To prevent cardiovascular events in hyperlipidaemic patients, plaque stabilization by inhibition of localized inflammatory reactions in the blood vessels is important in addition to cholesterol lowering. Cerivastatin, a 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor (statin), has more potent enzyme-inhibitory effects than other statins and has also been reported in vitro to inhibit, at low concentrations, various inflammatory reactions due to plaque instability. Cerivastatin was therefore administered over 12 months to five patients with hypercholesterolaemia and atherosclerotic plaque diagnosed by ultrasonography of the carotid artery, and changes in the plaque composition were determined. The mean cholesterol level decreased over the study period, although not significantly. However, the mean percentage of fibrous matrix of the plaque increased significantly from a mean of 11.2 ± 7.7% at study entry to 18.3 ± 5.9% at the end of the study. Additionally, the mean maximum plaque height was significantly reduced from 3.7 ± 0.9 mm to 3.0 ± 0.7 mm. These results indicate that cerivastatin induces plaque stability independently of cholesterol lowering.
The series of ECG examination were performed to study the influence of different kinds of exercise on heart of two untrained middle aged healthy male volunteers.One of them was assigned to run 10 kilometers or so, as fast as he could, once a day for 17 days. The other was assigned to run on a treadmill of three degree gradient for 20 minutes with a speed of 150 meters per minute once a day for 10 years. This volume of exercise was designed at a workload requiring 2/3 of his VO2max value.In the former case, frequent supraventricular premature beats with ventricular aberrant conduction occurred on the 21 st day from the beginning of the study. These changes on ECG were complicated with sinus arrhythmia and complete AV block on the 23 rd day. Sinus bradycardia and supraventricular bigeminy with ventricular aberrant conduction were noted on the 44 th day. Supraventricular bigeminies still persisted on the 213 th day, however they disappeared after that.The latter developed interpolated ventricular premature beats at rest for the first time in the 5 th year from the beginning of the study. These premature beats disappeared during exercise and recurred at rest. In the 8 th year ventricular premature beats became to show bigeminies.These results suggest that the severe exercise could cause various types of arrhythmia for a long period of time after the cessation of exercise even if the term of exercise would be short. On the other hand, the moderate load of exercise could not cause clinically significant arrhythmias inspite of continuous performance for a long term.
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