Reply to Letter Regarding Article, "Impact of Statin Therapy on Left Ventricular Function and Carotid Arterial Stiffness in Patients With Hypercholesterolemia"(Letter to the Editor)

We appreciate the interesting comments by Dr Ntaios and colleagues who raised several important points that were not emphasized in our article.1 We demonstrated that 1-year pitavastatin treatment improves left ventricular function and carotid arterial stiffness, but there was an insufficient effect of pitavastatin on carotid intima–media thickness (IMT) in our study. 1 As they pointed out, however, several other studies have indicated that statin therapy decreases carotid IMT. 2–9 In our study, the maximum and mean IMTs after pitavastatin therapy tended to decrease, but there were no significant differences. In addition, we previously reported that left ventricular function, particularly diastolic function, is strongly related to carotid or aortic arterial stiffness rather than carotid IMT in subclinical patients with cardiovascular risk factors. 10,11