The Effects of Statin Therapy on the Progression of Aortic Sclerosis

Joseph Brown (2010). The Effects of Statin Therapy on the Progression of Aortic Sclerosis MPhil Thesis, School of Medicine, The University of Queensland.

       
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Author Joseph Brown
Thesis Title The Effects of Statin Therapy on the Progression of Aortic Sclerosis
School, Centre or Institute School of Medicine
Institution The University of Queensland
Publication date 2010-03
Thesis type MPhil Thesis
Supervisor Dr Karam Kostner
Dr David Colquhoun
Total pages 73
Total colour pages 7
Total black and white pages 66
Subjects 11 Medical and Health Sciences
Abstract/Summary Chapter one of this thesis is a detailed introduction to aortic sclerosis and the statins. The first half of chapter one focuses primarily on the prevalence and pathogenesis of aortic sclerosis, whilst the second half introduces statins and explains the potential of statin therapy in modifying the pathogenesis of calcific aortic valve disease. Only over the last decade has the understanding of the pathogenesis of aortic valve calcification changed from being a simple degenerative disease to a complex and very active cellular process, characterised by lipid infiltration, oxidation and inflammation. Current literature supports the hypothesis that the pathogenesis of aortic sclerosis and 5 stenosis share many similarities with atherosclerosis, and thus statins have been proposed as a possible therapeutic strategy to modify the disease process. The clinical evidence for this hypothesis however remains controversial, since only advanced calcific disease states have been investigated with statin therapy. Currently, only limited data is available on the potential of lipid lowering with statins on early valve disease, such as aortic sclerosis. The penultimate section of chapter one is a detailed literature review of the published studies investigating the effects of statins therapy in calcific aortic valve disease. Finally, Chapter One is summarised with the rationale for which this manuscript is based, including the aims and hypotheses which embody the thesis. Chapter Two describes the methodology of the studies contained in the thesis, including an explanation of study design, statistical analysis and patient selection protocol, including flow diagrams depicting how patients were included, excluded and grouped. In addition, chapter two outlines the different techniques used in quantifying aortic sclerosis, including visual and Doppler assessment and calibrated integrated backscatter. There are two studies that form the main content of the thesis. Chapter Three is a retrospective investigation of statin use in patients with known aortic sclerosis. Chapter Four is a prospective, intervention study with a similar hypothesis, however investigates more thoroughly the specific effects of relative statin dose and the effects on progression of disease in patients who reach an actual target lipid level with statin therapy. Both the retrospective and prospective studies provide an interesting insight into the potential benefit of statin therapy in early calcific aortic valve disease, namely aortic sclerosis.
Keyword Aortic sclerosis, calcification, cholesterol, statin therapy, echocardiography, backscatter
Additional Notes Colour Pages: 16,20,33,34,37,39,47

 
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Created: Sat, 30 Oct 2010, 08:40:12 EST by Mr Joseph Brown on behalf of Library - Information Access Service