Assessing Impact of High-Dose Pitavastatin on Carotid Artery Elasticity with Speckle-Tracking Strain Imaging

Aim: Speckle-tracking imaging has been introduced for the precise assessment of vessel mechanics. However, there are no data on the role of this imaging tool in assessing the changes in vasculature with statin therapy, which is known to enhance vascular elasticity. Methods: This study was a prospective study including 48 statin-naïve patients (age, 58.2 ± 8.4 years; 29.2% male) with hypercholesterolemia. Circumferential carotid artery strain (CAS) and stiffness index (β(2)) were measured using speckle-tracking imaging before and after 3 months of high-dose pitavastatin treatment (4 mg daily). For the comparison, we measured conventional carotid elasticity parameters and intima–media thickness using B-mode ultrasound at the same time points. Results: Compared with baseline, there was significant improvement in circumferential CAS (2.98% ± 1.18% to 3.40% ± 1.43%, p = 0.008) and β(2) (0.19 ± 0.07 to 0.17 ± 0.08, p = 0.047) after statin therapy. Contrariwise, there were no significant changes in all conventional carotid elasticity metrics and intima–media thickness. When stratifying patients into two subgroups by 10 year atherosclerotic cardiovascular disease (ASCVD) risk, speckle-tracking-derived circumferential CAS and β(2) improved significantly only in patients with ASCVD risk ≥ 7.5%. Conclusions: Short-term treatment with high-dose pitavastatin improved carotid artery elasticity measured by speckle-tracking method, but not conventional parameters by B-mode ultrasound. Speckle-tracking-based measurements may allow the early noninvasive assessment of statin effects on vascular function in hypercholesterolemic patients. Abbreviations: CAS: carotid artery strain, β(1): classic stiffness index, β(2): speckle-tracking-derived stiffness index, IMT: intima-media thickness, ASCVD: atherosclerotic cardiovascular disease, CHD: coronary heart disease, LCL-C: low-density lipoprotein cholesterol, HDL-C: high-density lipoprotein cholesterol, CCA: common carotid artery