Effects of ameliorated haemorheology on clinical symptoms in cerebrovascular disease.

Cerebrovascular disease (CVD) is associated with high fibrinogen levels and lipid fractions leading to an increase of both plasma and whole blood viscosity as well as raised aggregability of blood cells. One important 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 extracorporeal LDL precipitation (H.E.L.P.), a method for safe and immediate reduction of parameters relevant to haemorheology, such as plasma fibrinogen and the lipoproteins, was investigated in 98 patients with MID. All the patients underwent two H.E.L.P. applications within 8 days. The impact of H.E.L.P. on CVD was studied by changes of laboratory data and by evaluation of clinical symptoms before and after treatment. Each H.E.L.P. session caused an immediate, safe and significant reduction of important rheological parameters such as fibrinogen (P < 0.001), whole blood viscosity at high and low shear rate, plasma viscosity and red cell transit time (P < 0.01 each). Also total cholesterol and low density lipoprotein (P < 0.0001 each), lipoprotein (a) (P < 0.003) and the triglycerides (P < 0.0001) had been reduced. The results in 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-Living-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.