Quantitative 3T MR imaging of the descending thoracic aorta: patients with familial hypercholesterolemia have an increased aortic plaque burden despite long-term lipid-lowering therapy.
OBJECTIVE
To compare the aortic plaque burden in patients with heterozygous familial hypercholesterolemia on long-term statin treatment with that of matched control subjects.


METHODS
The authors studied 11 heterozygous, nonsmoking, nondiabetic, and nonhypertensive patients with familial hypercholesterolemia (mean age, 44 years +/- 10) who had been receiving cholesterol-lowering management for a mean of 12 years +/- 5, including 8.25 years +/- 4.24 with the highest tolerable doses of a statin (or a statin plus ezetimibe), and 26 age- and sex-matched control subjects with 3T magnetic resonance (MR) imaging of the descending thoracic aorta by using an axial T2-weighted turbo spin-echo sequence.


RESULTS
Quantitative analysis demonstrated that the aortic vessel wall area was significantly larger in patients with familial hypercholesterolemia than in control subjects (123 mm(2) +/- 23 vs 102 mm(2) +/- 18, respectively; P < .007), as was vessel wall thickness (1.63 mm +/- 0.28 vs 1.37 mm +/- 0.16, respectively; P < .001). No significant difference was found between mean values of routine serum lipid and lipoprotein parameters.


CONCLUSIONS
The results of this preliminary study show that patients with heterozygous familial hypercholesterolemia have a higher aortic atherosclerotic plaque burden than control subjects at quantitative MR imaging despite long-term lipid-lowering therapy. This information may help design future studies evaluating plaque burden and cardiovascular risk.
Schmitz
Stephan A
SA
Imaging Sciences Department, MRC Clinical Sciences Centre, Imperial College, Hammersmith Hospital Campus, Du Cane Rd, London, W12 0NN England. stephan.schmitz@imperial.ac.uk
O'Regan
Declan P
DP
Fitzpatrick
Julie
J
Neuwirth
Clare
C
Potter
Elizabeth
E
Tosi
Isabella
I
Hajnal
Joseph V
JV
Naoumova
Rossi P
RP
D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000187:drug effects / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000175:diagnosis* / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome
D000960:Hypolipidemic Agents