Effect of LDL apheresis on oxygen tension in skeletal muscle in patients with cardiac allograft vasculopathy and severe lipid disorder

Abstract

In this study, the extent to which intramuscular pO₂ is influenced by a single HELP‐apheresis (Heparin‐induced Extracorporeal LDL Precipitation) was investigated in 10 patients with cardiac allograft vasculopathy (CAV) and severe lipid disorder. For this purpose, a sterile flexible pO₂ microcatheter was inserted into the anterior tibial muscle and pO₂ monitoring was begun 10 minutes before starting apheresis treatment. The intramuscular pO₂ values were recorded continuously until the end of apheresis treatment and a subsequent 30‐minute further observation phase.

The patients with CAV and severe lipid disorder presented with 11.6±3.8 mmHg significantly and pathologically reduced intramuscular pO₂ (p<0.001). LDL apheresis resulted in a significant increase in pO₂ in the anterior tibial muscle. Thirty minutes after the end of HELP‐apheresis, intramuscular partial oxygen pressure had increased by 162% and showed values at this point, 30.3±9.8 mmHg, similar to those found in healthy subjects.