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- Title
Atorvastatin Treatment Improves Myocardial and Peripheral Blood Flow in Familial Hypercholesterolemia Subjects without Evidence of Coronary Atherosclerosis.
- Authors
Lario, Fabio C.; Miname, Marcio H.; Tsutsui, Jeane M.; Santos, Raul D.; Kowatsch, Ingrid; Sbano, João C.N.; Ramires, Jose A.F.; Filho, Roberto Kalil; Mathias, Wilson
- Abstract
Background: Hypercholesterolemia induces early microcirculatory functional and structural alterations that are reversible by cholesterol reduction. Real time myocardial contrast echocardiography ( RTMCE) and vascular ultrasound evaluate the effects of hyperlipidemia on peripheral and central blood flow reserve. This study investigated the effects of lipid-lowering therapy on coronary and peripheral artery circulation in patients with familial hypercholesterolemia ( FH). Methods: RTMCE and vascular ultrasound were performed in 10 healthy volunteers (validation group) at baseline and after 12-week clinical observation, and in 16 age- and sex-matched FH patients without obstructive coronary artery disease ( CAD) by computed tomography angiography at baseline and after 12-week atorvastatin treatment. Indexes of relative myocardial blood flow ( MBF) were obtained at rest and during adenosine infusion. Results: In validation group, there was no significant difference between flow-mediated dilation ( FMD) at baseline and after 12 weeks (0.15 ± 0.02 vs. 0.14 ± 0.03; P = 0.39). Similarly, no differences were observed in MBF reserve at baseline and after 12 weeks (3.31 ± 0.63 vs. 3.48 ± 0.89; P = 0.89). FMD was blunted in FH patients, at baseline, as compared with validation group (0.08 ± 0.04 vs. 0.15 ± 0.02; P < 0.001) and became similar to that group (0.13 ± 0.05 vs. 0.14 ± 0.03; P = 0.07) after treatment. MBF reserve was blunted at baseline in FH patients in comparison with the validation group (2.78 ± 0.71 vs. 3.31 ± 0.63; P = 0.003). After treatment, MBF reserve values were no longer different (3.43 ± 0.66 and 3.48 ± 0.89; P = 0.84, respectively, for FH and validation groups). Conclusion: Patients with FH and no obstructive CAD have blunted MBF reserve and lower FMD values as compared with healthy volunteers. Both FMD and MBF reserve were normalized after atorvastatin treatment.
- Subjects
ATORVASTATIN; DOPPLER ultrasonography; ANALYSIS of variance; BLOOD circulation; CHI-squared test; CORONARY arteries; CORONARY disease; ECHOCARDIOGRAPHY; FISHER exact test; HYPERCHOLESTEREMIA; PERIPHERAL circulation; RESEARCH funding; T-test (Statistics); INTER-observer reliability; REPEATED measures design; CONTRAST media; DATA analysis software; THERAPEUTICS
- Publication
Echocardiography, 2013, Vol 30, Issue 1, p64
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/j.1540-8175.2012.01810.x