EFFECTS OF AMELIORATED HEMORHEOLOGY ON CLINICAL SYMPTOMS IN CEREBROVASCULAR-DISEASE

Cerebrovascular disease (CVD) is associated with high fibrinogen level s and lipid fractions leading to an increase of both plasma and whole blood viscosity as well as raised aggregability of blood cells. One im portant goal in the treatment of cerebral multiinfarct dementia (MID) therefore should be to reduce fibrinogen and lipoproteins and thereby to improve the haemorheological state. The effect of heparin-induced e xtracorporeal LDL precipitation (H.E.L.P.), a method for safe and imme diate reduction of parameters relevant to haemorheology, such as plasm a fibrinogen and the lipoproteins, was investigated in 98 patients wit h MID. All the patients underwent two H.E.L.P. applications within 8 d ays. The impact of H.E.L.P. on CVD was studied by changes of laborator y data and by evaluation of clinical symptoms before and after treatme nt. Each H.E.L.P. session caused an immediate, safe and significant re duction of important rheological parameters such as fibrinogen (P < 0. 001), whole blood viscosity at high and low shear rate, plasma viscosi ty and red cell transit time (P < 0.01 each). Also total cholesterol a nd low density lipoprotein (P < 0.0001 each), lipoprotein (a) (P < 0.0 03) and the triglycerides (P < 0.0001) had been reduced. The results i n laboratory measurement were followed by a statistically significant improved neurologic recovery, represented in the values of the Mathew Scale, the Mini Mental State Examination and the Activilies-of-Daily-L iving-Test. These results can indicate the importance and influence of haemorheology on clinical symptoms in CVD. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.