Improved plaque neovascularization following 2-year atorvastatin therapy based on contrast-enhanced ultrasonography: A pilot study

Abstract

Abstract. The present study assessed changes in carotid plaque neovascularization following long-term atorvastatin therapy (20 mg/day) using contrast-enhanced ultrasonography (CEUS). In this prospective case series, seven males (mean age, 68±9 years) and three females (mean age, 67±10 years) with a total of 13 carotid plaques underwent standard ultrasonography and CEUS at baseline, as well as after 1 and 2 years of atorvastatin treatment. The same plaques were then examined using real-time CEUS. The results of the enhanced intensity of plaque neovascularization at baseline were compared with results obtained during follow-up to examine the effects of long-term atorvastatin therapy. Standard ultrasonography revealed that 7 of the 13 carotid plaques were uniformly echolucent, whereas 6 carotid plaques were predominantly echolucent. CEUS revealed an enhanced intensity of 10.5±2.1 decibels (dB) prior to treatment, which decreased significantly to 7.3±2.6 dB following 2 years atorvastatin therapy (P<0.001). The ratio of enhanced intensity in the carotid artery lumen to that in the plaque was 3.10±1.10 at baseline and this value significantly increased to 4.96±2.98 following treatment for 2 years (P<0.001). The current pilot study therefore indicates that two-year atorvastatin therapy (20 mg/day) may reduce plaque neovascularization in the Chinese population.

The Course of Carotid Plaque Vulnerability Assessed by Advanced Neurosonology

“…During the 6 months of follow-up, we found no significant changes in IPN. A Japanese CEUS study found a non-significant trend toward reduced IPN in plaques that had been asymptomatic for >6 months ( 18 ), while another study demonstrated reduced IPN after 2 years of atorvastatin therapy ( 19 ). It is possible that 6 months of follow-up is insufficient to detect a decrease in IPN, as these changes are gradual.…”

“…The presence of microembolic signals (MES) on transcranial Doppler indicates ongoing embolization and is an independent predictor of future stroke in symptomatic and asymptomatic carotid artery disease ( 15 , 16 ). Data on the time course of MES and IPN in patients with carotid plaques are limited ( 17 – 19 ). We aimed to assess temporal changes in microembolization and neovascularization during a 6-month follow-up study and explored the utility of advanced neurosonology in acute ischemic stroke.…”

A new approach of statin therapy in carotid atherosclerosis: Targeting indices of plaque vulnerability on the top of lipid-lowering. A narrative review

“…p l / k a r d i o l o g i a _ p o l s k a CEUS. All of them suggested reduced IPN after either 6-month statin therapy [40,64], or 24-month atorvastatin administration (20 mg/d) [65], or angiotensin-converting enzyme inhibitors and statins treatment [66]. Similarly, in 45 statin-naive patients with asymptomatic carotid atherosclerosis, 24-month rosuvastatin therapy (5-20 mg/d) reduced the MRI-based IPN [34].…”

Contrast-enhanced carotid ultrasound: current status

“…Так, Xu B, et al оценивали изменение неоваскуляризации АСБ СА на фоне длительной терапии аторвастатином (20 мг/сут.) и показали значительное уменьшение неоваскуляризации АСБ через два года наблюдения [38]. Авторы сделали вывод о том, что УЗИ с контрастным усилением может быть новым инструментом для оценки влияния терапии на состояние сосудов в клинических исследованиях.…”