Changes in Coronary Flow Reserve Assessed by Transthoracic Echocardiography after Lipid-Lowering Therapy in Patients with Hypercholesterolemia.
10.4070/kcj.2004.34.7.670
- Author:
Myung A KIM
1
;
Dae Won SOHN
;
Young Seok CHO
;
Yong Jin KIM
;
Young Bae PARK
;
Yun Shik CHOI
Author Information
1. Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. dwsohn@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Coronary circulation;
Hypercholesterolemia;
Echocardiography
- MeSH:
Cholesterol;
Coronary Circulation;
Coronary Disease;
Coronary Vessels;
Echocardiography*;
Echocardiography, Doppler;
Humans;
Hypercholesterolemia*;
Lipoproteins;
Risk Factors
- From:Korean Circulation Journal
2004;34(7):670-676
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The coronary flow reserve is known to be reduced in patients with hypercholesterolemia, and has also been reported to improve after lipid-lowering therapy. Using transthoracic Doppler echocardiography, the changes in the coronary flow reserve were evaluated after lipid-lowering therapy in hypercholesterolemic patients. METHODS: The coronary flow reserve was determined by pulsed-wave Doppler examination at the distal left anterior descending coronary artery before and after five months of lipid-lowering therapy in 14 hypercholesterolemic patients (total cholesterol > or =230 mg/dL) with no other modifiable risk factors of coronary heart disease. RESULTS: In all patients, the total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly decreased after therapy (from 273+/-27 mg/dL to 199+/-22 mg/dL, p=0.001, from 182+/-25 mg/dL to 110+/-27 mg/dL, p=0.001, respectively). However, there was no significant change in the coronary flow reserve after lipid-lowering therapy (from 2.4+/-0.5 to 2.5+/-0.5, p=0.875). The Baseline LDL-cholesterol showed an inverse correlation with the baseline coronary flow reserve (r =-0.649, p=0.012). CONCLUSIONS: In the present study, no significant change in the coronary flow reserve was noted after lipid-lowering therapy in hypercholesterolemic patients with no other risk factors of coronary heart disease, although the baseline LDL-cholesterol levels were found to correlate well with the baseline coronary flow reserve. Transthoracic Doppler echocardiography can be used to easily and non-invasively evaluate the changes in the coronary flow velocity, coronary flow reserve and other related parameters. Therefore, a controlled trial using transthoracic Doppler echocardiography relating to the effect of lipid-lowering therapy on patients showing a wider range of baseline risk factors and LDL-cholesterol level is required.
