Intervention Of The Effect Of Intensive Lipid-lowering Therapy On Neovascularization In The Carotid Atherosclerotic Plaques By Contrast-Enhanced Ultrasonography

Objective:To analysis the correlation between characteristics of the carotid artery plaque neovascularization and LDL, TG levels,the evolving role of Contrast-Enhanced Ultrasonography(CEUS)in early diagnosis of the vulnerable plaque was evaluated, and the clinical significance of intensive lipid-lowering therapy on carotid vulnerable plaque, as well as evaluate the relatians between plaque neovascularization and plaque stability.Methods:1.40 patients (40 plaques total) who conformed to inclusive criteria were divided into two groups,23 patients were in treatment group, and 17 patients in control group. Treatment of basic diseases in all the patients were obtained before and after the atorvastatin treatment. Then a high dose(40mg/d)of atorvastatin was given to the treatment group for at least three months,the control group took nothing any more.2. Serum levels of each patient was measured;routine ultrasound examination and the CEUS were taken to each patient.Then all the data of the examinations were analyzed and compared. These tests above were repeated in the same target plaque after 3 months.3. The serum markers, routine ultrasound and the CEUS parameters were analysised between the two groups before and after treatment, and comparing the correlation among these parameters.Results:1. Before treatment, there were no difference between the two groups in serum levels, routine ultrasound and the CEUS parameters (p>0.05). 2. By routine ultrasonography, the IMT thickness, the area and thickness of the target plaque minimized in treatment group (p<0.01), all these data had no significant difference(p>0.05).3. Before treatment,40 plaques were enhanced by CEUS in different patterns.15 plaques were enhanced from ektexine of vascular into the inside of the plaque,22 plaques were enhanced from the ektexine and the cavity of vascular into the inside of the plaque. In our study, the mostly enhanced site during CEUS procedures localized in the peripheral and the shoulder of the plaques. After treatment, EI of all the plaques by CEUS diminished in treatment group (p<0.01). And no difference in the controls after three months(p> 0.05). And there were no significant changes in AT, TTP and BI, PI between the two groups(p>0.05).4. Serum levels like LDL, TG decreased obviously after atorvastatin treatment in treatment group (p<0.01), there were no significant changes in control group before and after treatment (p>0.05).Conclusion:A high dose of oral atorvastatin were supposed to have an important role in stabilizing vulnerable plaques. Contrast-Enhanced Ultrasonography showed to be reliable and effective in evaluating the vulnerable plaques. To reduce neovascularization in the carotid atherosclerotic plaques may be the possible mechanism. CEUS can be used as an effective means of treatment evaluation, and can be followed up on the review of carotid artery plaque.