Detection of subclinical atherosclerosis in familial hypercholesterolemia using non-invasive imaging modalities
Caballero P et al. – Asymptomatic middle–aged FH patients have significantly higher atherosclerotic burden than controls. Carotid intima–media thickness (cIMT) has shown a significant correlation with aortic wall volume and magnetic resonance imaging (MRI) allowed the detection of lipid–rich plaques in familial hypercholesterolemia (FH) subjects that were associated with family history of premature coronary artery disease.Methods
- The atherosclerotic burden of 36 molecularly defined FH patients (18 males, 45.7±10.9 years) without evidence of cardiovascular disease receiving lipid–lowering treatment and 19 (47.8±11.3 years) controls was investigated.
- Descending thoracic aorta magnetic resonance imaging (MRI) was performed in a 1.5T equipment with T1 and T2 sequences to characterize atherosclerotic plaques and to measure aortic wall volumen.
- Carotid intima–media thickness (cIMT) and presence of plaques were measured using B–mode carotid ultrasound.
- Mean aortic wall volumen, cIMT and atherosclerotic plaques in aorta were significantly higher in FH cases (P<0.001).
- A significant correlation between aortic wall volume and cIMT was observed (P<0.01).
- Aortic MRI detected plaques in 94% and carotid ultrasound in 14% of cases.
- Lipid–rich plaques were observed only in FH cases (33%) and were associated with family history of premature coronary artery disease (P<0.05).