期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 58, 期 10, 页码 1068-1076出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2011.04.034
关键词
lipids; magnetic resonance imaging; peripheral vascular disease
资金
- National Heart, Lung, and Blood Institute [R01 HL075792]
- National Center for Research Resources [M01RR000847]
- National Institute of Biomedical Imaging and Bioengineering [T32 EB003841]
- Siemens Healthcare
Objectives We hypothesized that low-density lipoprotein (LDL) reduction regardless of mechanism would improve calf muscle perfusion, energetics, or walking performance in peripheral arterial disease (PAD) as measured by magnetic resonance imaging and magnetic resonance spectroscopy. Background Statins improve cardiovascular outcome in PAD, and some studies suggest improved walking performance. Methods Sixty-eight patients with mild to moderate symptomatic PAD (age 65 +/- 11 years; ankle-brachial index [ABI] 0.69 +/- 0.14) were studied at baseline and annually for 2 years after beginning simvastatin 40 mg (n = 20) or simvastatin 40 mg/ezetimibe 10 mg (n = 18) if statin nave, or ezetimibe 10 mg (n = 30) if taking a statin. Phosphocreatine recovery time was measured by (31)P magnetic resonance spectroscopy immediately after symptom-limited calf exercise on a 1.5-T scanner. Calf perfusion was measured using first-pass contrast-enhanced magnetic resonance imaging with 0.1 mM/kg gadolinium at peak exercise. Gadolinium-enhanced magnetic resonance angiography was graded. A 6-min walk and a standardized graded Skinner-Gardner exercise treadmill test with peak V(O2) were performed. A repeated-measures model compared changes over time. Results LDL reduction from baseline to year 2 was greater in the simvastatin 40 mg/ezetimibe 10 mg group (116 +/- 42 mg/dl to 56 +/- 21 mg/dl) than in the simvastatin 40 mg group (129 +/- 40 mg/dl to 90 +/- 30 mg/dl, p < 0.01). LDL also decreased in the ezetimibe 10 mg group (102 +/- 28 mg/dl to 79 +/- 27 mg/dl, p < 0.01). Despite this, there was no difference in perfusion, metabolism, or exercise parameters between groups or over time. Resting ABI did improve over time in the ezetimibe 10 mg group and the entire study group of patients. Conclusions Despite effective LDL reduction in PAD, neither tissue perfusion, metabolism, nor exercise parameters improved, although rest ABI did. Thus, LDL lowering does not improve calf muscle physiology or functional capacity in PAD. (Comprehensive Magnetic Resonance of Peripheral Arterial Disease; NCT00587678) (J Am Coll Cardiol 2011; 58: 1068-76) (C) 2011 by the American College of Cardiology Foundation
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据