Integrated Backscatter and Intima-Media Thickness of the Thoracic Aorta Evaluated by Transesophageal Echocardiography in Hypercholesterolemic Patients: Effect of Pitavastatin Therapy

The effect of a strong, lipophilic statin (pitavastatin) on the thoracic aorta has not yet been elucidated. The purpose of the present study was to evaluate the effects of pitavastatin (P) therapy on plaque components and morphology in the thoracic aorta by transesophageal echocardiography (TEE) and clarify the impact of the therapy on media and intima in patients with hypercholesterolemia. Sixty-four media and 64 intima of the thoracic aorta were investigated in 32 patients with hypercholesterolemia. The corrected integrated backscatter (c-IBS) values in the thoracic aortic wall and intima-media thickness (IMT) at the same site were measured before and after P therapy or diet (D) for 7 mo. Moreover, c-IBS values in media were measured in 168 patients without hypercholesterolemia to estimate age-dependent changes. C-IBS values in media were correlated with age (r = 0.84, p < 0.001). C-IBS and IMT of media in the P group significantly decreased from −17.8 ± 2.4 to −20.1 ± 3.7 dB and from 1.7 ± 0.3 to 1.5 ± 0.3 mm, respectively (p < 0.001), whereas those in the D group significantly increased from −18.3 ± 2.0 to −16.7 ± 2.1 dB and from 1.6 ± 0.3 to 1.7 ± 0.2 mm, respectively (p < 0.001). IMT in intima in the P group significantly decreased from 3.7 ± 0.4 to 3.3 ± 0.4 mm (p < 0.001). C-IBS in intima in the P group significantly increased from −10.2 ± 2.2 to −6.9 ± 1.7 dB, which indicated plaque stabilization. Pitavastatin improved the atherosis measured by IMT and sclerosis measured by c-IBS values in the media and induced stabilization and regression of plaques in the intima of the thoracic aorta. (E-mail: masanori@ya2.so-net.ne.jp)