Department of Cardiology, University Medical Center Nijmegen, Nijmegen, The Netherlands.
Clin Auton Res. 2010 Apr;20(2):73-8. doi: 10.1007/s10286-009-0041-2. Epub 2009 Dec 4.
Increased (central) sympathetic activity is a key feature of heart failure and associated with worse prognosis. Animal studies suggest that statin therapy can reduce central sympathetic outflow. This study assessed statin effects on (central) sympathetic activity in human chronic heart failure (CHF) patients.
Sympathetic activity was measured in eight patients with CHF patients during 8 weeks after discontinuation and 4 weeks after restart of statin therapy by microneurography for direct muscle sympathetic nerve recording (MSNA) and measurement of arterial plasma norepinephrine concentrations.
During discontinuation of statin therapy, MSNA was significantly increased (73 +/- 4 vs. 56 +/- 5 and 52 +/- 6 bursts/100 beats, p = 0.01). Burst frequency was significantly higher after statin discontinuation (42 +/- 3 burst/min without statin vs. 32 +/- 3 and 28 +/- 3 burst/min during statin therapy, p = 0.004). Mean normalized burst amplitude and total normalized MSNA were significantly higher after statin discontinuation (mean normalized burst amplitude 0.36 +/- 0.04 without statin vs. 0.29 +/- 0.04 and 0.22 +/- 0.04 during statin, p < 0.05; total normalized MSNA 15.70 +/- 2.78 without statin, vs. 9.28 +/- 1.41 and 6.56 +/- 1.83 during statin, p = 0.009). Arterial plasma norepinephrine levels and blood pressure were unaffected.
Statin therapy inhibits central sympathetic outflow in CHF patients, as measured by MSNA.
交感神经活性增高（中枢性）是心力衰竭的一个重要特征，并与预后不良相关。动物研究表明他汀类药物治疗可减少中枢交感神经输出。本研究评估了他汀类药物治疗对慢性心力衰竭（CHF）患者中枢交感神经活性的影响。
8 例 CHF 患者在停止他汀类药物治疗 8 周后和重新开始他汀类药物治疗 4 周后，通过微神经记录直接肌肉交感神经记录（MSNA）和动脉血浆去甲肾上腺素浓度测量来评估交感神经活性。
在停止他汀类药物治疗期间，MSNA 显著增加（73±4 比 56±5 和 52±6 次/100 次搏动，p=0.01）。在没有他汀类药物治疗时，MSNA 频率显著升高（42±3 次/分钟，而在他汀类药物治疗期间为 32±3 和 28±3 次/分钟，p=0.004）。在停止他汀类药物治疗后，平均归一化爆发幅度和总归一化 MSNA 显著升高（无他汀类药物时平均归一化爆发幅度为 0.36±0.04，而在他汀类药物治疗期间为 0.29±0.04 和 0.22±0.04，p<0.05；无他汀类药物时总归一化 MSNA 为 15.70±2.78，而在他汀类药物治疗期间为 9.28±1.41 和 6.56±1.83，p=0.009）。动脉血浆去甲肾上腺素水平和血压不受影响。
他汀类药物治疗抑制 CHF 患者的中枢交感神经输出，通过 MSNA 测量。
