results: We found a reduction in the natural logarithm of reactive hyperaemia index (Ln-RHI), assessed immediately after the procedure (0.57±0.21 vs 0.72± 0.29); difference between T2 and T0 was statistically significant (0.43±0.24 vs 0.72±0.29; p=0.006). Reduction in Ln-RHI values was documented in all patients, two subjects showing a Ln-RHI<0.4 at T1, and four at T2. At T3, PAT values were increased significantly (0.91±0.18) in comparison to T1 and T2, showing a median value higher than at T0. Cd34+/Kdr+ and Cd133+/Kdr+ showed a minimum increase in median values at T1, and a higher increase at T2, in comparison to baseline. Differences in Cd34+/133+/Kdr+ values at different times were not statistically significant. A significant reduction in circulating endothelial cells (CEC) count at T2 in comparison to T0 was found (12.00±8.85 vs 23.86±12.39; p=0.024).

Discussion: At 24h and 72h after procedures, we found an improvement in endothelial function, expressed by an increase in PAT values and EPC levels, and by a reduction in CEC.

Read Full Article HTML DOI: 10.29328/journal.hjvsm.1001001 Cite this Article Read Full Article PDF

References

  1. Abbate R, Cioni G, Ricci I, Miranda M, Gori AM. Thrombosis and acute coronary syndrome. Thromb Res. 2012; 129: 235-240. Ref.: https://goo.gl/NRJX4t
  2. Klingel R, Heibges A, Fassbender C. Lipoprotein apheresis results in plaque stabilization and prevention of cardiovascular events: comments on the prospective Pro(a)LiFe study. Clin Res Cardiol Suppl. 2015; 10: 46-50. Ref.: https://goo.gl/0nA3Qx
  3. Koziolek MJ, Hennig U, Bramlage C, Grupp C, Zapf A, et al. Retrospective analysis of long-term LDL-apheresis in a single centre. Ther Apher Dial. 2010; 14: 143-152. Ref.: https://goo.gl/t2USVF
  4. Ramunni A, Petrarulo F, Grasso C, Papagni S, Brescia P. Acute and chronic effects of therapeutic apheresis. Atheroscler Suppl. 2013; 14: 83-87. Ref.: https://goo.gl/9Vys03
  5. Tamai O, Matsuoka H, Itabe H, Wada Y, Kohno K, Imaizumi T. Single LDL apheresis improves endothelium-dependent vasodilatation in hypercholesterolemic humans. Circulation. 1997; 95: 76-82. Ref.: https://goo.gl/fBNtqo
  6. Igarashi K, Tsuji M, Nishimura M, Horimoto M. Improvement of endothelium-dependent coronary vasodilation after a single LDL apheresis in patients with hypercholesterolemia. J Clin Apher. 2004; 19: 11-16. Ref.: https://goo.gl/w726k7
  7. Strauchmann J, Wallbach M, Bramlage C, Puls M, Konstantinides S, et al. Lipoprotein apheresis reduces biomarkers of plaque destabilization and cardiovascular risk. J Clin Apher. 2014; 29: 235-242. Ref.: https://goo.gl/kPtnrK
  8. Patschan D, Patschan S, Henze E, Wessels JT, Koziolek M, et al. LDL lipid apheresis rapidly increases peripheral endothelial progenitor cell competence. J Clin Apher. 2009; 24: 180-185. Ref.: https://goo.gl/3Zrzid
  9. Ramunni A, Brescia P, Dambra P, Capuzzimati L, Ria R, et al. Effect of low-density lipoprotein apheresis on circulating endothelial progenitor cells in familial hypercholesterolemia. Blood Purif. 2010; 29: 383-389. Ref.: https://goo.gl/WybIsJ
  10. Schwartz J, Winters JL, Padmanabhan A, Balogun RA, Delaney M, et al. Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the Writing Committee of the American Society for Apheresis: the sixth special issue. J Clin Apher. 2013; 28: 145-284. Ref.: https://goo.gl/3wZ3dt
  11. Schnall RP, Shlitner A, Sheffy J, Kedar R, Lavie P. Periodic, Profound Peripheral Vasoconstriction – A New Marker of obstructive Sleep Apnea. SLEEP. 1999; 22: 939-946. Ref.: https://goo.gl/MbmEiC

 

  1. Kuvin JT, Patel AR, Sliney KA, Pandian NG, Sheffy J, et al. Assessment of Peripheral Vascular Endothelial Function with Finger Arterial Pulse Wave Amplitude. AHJ. 2003; 146: 168-174. Ref.: https://goo.gl/gykB9P
  2. Kuvin JT, Mammen A, Mooney P, Alsheikh-Ali AA, Karas RH. Assessment of Peripheral Vascular Endothelial Function in the Ambulatory Setting. Vascular Medicine. 2007; 12: 13-16. Ref.: https://goo.gl/wpDZCc
  3. Faizi AK, Kornmo DW, Agewall S. Evaluation of endothelial function using finger plethysmography. Clin Physiol Funct Imaging. 2009; 29: 372-375. Ref.: https://goo.gl/w8tc98
  4. Dhindsa M, Sommerlad SM, DeVan AE, Barnes JN, Sugawara J, et al. Interrelationships among non invasive measures of post ischemic macro- and microvascular reactivity. J Appl Physiol. 2008; 105: 427-432. Ref.: https://goo.gl/hXgbzG
  5. Cioni G, Berni A, Gensini GF, Abbate R, Boddi M. Impaired Femoral Vascular Compliance and Endothelial Dysfunction in 30 Healthy Male Soccer Players: Competitive Sports and Local Detrimental Effects. Sports Health. 2015; 7: 335-340. Ref.: https://goo.gl/2aDio0
  6. Fatini C, Sticchi E, Cesari F, Gori AM, Cioni G, et al. Relationship among endothelial response to hyperemia, bone marrow-derived progenitor cells, and parathyroid hormone in renal transplantation. Transplantation. 2012; 93: 835-841. Ref.: https://goo.gl/purHN0
  7. Cesari F, Nencini P, Nesi M, Caporale R, Giusti B,et al. Bone marrow-derived progenitor cells in the early phase of ischemic stroke: Relation with stroke severity and discharge outcome. J Cereb Blood Flow Metab. 2009; 29: 1983-1990. Ref.: https://goo.gl/nuifUh
  8. Cioni G, Boddi M, Fatini C, Romagnuolo I, Casini A, et al. Peripheral-arterial tonometry for assessing endothelial function in relation to dietary habits. Investig Med. 2013; 61: 867-871. Ref.: https://goo.gl/ivWgt
  9. Lu Q, Eriksson M, Jogestrand T, henriksson P, Freyschuss A. Micro- and macrocirculatory effects of apheresis in patients with familial hyperlipidemia. Ther Apher Dial. 2003; 7: 115-118. Ref.: https://goo.gl/LIhArB
  10. Mellwig KP, Pulawski E, Horstkotte D, van Buuren F. Lipid apheresis: oxidative stress, rheology, and vasodilatation. Clin Res Cardiol Suppl. 2012; 7: 45-49. Ref.: https://goo.gl/ENvLcQ
  11. Mellwig KP, van Buuren F, Schmidt HK, Wielepp P, Burchrt W, et al. Improved coronary vasodilatatory capacity by H.E.L.P. apheresis: comparing initial and chronic treatment. Ther Apher Dial. 2006; 10: 510-517. Ref.: https://goo.gl/azoLZL
  12. Steven S, Münzel T, Daiber A. Exploiting the Pleiotropic Antioxidant Effects of Established Drugs in Cardiovascular Disease. Int J Mol Sci. 2015; 16: 18185-223. Ref.: https://goo.gl/vz6pbm

Figures:

Similar Articles

Recently Viewed

  • Environmental Factors Affecting the Concentration of DNA in Blood and Saliva Stains: A Review
    Divya Khorwal*, GK Mathur, Umema Ahmed and SS Daga Divya Khorwal*, GK Mathur, Umema Ahmed, SS Daga. Environmental Factors Affecting the Concentration of DNA in Blood and Saliva Stains: A Review. J Forensic Sci Res. 2024: doi: 10.29328/journal.jfsr.1001057; 8: 009-015
  • Why Down-managing Backlog Forensic DNA Case Entries Matters
    JH Smith* and JS Horne JH Smith*, JS Horne. Why Down-managing Backlog Forensic DNA Case Entries Matters. J Forensic Sci Res. 2024: doi: 10.29328/journal.jfsr.1001056; 8: 001-008
  • Scintigraphic non-invasive diagnosis of amyloid cardiomyopathy
    Laroussi Mohamed-Salem*, Tomás E Rodríguez-Locarno, Tatiana Moreno-Monsalve, Isabel Castellón-Sánchez, José F Contreras-Gutiérrez and Antonia Claver-Valderas Laroussi Mohamed-Salem*,Tomás E Rodríguez-Locarno,Tatiana Moreno-Monsalve,Isabel Castellón-Sánchez,José F Contreras-Gutiérrez ,Antonia Claver-Valderas. Scintigraphic non-invasive diagnosis of amyloid cardiomyopathy. J Cardiol Cardiovasc Med. 2019: doi: 10.29328/journal.jccm.1001058; 4: 156-158
  • Anomalies of coronary artery origin: About two cases
    Dioum M*, Sarr EM, Manga S, Mingou JS, Diack A, Diop AD, Bindia D, Diagne PA, Sarr AN and Diop IB Dioum M*,Sarr EM,Manga S,Mingou JS,Diack A,Diop AD,Bindia D,Diagne PA,Sarr AN,Diop IB. Anomalies of coronary artery origin: About two cases. J Cardiol Cardiovasc Med. 2019: doi: 10.29328/journal.jccm.1001051; 4: 117-119
  • Late discover of a traumatic cardiac injury: Case report
    Benlafqih C, Bouhdadi H*, Bakkali A, Rhissassi J, Sayah R and Laaroussi M Benlafqih C,Bouhdadi H*,Bakkali A,Rhissassi J,Sayah R,Laaroussi M. Late discover of a traumatic cardiac injury: Case report. J Cardiol Cardiovasc Med. 2019: doi: 10.29328/journal.jccm.1001048; 4: 100-102

Read More

Most Viewed

Read More

Help ?