Regression of Achilles tendon thickness after statin treatment in patients with familial hypercholesterolemia: An ultrasonographic study (Journal article)

Tsouli, S. G./ Xydis, V./ Argyropoulou, M. I./ Tselepis, A. D./ Elisaf, M./ Kiortsis, D. N.

Objective: Achilles tendon xanthomas (ATX) have been associated with increased cardiovascular risk in patients with familial hypercholesterolemia (FH). The aim of this study was to evaluate clinical and ultrasonographic changes of ATX in patients with FH under statin treatment. Methods: Achilles tendon thickness (ATT) and echostructure were studied by ultrasonography (US) in 80 unrelated heterozygous FH patients and in 80 age- and sex-matched controls. For ATT measurements the anterioposterior diameter (mm) of the Achilles tendon was measured on sagittal scans. Patients were treated with atorvastatin (mean dose 20 10 mg/day) and a follow-up examination was performed 12 months later. Results: Clinical examination revealed xanthomas in 15 patients. On US normal fibrillar echostructure (grade 1) of the Achilles tendon (AT) was observed in 42 patients, abnormal echostructure with diffuse heterogeneous echo pattern (grade 2) in 30 patients and focal hypoechoic lesions (grade 3) in 8 patients. At baseline, ATT of all patients (5.23 +/- 0.91 mm) was significantly larger compared with controls (4.20 +/- 0.70mm) (p<0.05). Patients with grades 2 (5.20 +/- 0.60mm) and 3 (6.98 +/- 1.07mm) had significantly larger ATT than those with grade 1 (4.90 +/- 0.55 mm), In < 0.05. Patients with grade I showed significant reduction in ATT after statin treatment (from 4.90 0.55 mm to 4.50 +/- 0.43 mm, p < 0.01). In patients with grades 2 and 3 abnormal echostructure remained unchanged and no significant reduction in ATT was observed. Conclusion: Statin treatment reduces ATT in FH patients with normal AT echostructure. Ultrasound detects AT structural involvement and is useful in the monitoring of response to treatment. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Θετικών Επιστημών. Τμήμα Χημείας
Keywords: achilles tendon thickness,familial hypercholesterolemia,atorvastatin,cholesteryl ester transfer,coronary-artery disease,receptor gene mutation,femoral atherosclerosis,computed-tomography,probucol treatment,xanthomas,pravastatin
URI: https://olympias.lib.uoi.gr/jspui/handle/123456789/9055
ISSN: 0021-9150
Link: <Go to ISI>://000268115000023
http://ac.els-cdn.com/S0021915008007740/1-s2.0-S0021915008007740-main.pdf?_tid=8c66cc3877eae55469dd588285b75834&acdnat=1333112364_8fbba45b648fcc9a055a4f7cfc95944a
Publisher: Elsevier Ireland
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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