Impact of Statin Therapy on Left Ventricular Function and Carotid Arterial Stiffness in Patients With Hypercholesterolemia

Background Hypercholesterolemia is a well-established risk factor for the development of vascular events. Statins have pleiotropic effects beyond reducing the low-density lipoprotein-cholesterol (LDL-C) concentration. This study sought to determine whether treatment with pitavastatin affects latent regional left ventricular (LV) systolic and diastolic dysfunction and carotid arterial stiffness in patients with hypercholesterolemia and preserved LV ejection fraction (LVEF), using newly developed ultrasonic strain imaging and carotid ultrasonography. Methods and Results A total of 30 patients with hypercholesterolemia (≥220 mg/dl for serum total cholesterol, and/or ≥140 mg/dl for LDL-C) were randomized to either administration of pitavastatin (1 or 2 mg/day; n=15) or no statin therapy (n=15) for 12 months. LV systolic and diastolic functions were evaluated by measuring transmitral flow velocity, mitral annular motion velocity, and the myocardial strain and strain rate profiles using pulsed Doppler, tissue velocity, and ultrasonic strain imaging. Subclinical atherosclerosis also was determined by measuring the intima - media thickness (IMT) and stiffness β of the left and right common carotid arteries using B- and M-mode ultrasonography. During the follow-up period, the mean peak systolic strains of the LV posterior and inferior walls increased from 39.2±15.9% to 51.5±17.7% (p