Observational studyJACC. Cardiovascular imaging2019
Lipoprotein Apheresis Acutely Reverses Coronary Microvascular Dysfunction in Patients With Severe Hypercholesterolemia.
Observational study in JACC. Cardiovascular imaging, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02388633 (Acute Microvascular Changes With LDL Apheresis), which is not on this map. Cited by 19 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Acute Microvascular Changes With LDL Apheresis
Who cites it
19 citing papers in PubMed.
- Single nucleotide polymorphisms: Implications in the early diagnosis and targeted intervention of coronary microvascular dysfunction.Genes & diseases · 2025Review
- Advances in the diagnosis and management of post-percutaneous coronary intervention coronary microvascular dysfunction: Insights into pathophysiology and metabolic risk interactions.World journal of cardiology · 2025Review
- The diagnostic value of serum C-reactive protein/albumin and homocysteine/high-density lipoprotein-cholesterol in coronary microvascular angina pectoris.Revista da Associacao Medica Brasileira (1992) · 2025Article
- Beyond the Obstructive Paradigm: Unveiling the Complex Landscape of Nonobstructive Coronary Artery Disease.Journal of clinical medicine · 2024Review
- Emerging Pathway to a Precision Medicine Approach for Angina With Nonobstructive Coronary Arteries in Women.JACC. Advances · 2024Review
- Oxidized phospholipids in cardiovascular disease.Nature reviews. Cardiology · 2024Review
- Article
- Influence of Atherosclerotic Risk Factors on the Effectiveness of Therapeutic Ultrasound Cavitation for Flow Augmentation.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2024Article
- Coronary microcirculatory dysfunction in hypercholesterolemic patients with COVID-19: potential benefit from cholesterol-lowering treatment.Annals of medicine · 2023Article
- Familial Hypercholesterolemia: From Clinical Suspicion to Novel Treatments.Reviews in cardiovascular medicine · 2023Review
- Article
- Lipoprotein Apheresis: Current Recommendations for Treating Familial Hypercholesterolemia and Elevated Lipoprotein(a).Current atherosclerosis reports · 2023Review
- Familial Hypercholesterolemia Patients with COVID-19-Effective Cholesterol-Lowering Therapy is Urgent both during and after Infection.Reviews in cardiovascular medicine · 2022Review
- Contrast Ultrasound Assessment of Skeletal Muscle Recruitable Perfusion after Permanent Left Ventricular Assist Device Implantation: Implications for Functional Recovery.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2022Article
- Vasomotor Dysfunction in Patients with Ischemia and Non-Obstructive Coronary Artery Disease: Current Diagnostic and Therapeutic Strategies.Biomedicines · 2021Review
- Diagnosis and Treatment of Heterozygous Familial Hypercholesterolemia.Journal of the American Heart Association · 2019Review
- Contrast Enhanced Ultrasound Perfusion Imaging in Skeletal Muscle.Journal of cardiovascular imaging · 2019Review
- Microvascular Dysfunction and Clinical Outcomes.Circulation. Cardiovascular imaging · 2018Article
- Why continued lipoprotein apheresis is vital for homozygous familial hypercholesterolemia patients with COVID-19.Journal of clinical lipidologyArticle
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Authors and funding
12 authors.
Funding
Abstract
objectivesThis study evaluated whether lipoprotein apheresis produces immediate changes in resting perfusion in subjects with severe hypercholesterolemia, and whether there is a difference in the response between peripheral and coronary microcirculations.
backgroundLipoprotein apheresis is used in patients with severe hypercholesterolemia to reduce plasma levels of low-density lipoprotein cholesterol.
methodsQuantitative contrast-enhanced ultrasound perfusion imaging of the myocardium at rest and skeletal muscle at rest and during calibrated contractile exercise was performed before and immediately after lipoprotein apheresis in 8 subjects with severe hypercholesterolemia, 7 of whom had a diagnosis of familial hypercholesterolemia. Myocardial perfusion imaging was also performed in 14 normal control subjects. Changes in myocardial work and left ventricular function were assessed by echocardiography. Ex vivo ovine coronary and femoral artery ring tension assays were assessed in the presence of pre- and post-apheresis plasma.
resultsApheresis acutely decreased low-density lipoprotein cholesterol (234.9 ± 103.2 mg/dl vs. 67.1 ± 49.5 mg/dl; p < 0.01) and oxidized phospholipid on apolipoprotein B-100 (60.2 ± 55.2 nmol/l vs. 47.0 ± 24.5 nmol/l; p = 0.01), and acutely increased resting myocardial perfusion (55.1 [95% confidence interval: 77.2 to 73.1] IU/s vs. 135 [95% confidence interval: 81.2 to 189.6] IU/s; p = 0.01), without changes in myocardial work. Myocardial longitudinal strain improved in those subjects with reduced pre-apheresis function. Skeletal muscle perfusion at rest and during contractile exercise was unchanged by apheresis. Acetylcholine-mediated dilation of ex vivo ovine coronary but not femoral arteries was impaired in pre-apheresis plasma and was completely reversed in post-apheresis plasma.
conclusionsLipoprotein apheresis produces an immediate improvement in coronary microvascular function, which increases myocardial perfusion and normalizes endothelial-dependent vasodilation. These changes are not observed in the periphery. (Acute Microvascular Changes With LDL Apheresis; NCT02388633).
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Registered trials
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