Περίληψη:
Data regarding the effects of plasma lipid lowering on the evolution of
thoracic aortic atherosclerosis (TAA) are scarce. In this study, we
performed transesophageal echocardiography to characterize TAA in 16
newly diagnosed patients with heterozygous familial hypercholesterolemia
and to follow its evolution after 2 years of statin treatment. TAA wets
graded as follows: grade I = normal intima; grade II = increased intimal
echo density without thickening; grade IIIA = increased intimal echo
density with single atheromatous plaque less than or equal to 3 mm;
grade IIIB = multiple plaques less than or equal to 3mm; grade IV =
greater than or equal to 1 plaque >3 mm; and grade V = mobile or
ulcerated plaques. Baseline aortic intimal morphology was grade I in one
patient, grade II in 4, grade IIIA in 6, grade IIIB in 3, and grade IV
in 2 patients. Hypolipidemic treatment resulted in significant
reductions in plasma total cholesterol and low-density lipoprotein (LDL)
cholesterol. Follow-up aortic morphology was grade I in 5 patients,
grade II in 2, grade IIIA in 3, grade IIIB in 3, and grade IV in 3
patients. TAA remained stable in 7 patients, progressed in 3, and
regressed in 6 patients. TAA evolved in a uniform manner in the
ascending aorta, aortic arch, and descending aorta. Patients with TAA
regression were younger (39 +/- 14 vs 52 +/- 8 years, p = 0.038) and had
a greater decrease in plasma LDL cholesterol as a result of treatment
(138 +/- 56 vs 73 +/- 55 mg/dl, p = 0.036) than patients with TAA
stability or progression. These observations support the hypothesis that
hypolipidemic treatment may favorably affect the course of TAA in
patients with heterozygous familial hypercholesterolemia. (C) 1998 by
Excerpta Medica, Inc.
Συγγραφείς:
Pitsavos, CE
Aggeli, KI
Barbetseas, JD
Skoumas, IN and
Lambrou, SG
Frogoudaki, AA
Stefanadis, CI
Toutouzas, PK
