yperlipidemia is a well-established risk factor for the development of cardiovascular disease and its mortality. 1 Recently, the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or statins, were developed in the clinical setting, and have been demonstrated to have pleiotropic effects in addition to their strong lipid-lowering properties. 2 Several large-scale primary and secondary prevention trials have confirmed that cholesterollowering therapy can reduce the rates of the first occurrence and recurrence of coronary heart disease between 20% and 40%. [3][4][5][6] Moreover, it has been reported that long-term statin therapy improves aortic stiffness, 7 blood pressure, 8 and left ventricular (LV) function. 9-12 Widespread use of noninvasive investigations has enabled detailed evaluation of arterial stiffness 13 and LV systolic and diastolic function, 14,15 so in the present study, we used carotid ultrasonography and newly developed ultrasonic strain imaging to determine whether treatment with pitavastatin contributes to an improvement of carotid arterial stiffness and latent regional LV myocardial function beyond the lipid-lowering effect in patients with hypercholesterolemia and preserved LV ejection fraction (LVEF).
Methods
Study DesignThirty consecutive patients with hypercholesterolemia (≥220 mg/dl for serum total cholesterol, and/or ≥140 mg/dl for low-density lipoprotein-cholesterol (LDL-C)) who visited hospital between 2005 and 2006 were randomized to either administration of pitavastatin (1 or 2 mg/day; 9 men, 6 women; mean age: 54±10 years) or no statin therapy (6 men, 9 women; mean age: 56±11 years) for 12 months. Exclusion criteria were as follows: patients with any hypolipidemic treatment within the past 6 months, patients with inadequate echocardiographic recordings for proper measurement, patients with clinically significant valvular disease, diabetes, cardiomyopathy, previously demonstrated angina pectoris or myocardial infarction, hepatic dysfunction, renal failure, aortitis syndrome, previous stroke or Circ J 2008; 72: 538 -544 (Received July 25, 2007; revised manuscript received November 14, 2007; accepted November 16, 2007) Cardiovascular Section, Higashi Tokushima National Hospital, National Hospital Organization, Tokushima, Japan Mailing address: Yukio Mizuguchi, MD, Cardiovascular Section, Higashi Tokushima National Hospital, National Hospital Organization, 1-1 Ohmukai-kita, Ohtera, Itano-cho, Itano-gun, Tokushima 779-0193, Japan. E-mail: mizuguchi@higasitokusima.hosp.go.jp All rights are reserved to the Japanese Circulation Society. For permissions, please e-mail: cj@j-circ.or.jp
Impact of Statin Therapy on Left Ventricular Function and Carotid Arterial Stiffness in Patients With HypercholesterolemiaYukio Mizuguchi, MD; Yoshifumi Oishi, MD; Hirokazu Miyoshi, MD; Arata Iuchi, MD; Norio Nagase, MD; Takashi Oki, MDBackground Hypercholesterolemia is a well-established risk factor for the development of vascular events. Statins have pleiotropic effects beyond reducing the low-density...
