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CLINICAL RESEARCH: ATHEROSCLEROSIS EVALUATION BY ULTRASOUND

Effects of Fluvastatin on the Carotid Arterial Media as Assessed by Integrated Backscatter Ultrasound Compared With Pulse-Wave Velocity

Regeneration & Advanced Medical Science, Gifu University Graduate School of Medicine, Gifu, Japan

Manuscript received February 24, 2005; revised manuscript received June 1, 2005, accepted June 6, 2005.

^_* Reprint requests and correspondence: Dr. Hisayoshi Fujiwara, Regeneration & Advanced Medical Science, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan (Email: gifuim-gif{at}umin.ac.jp).

OBJECTIVES: Our goal is to show the effectiveness of fluvastatin in reducing arterial sclerosis using integrated backscatter (IB) values rather than depending on the pulse-wave velocity (PWV) and stiffness beta.

BACKGROUND: Atherosclerotic changes consist of two components: atherosis as a structural change and sclerosis as a functional change; IB ultrasound of carotid media was useful for assessment of arterial sclerosis.

METHODS: We measured IB values in the media of 40 segments of carotid arteries in 40 patients with hyperlipidemia before and after statin therapy or diet for 12 months (fluvastatin [F group] 40 mg/day, n = 20; control [C group]: diet, n = 20). Pulse-wave velocity, intima-media thickness, and stiffness beta were measured at the same time.

RESULTS: At baseline, IB values correlated with PWV (r = 0.71, p < 0.001) and stiffness beta (r = 0.47, p = 0.002) in 40 patients with hyperlipidemia. Integrated backscatter values did not change in the C group but decreased in the F group (from 12.3 ± 2.1 dB to 11.3 ± 2.1 dB, p = 0.002). Also, PWV increased in the C group (from 1,728 ± 687 cm/s to 1,771 ± 716 cm/s, p = 0.021) but decreased in the F group (from 1,848 ± 582 cm/s to 1,768 ± 549 cm/s, p = 0.012). Stiffness beta decreased in the F group (from 14.0 ± 3.9 to 12.1 ± 3.5, p = 0.002).

CONCLUSIONS: Statin therapy with fluvastatin improved arterial sclerosis as assessed by IB values.

Abbreviations and Acronyms   ApoB/A-I = ratio of apolipoprotein B to apolipoprotein A-I   CAD = coronary artery disease   CVD = cerebrovascular disease   DM = diabetes mellitus   HL = hyperlipidemia   hs-CRP = high-sensitivity C-reactive protein   HTN = hypertension   IB = integrated backscatter   IMT = intima-media thickness   LDL-C = low-density lipoprotein cholesterol   PWV = pulse-wave velocity   SBP = systolic blood pressure

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