Background-Statin therapy reduces adverse outcomes, with a minimal decrease in vessel stenosis. Magnetic resonance imaging (MRI) noninvasively detects atherosclerotic plaque (AP) reduction. We hypothesized that statin-induced AP regression can be monitored by MRI and detected earlier than previously reported and is significantly associated with its lipid-lowering effect. Methods and Results-APs in thoracic aorta were measured by combined surface/transesophageal MRI in 27 patients (treated with simvastatin 20 to 80 mg daily) before and after 6 months of therapy. AP volume and luminal dimensions were measured from 6 cross sections used to construct a 2.4-cm 3D volume of the aorta that included plaque and lumen. Method reproducibility was studied in 10 patients imaged twice, 1 week apart. AP volume was reduced from 3.3Ϯ0.1.4 to 2.9Ϯ1.4 cm 3 at 6 months (PϽ0.02), whereas luminal volume increase was less accentuated (from 12.0Ϯ3.9 to 12.2Ϯ3.7 cm 3 , PϽ0.06). LDL cholesterol decreased by 23% (from 125Ϯ32 to 97Ϯ27 mg/dL, PϽ0.05) in 6 months. AP regression (plaque volume/area reduction) was significantly related to LDL cholesterol reduction (PϽ0.02 and PϽ0.005, respectively), and luminal volume increase was inversely related to LDL cholesterol reduction (PϽ0.04). Plaque volume measurement was highly reproducible (intraclass correlation Rϭ0.98 and variabilityϭ4.8%). Intraobserver (0.91) and interobserver (0.81) concordances were documented for plaque volume assessment. Conclusions-AP regression and reverse remodeling can be detected accurately by MRI 6 months after statin therapy initiation, and it is strongly associated with LDL cholesterol reduction.
A rapid assay for detection of cytomegalovirus (CMV) in saliva was evaluated as a screening method for congenital infection. Samples of saliva were examined by detection of early antigen fluorescent foci (DEAFF) and standard tissue culture (TC). Results were compared with those from urine DEAFF. CMV was detected in saliva from 31 (1.7%) of 1870 newborns, 26 by DEAFF and TC, 1 by DEAFF alone, and 4 by TC alone. Urine DEAFF was positive in 28 of these 31 newborns. The sensitivities of various tests were saliva TC, 96.8%; saliva DEAFF, 87.1%; and urine DEAFF, 90.3%. A change in transport medium for 825 saliva samples resulted in improved sensitivities: saliva TC and saliva DEAFF, 100%; urine DEAFF, 92.3%. Screening saliva of newborns for CMV appears to be at least as sensitive a method for detecting congenital infection as detection of viruria; saliva can be collected with less difficulty and expense than urine.
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