Aggressive Statin Therapy can Halt the Progression of Aortic Sclerosis

Abstract

Error condition detected Background: Aortic sclerosis (ASC) is very common and often progresses to symptomatic aortic stenosis. Conventional Doppler measurements of ASC are of limited value in assessing progression. Ultrasonic backscatter (UB) has recently been used to assess ASC. In the present randomized prospective study, we investigated whether aggressive LDL-cholesterol reduction (LDL goal <2 mmol/L) can halt the progression of ASC over a period of 12 months period. Methods: LDL was reduced to <2 mmol/L prospectively with atorvastatin in 44 patients with ASC for 12 months. Images of the aortic valve were obtained in the parasternal long-axis view and saved in raw data format. Six square-shaped 11 pixel × 11 pixel regions of interest were placed on all leaflets, and calibrated UB values were obtained by subtracting the regions of interest in the blood pool from the averaged backscatter values obtained from the leaflets. Results: Mean LDL cholesterol levels were 1.8 ± 0.4 mmol/L after 12 months. Mean UB values after 12 months were −14.3 ± 4.6 dB compared to 10.1 ± 5.1 dB at the beginning of the study (p < 0.05). This change in UB did not correlate with LDL, HDL, TG or lipoprotein(a) changes. Conclusion: Measurement of backscatter from the valve leaflets of patients with ASC may be a feasible means of following the progression and treatment response of aortic sclerosis. Statins may be able to halt the progression of ASC over a 12-month period.