Toyosato Hospital, Shiga, Japan.
Circ J. 2011;75(9):2160-6. doi: 10.1253/circj.cj-11-0222. Epub 2011 Jul 8.
Effects of statin therapy on cardiac sympathetic nerve activity in patients with chronic heart failure (CHF) have not previously been evaluated.
To compare the effects of lipophilic atorvastatin and hydrophilic rosuvastatin on cardiac sympathetic nerve activity in CHF patients with dilated cardiomyopathy (DCM), 63 stable outpatients with DCM, who were already receiving standard therapy for CHF, were randomized to atorvastatin (n = 32) or rosuvastatin (n = 31). We evaluated cardiac sympathetic nerve activity by cardiac ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy, hemodynamic parameters and neurohumoral factors before and after 6 months of treatment. There were no differences in the baseline characteristics of the 2 groups. In the rosuvastatin group, there were no changes in MIBG parameters, left ventricular ejection fraction or plasma levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) after 6 months of treatment. In contrast, the atorvastatin group showed a significant increase in the delayed heart/mediastinum count ratio (2.18 ± 0.4 vs. 2.36 ± 0.4, P < 0.0001), and the washout rate was significantly decreased (34.8 ± 5.7 vs. 32.6 ± 6.3%, P = 0.0001) after 6 months of treatment compared with the baseline values. The plasma NT-proBNP level was also significantly decreased (729 ± 858 vs. 558 ± 747 pg/ml, P = 0.0139).
Lipophilic atorvastatin but not hydrophilic rosuvastatin improves cardiac sympathetic nerve activity in CHF patients with DCM.
他汀类药物治疗对慢性心力衰竭（CHF）患者心脏自主神经活动的影响此前尚未得到评估。
为了比较亲脂性阿托伐他汀和亲水性瑞舒伐他汀对扩张型心肌病（DCM）CHF 患者心脏自主神经活动的影响，将 63 例稳定的 DCM 门诊患者随机分为阿托伐他汀组（n = 32）或瑞舒伐他汀组（n = 31），这些患者已经接受 CHF 的标准治疗。我们在治疗前和治疗 6 个月后通过心脏¹²³I-间碘苄胍（MIBG）闪烁显像、血流动力学参数和神经激素因子评估心脏自主神经活动。两组的基线特征无差异。在瑞舒伐他汀组，MIBG 参数、左心室射血分数或 N 末端 pro-B 型利钠肽（NT-proBNP）的血浆水平在治疗 6 个月后均无变化。相比之下，阿托伐他汀组在治疗 6 个月后延迟心脏/纵隔计数比（2.18 ± 0.4 比 2.36 ± 0.4，P < 0.0001）显著增加，洗脱率也显著降低（34.8 ± 5.7 比 32.6 ± 6.3%，P = 0.0001）。治疗 6 个月后，血浆 NT-proBNP 水平也显著降低（729 ± 858 比 558 ± 747 pg/ml，P = 0.0139）。
亲脂性阿托伐他汀而非亲水性瑞舒伐他汀可改善 DCM CHF 患者的心脏自主神经活动。
