Heart and Vessels

, Volume 12, Issue 5, pp 234–240 | Cite as

Correction of erythrocyte shape abnormalities in familial hypercholesterolemia after LDL-apheresis: Does it influence cerebral hemodynamics?

  • Arcangelo Iannuzzi
  • Giorgio Bianciardi
  • Fulvio Faccenda
  • Agostino Gnasso
  • Nicola Scarpato
  • Lucrezia Di Marino
  • Guido Iaccarino
  • Cristobao Simoes
  • Giovanni Sacchi
  • Elisabetta Weber


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.

Key words

Erythrocyte shape Familial hypercholesterolemia LDL-apheresis Blood component removal Cerebral flow velocity Transcranial Doppler Cholesterol 


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Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • Arcangelo Iannuzzi
    • 1
  • Giorgio Bianciardi
    • 3
  • Fulvio Faccenda
    • 1
  • Agostino Gnasso
    • 1
  • Nicola Scarpato
    • 2
  • Lucrezia Di Marino
    • 1
  • Guido Iaccarino
    • 2
  • Cristobao Simoes
    • 3
  • Giovanni Sacchi
    • 4
  • Elisabetta Weber
    • 4
  1. 1.Institute of Internal Medicine and Disease of Metabolism, Department of Clinical and Experimental Medicine, Second Medical SchoolFederico II UniversityNaplesItaly
  2. 2.Department of Immunohematology, Second Medical SchoolFederico II UniversityNaplesItaly
  3. 3.Institute of Pathology, Center of Research on AtherosclerosisUniversity of SienaItaly
  4. 4.Institute of AnatomyUniversity of SienaItaly

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