Nursel YURTTUTAN, Murat BAYKARA, Özlem Gündoğdu SEÇEN, Betül KIZILDAĞ, Mehmet Akif SARICA

Premenopozal Dislipidemik Kadın Hastalarda Atorvastatin Tedavisi Sonrası Ana Karotid ve Femoral Arter IMK ve Kompliyansının Ultrasonografik Olarak Değerlendirilmesi

GİRİŞ ve AMAÇ: Bu çalışmada dislipidemik premenopozal kadın hasta grubunda ultrasonografi US ile atorvastatin tedavisinin ana karotid arter ve femoral arter intima media kalınlığı IMK ile arteriyel kompliyans üzerine etkisini değerlendirmeyi amaçladık.YÖNTEM ve GEREÇLER: Bu çalışmada dislipidemi tanısı bulunan 40 premenopozal kadın yer aldı. Katılımcılar 60 gün boyunca 80 mg / gün atorvastatin aldı; bazal ve tedavi sonrası ölçümleri adet döngüsünün olası etkisini önlemek için adetin ilk günü yapıldı. Ölçümler non-invazif olarak yüksek çözünürlüklü bir ultrasonografi cihazı ile yapıldı. Arteriyel kompliyans kesitsel kompliyans, kesitsel esneklik, diyastolik duvar basıncı ve elastik modül gibi çeşitli göstergeler kullanılarak değerlendirildi. Başlangıçta ve iki aylık tedavi sonrası elde edilen veriler Wilcoxon testi ile karşılaştırıldı, p

Anahtar Kelimeler:

Arteriyel kompliyans, Atorvastatin, dislipidemi, intima-media kalınlığı, sertlik

Ultrasonographic Evaluation of Common Carotid and Femoral Artery IMT and Compliance After Atorvastatin Treatment in Premenopausal Dyslipidemic Female Patients

INTRODUCTION: In this study we aimed to evaluate the effect of atorvastatin treatment on common carotid artery CCA and femoral artery FA intima media thickness IMT and arterial compliance by using ultrasonography US in premenopausal females with dyslipidemia. METHODS: The current study consisted of 40 premenopausal women with a diagnosis of dyslipidemia. The participants received 80 mg/day atorvastatin for 60 days, baseline and posttreatment measurements were performed on the first day of menstruation to avoid the possible effect of the menstrual cycle. Ultrasonographic measurements were non-invasively taken using a high resolution US system. Arterial compliance was evaluated using several indicators, such as cross-sectional compliance CSC , cross-sectional distensibility CSD , diastolic wall stress DWS , and elastic modulus EM . Data obtained at baseline and in the second post-treatment month were compared via a Wilcoxon test, p values of

Keywords:

Arterial compliance, Atorvastatin, dyslipidemia, intima-media thickness, stiffness,

PDF

___

Van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS, et al. Association between arterial stiffness and atherosclerosis: The Rotterdam Study. Stroke 2001; 32: 454–460.
Simons PC, Algra A, Bots ML, Grobbee DE, van der Graaf Y. Common carotid intima-media thickness and arterial stiffness: Indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestations of ARTerial Disease). Circulation 1999; 100: 951–957.
Liao D, Arnett DK, Tyroler HA, Riley WA, Chambless LE, Szklo M, et al. Arterial stiffness and the development of hypertension. The ARIC study. Hypertension 1999; 34: 201–206.
Tsivgoulis G, Vemmos K, Papamichael C, Spengos K, Daffertshofer M, Cimboneriu A, et al. Common carotid arterial stiffness and the risk of ischaemic stroke. Eur J Neurol 2006; 13: 475– 481.
Kass DA. Ventricular arterial stiffening: integrating the pathophysiology. Hypertension 2005; 46: 185–193.
Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arterioscler Thromb Vasc Biol 2005; 25: 932–943.
Ray KK, Cannon CP. Atorvastatin and cardiovascular protection: a review and comparison of recent clinical trials. Expert Opin Pharmacother 2005; 6: 915–927.
Atabek ME, Kurtoglu S, Pirgon O, Baykara M. Arterial wall thickening and stiffening in children and adolescents with type 1 diabetes. Diabetes Res Clin Pract 2006; 74: 33–40.
Mackenzie IS, Wilkinson IB, Cockcroft JR. Assessment of arterial stiffness in clinical practice. QJM 2002; 95(2): 67- 74.
Nichols WW, O'Rourke MF. McDonald's blood flow in arteries: theoretical, experimental and clinical principles, 5th ed. London: Hodder Arnold 2005; 129-225.
Gamble G, Zorn J, Sanders G, MacMahon S, Sharpe N. Estimation of arterial stiffness, compliance, and distensibility from M-mode ultrasound measurements of the common carotid artery. Stroke 1994; 25: 11-16.
Van den Berkmortel F, Wollersheim H, van Langen H, Thien T. Dynamic vessel wall properties and their reproducibility in subjects with increased cardiovascular risk. J Hum Hypertens 1998; 12: 345-350.
O'Donnell ME, Badger SA, Sharif MA, Young IS, Lee B, Soong CV. The vascular and biochemical effects of cilostazol in patients with peripheral arterial disease. J Vasc Surg 2009; 49: 1226-1234.
Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010; 55: 1318-1327.
Ratchford EV, Gutierrez J, Lorenzo D, McClendon MS, Della-Morte D, DeRosa JT et al. Short-term effect of atorvastatin on carotid artery elasticity: a pilot study. Stroke 2011; 42(12): 3460-4.
Vlachopoulos C, Aznauridis K, Dagre A, Vasiliadou C, Masoura C, Stefanadi E, et al. Protective effect of atorvastatin on acute systemic inflammation-induced endothelial dysfunction in hypercholesterolaemic subjects. Eur Heat J 2007; 10: 1093.
Susekov AV, Rozhkova TA, Tripoten MI, Pogorelova OA, Kulev BD, Balakhonova TV, et al. Randomized FARVATER study. Part 2. Effect of atorvastatin on endothelial function, distensibility and stiffness of vascular wall. Kardiologiia 2007; 47: 25–30.
Brown SL, Raal FJ, Panz VR, Stevens BA, Veller MG. High- dose atorvastatin therapy is required for significant improvement of endothelial function in heterozygous familial hypercholesterolaemic patients. Cardiovasc J S Afr 2004; 15: 70 –75.
Wang J, Xu J, Zhou C, Zhang Y, Xu D, Guo Y et al. Improvement of arterial stiffness by reducing oxidative stress damage in elderly hypertensive patients after 6 months of atorvastatin therapy. J Clin Hypertens (Greenwich) 2012; 14(4): 245-9.