Statin-Induced Cholesterol Lowering and Plaque Regression After 6 Months of Magnetic Resonance Imaging–Monitored Therapy

Lima, João A.C.; Desai, Milind Y.; Steen, Henning; Warren, William P.; Gautam, Sandeep; Lai, Shenghan

doi:10.1161/01.cir.0000145170.22652.51

Cited by 181 publications

(88 citation statements)

References 39 publications

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“…Earlier reports have shown a reduction in either the event rate or the vessel wall area after a pharmacological intervention disproportionately to or in the absence of luminal changes (10 -12). In a follow-up study of patients on statin therapy, no luminal changes were observed in the thoracic aorta by MRI after a short treatment period of six months, but plaque volume and area decreased significantly (12). Prolonged treatment has been shown to significantly increase the luminal area with a range of 4% to 6% in both the aorta and the carotid artery, along with a regression in the vessel wall thickness and area of up to 20% (11).…”

Section: Discussionmentioning

confidence: 96%

Assessment of the carotid artery by MRI at 3T: A study on reproducibility

Dehnavi

Doornbos

Tamsma

et al. 2007

Magnetic Resonance Imaging

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Purpose:To examine the reproducibility of carotid artery dimension measurements using 3T MRI. Materials and Methods:Ten healthy volunteers underwent three scans on two occasions for assessment of total vessel wall area (TVWA), total luminal area (TLA), and minimum (MinT) and maximum (MaxT) vessel wall thickness. A double inversion-recovery (IR) fast gradient-echo (FGRE) sequence was used on a commercial 3T system. During the first visit the subjects were scanned twice. The third scan was performed at least four days later. One observer traced all scans, and a second observer retraced the first scan series. Conclusion:With the use of a commercial 3T MR system, TVWA, TLA, and wall thickness measurements of the carotid artery can be assessed with good reproducibility.

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Section: Discussionmentioning

confidence: 96%

Assessment of the carotid artery by MRI at 3T: A study on reproducibility

Dehnavi

Doornbos

Tamsma

et al. 2007

Magnetic Resonance Imaging

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“…Clinical trials have shown that LDL apheresis, which removes plasma LDL particles physically, can improve endothelium-dependent vasomotion through acute reduction in serum cholesterol levels [68]. Cholesterol lowering modifies atherosclerotic-plaque biology, thereby decreasing vascular inflammation and leukocyte activation [69]. Thus, statins can improve endothelial function through reduction in serum cholesterol levels.…”

Section: Statins and Vascular Dysfunctionmentioning

confidence: 99%

Pleiotropic effects of statin therapy: molecular mechanisms and clinical results

Wang

Liu

Liao

2008

Trends in Molecular Medicine

536

394

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Statins inhibit the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which is required for cholesterol biosynthesis, and are beneficial in the primary and secondary prevention of cardiovascular disease. Most of the benefits of statin therapy are owing to the lowering of serum cholesterol levels. However, by inhibiting HMG-CoA reductase, statins can also inhibit the synthesis of isoprenoids, which are important lipid attachments for intracellular signaling molecules, such as Rho, Rac and Cdc42. Therefore, it is possible that statins might exert cholesterol-independent or 'pleiotropic' effects through direct inhibition of these small GTP-binding proteins. Recent studies have shown that statins might have important roles in diseases that are not mediated by cholesterol. Here, we review data from recent clinical trials that support the concept of statin pleiotropy and provide a rationale for their clinical importance. [6], have demonstrated the beneficial effects of statin therapy for primary and secondary prevention of cardiovascular disease. Because 60-70% of serum cholesterol is derived from hepatic synthesis and HMG-CoA reductase is the crucial, rate-limiting enzyme in the cholesterol biosynthetic pathway, inhibition of this enzyme by statins results in a dramatic reduction in circulating low-density lipoprotein (LDL)-cholesterol (Figure 1). In addition, reduction of LDL-cholesterol leads to upregulation of the LDL receptor and increased LDL clearance. The lowering of serum cholesterol levels is therefore thought to be the primary mechanism underlying the therapeutic benefits of statin therapy in cardiovascular disease [1]. Pleiotropy of statins: beyond cholesterol loweringStatins, however, might also exert cholesterol-independent or pleiotropic effects. By inhibiting the conversion of HMG-CoA to L-mevalonic acid, statins prevent the synthesis of important isoprenoids, such as farnesylpyrophosphate (FPP) and geranylgeranylpyrophosphate (GGPP), which are precursors of cholesterol biosynthesis [7] (Figure 1). These intermediates serve as important lipid attachments for the post-translational modification of proteins, such as nuclear lamins, Ras, Rho, Rac and Rap [8]. These isoprenylated proteins constitute approximately 2% of total cellular proteins [9]. Protein isoprenylation (see Glossary) enables proper subcellular localization and trafficking of intracellular proteins. Given that isoprenylated proteins might

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“…Studies with carotid MRI demonstrated an interstudy reproducibility of 4.4% 85 . A number of serial studies in humans have assessed CMR in the longitudinal measurement of aortic and carotid atheroma [86][87][88][89][90] .…”

Section: Cardiovascular Magnetic Resonancementioning

confidence: 99%

“…Atherosclerotic plaque 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 89 . Plaque 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.…”

Section: Cardiovascular Magnetic Resonancementioning

confidence: 99%

Métodos por imagem da aterosclerose em estudos de progressão/regressão: marcador substituto ou janela direta para o processo patológico da aterosclerose?

Schoenhagen¹,

Tuzcu²

2008

Arq. Bras. Cardiol.

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SummaryCAD remains a major global cause of morbidity and mortality. Comprehensive drug development programs of novel pharmacological treatment strategies frequently utilize traditional mortality/morbidity endpoints studies and additional surrogate endpoints trials. This parallel approach allows an assessment of efficacy several years in advance of the availability of data from clinical endpoint trials. Several atherosclerosis imaging markers have been introduced into these drug-development strategies, including angiography, carotid ultrasound, IVUS, MRI, and CT. This review will discuss the current status of atherosclerosis imaging as an endpoint in progression/regression trials, with an emphasis on evidence-based data. In addition to a discussion of the results of individual imaging modalities, the emerging data comparing different modalities and approaches are presented.

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Statin-Induced Cholesterol Lowering and Plaque Regression After 6 Months of Magnetic Resonance Imaging–Monitored Therapy

Cited by 181 publications

References 39 publications

Assessment of the carotid artery by MRI at 3T: A study on reproducibility

Assessment of the carotid artery by MRI at 3T: A study on reproducibility

Pleiotropic effects of statin therapy: molecular mechanisms and clinical results

Métodos por imagem da aterosclerose em estudos de progressão/regressão: marcador substituto ou janela direta para o processo patológico da aterosclerose?

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