Takagi Atsushi, Tsurumi Yukio, Ishizuka Naoko, Omori Hisako, Arai Kotaro, Hagiwara Nobuhisa, Kasanuki Hiroshi
Department of Cardiology, Tokyo Women's Medical University Hospital, 8-1 Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan.
Heart Vessels. 2006 Sep;21(5):298-301. doi: 10.1007/s00380-006-0905-5. Epub 2006 Sep 29.
HMG-CoA reductase inhibitors (statins) have been shown to improve the endothelial function by lowering lipids. Recent studies also suggest a direct impact of statins on the vascular wall. We assessed the rapid effect of cerivastatin on the coronary flow velocity reserve (CFVR) using transthoracic Doppler echocardiography (TTDE). The coronary flow velocity from the distal left anterior descending artery was measured in 16 healthy subjects (all male, age 24-38 years) using a 5-MHz transducer, on the day before, just before, and 3 h after administering 0.3 mg of cerivastatin. Hyperemia was achieved by the intravenous administration of adenosine, and the CFVR was calculated as the radio of the mean diastolic hyperemic coronary flow velocity to the basal flow velocity. The serum lipid profile and high-sensitivity C-reactive protein (hsCRP) were measured. The CFVR following the single administration of cerivastatin increased from 2.93+/-0.58 to 3.91+/-0.86, P=0.003, and was significantly higher than the CFVR measured at the same time on the previous day (3.91+/-0.86 vs 3.37+/-0.48, P=0.009). Neither the serum lipid profile nor hsCRP exhibited a remarkable change after cerivastatin administration. We concluded that a single-dose administration of cerivastatin, an HMG-CoA reductase inhibitor, improves the coronary flow velocity reserve without modifying the serum lipid profile.
HMG-CoA还原酶抑制剂(他汀类药物)已被证明可通过降低血脂来改善内皮功能。近期研究还表明他汀类药物对血管壁有直接影响。我们使用经胸多普勒超声心动图(TTDE)评估了西立伐他汀对冠状动脉血流储备(CFVR)的快速作用。在16名健康受试者(均为男性,年龄24 - 38岁)中,使用5兆赫换能器在服用0.3毫克西立伐他汀前一天、即将服用时以及服用后3小时测量左前降支远端的冠状动脉血流速度。通过静脉注射腺苷实现充血,CFVR计算为平均舒张期充血冠状动脉血流速度与基础血流速度之比。测量血清脂质谱和高敏C反应蛋白(hsCRP)。单次服用西立伐他汀后的CFVR从2.93±0.58增加到3.91±0.86,P = 0.003,且显著高于前一天同一时间测量的CFVR(3.91±0.86对3.37±0.48,P = 0.009)。服用西立伐他汀后血清脂质谱和hsCRP均未出现明显变化。我们得出结论,单剂量服用HMG-CoA还原酶抑制剂西立伐他汀可改善冠状动脉血流储备,而不改变血清脂质谱。