Department of Hypertension, Medical University of Łódź, Łódź, Poland.
Med Sci Monit. 2009 Dec;15(12):MS12-23.
We assessed the influence of atorvastatin on selected indicators of an inflammation, function of the left ventricle and factors affecting the occurrence of rehospitalisation and mortality in patients with dilated cardiomyopathy (DCM).
MATERIAL/METHODS: In a prospective, randomized study, 68 patients with DCM with LVEF <or=40% were divided into 2 groups: group A consisted of 41 patients who were administered atorvastatin 40 mg/daily for 2 months and 10 mg for the next 4 months; and B consisted of 27 patients who were treated without statin therapy. Initial tests included the measurement of TNF-alpha, IL-6, IL-10, and NT-proBNP concentrations, echocardiographic examination and the assessment of exercise capacity in the 6-min walk test (6-MWT).
In group A (vs group B), IL-6 was significantly lower (p<0.0001) after 2 months of treatment with atorvastatin. IL-6 and TNFalpha decreased significantly in group A, compared with initial values (p=0.0017 and p=0.0087, respectively). NT-proBNP was also significantly reduced in the atorvastatin group (p=0.0004), while in the control group an increase of NT-proBNP was observed (p=0.0021). After 6 months, the number of patients in NYHA class III was significantly decreased (from 47% to 22.5%) in group A, and the distance in 6-MWT considerably lengthened (p<0.05), while in group B the distance shortened significantly (p=0.0147). After 6 months, patients without statin treatment required more hospitalizations because of cardiac insufficiency (32% vs 12%, p=0.04).
Atorvastatin treatment significantly decreases the concentration of IL-6, and NT-proBNP in patients with DCM after 2 months of therapy. These results were consistent with the significant lengthening of the distance in 6-MWT, improvement of NYHA class, and fewer rehospitalizations due to heart failure, observed both after 2 and 6 months of atorvastatin treatment (ClinialTrial.gov No.: NCT01015144).
我们评估了阿托伐他汀对炎症、左心室功能的某些指标以及影响扩张型心肌病（DCM）患者再住院和死亡率的因素的影响。
材料/方法：在一项前瞻性、随机研究中，我们将 68 例 LVEF≤40%的 DCM 患者分为两组：A 组 41 例患者给予阿托伐他汀 40mg/d，持续 2 个月，然后给予 10mg/d 持续 4 个月；B 组 27 例患者未接受他汀类药物治疗。初始检查包括 TNF-α、IL-6、IL-10 和 NT-proBNP 浓度的测定、超声心动图检查和 6 分钟步行试验（6-MWT）运动能力评估。
A 组（与 B 组相比），阿托伐他汀治疗 2 个月后 IL-6 显著降低（p<0.0001）。A 组的 IL-6 和 TNFalpha 与初始值相比显著降低（p=0.0017 和 p=0.0087）。阿托伐他汀组的 NT-proBNP 也显著降低（p=0.0004），而对照组的 NT-proBNP 升高（p=0.0021）。6 个月后，A 组 NYHA 心功能分级 III 级患者数量显著减少（从 47%降至 22.5%），6-MWT 距离明显延长（p<0.05），而 B 组的距离明显缩短（p=0.0147）。6 个月后，未接受他汀治疗的患者因心功能不全需要更多的住院治疗（32%比 12%，p=0.04）。
阿托伐他汀治疗 2 个月后，可显著降低 DCM 患者的 IL-6 和 NT-proBNP 浓度。这些结果与 6-MWT 距离的显著延长、NYHA 心功能分级的改善以及阿托伐他汀治疗 2 个月和 6 个月后因心力衰竭再住院率的降低相一致（临床试验注册编号：NCT01015144）。
