Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America.
PLoS One. 2011;6(9):e25320. doi: 10.1371/journal.pone.0025320. Epub 2011 Sep 28.
Although statins impart a number of cardiovascular benefits, whether statin therapy during the peri-infarct period improves subsequent myocardial structure and function remains unclear. Thus, we evaluated the effects of atorvastatin on cardiac function, remodeling, fibrosis, and apoptosis after myocardial infarction (MI). Two groups of rats were subjected to permanent coronary occlusion. Group II (n = 14) received oral atorvastatin (10 mg/kg/d) daily for 3 wk before and 4 wk after MI, while group I (n = 12) received equivalent doses of vehicle. Infarct size (Masson's trichrome-stained sections) was similar in both groups. Compared with group I, echocardiographic left ventricular ejection fraction (LVEF) and fractional area change (FAC) were higher while LV end-diastolic volume (LVEDV) and LV end-systolic and end-diastolic diameters (LVESD and LVEDD) were lower in treated rats. Hemodynamically, atorvastatin-treated rats exhibited significantly higher dP/dt(max), end-systolic elastance (Ees), and preload recruitable stroke work (PRSW) and lower LV end-diastolic pressure (LVEDP). Morphometrically, infarct wall thickness was greater in treated rats. The improvement of LV function by atorvastatin was associated with a decrease in hydroxyproline content and in the number of apoptotic cardiomyocyte nuclei. We conclude that atorvastatin therapy during the peri-infarct period significantly improves LV function and limits adverse LV remodeling following MI independent of a reduction in infarct size. These salubrious effects may be due in part to a decrease in myocardial fibrosis and apoptosis.
尽管他汀类药物具有多种心血管益处,但在梗塞发生期间进行他汀类药物治疗是否能改善随后的心肌结构和功能仍不清楚。因此,我们评估了阿托伐他汀对心肌梗塞(MI)后心脏功能、重构、纤维化和细胞凋亡的影响。两组大鼠均进行永久性冠状动脉闭塞。第 II 组(n = 14)在 MI 前 3 周和 MI 后 4 周每天接受口服阿托伐他汀(10 mg/kg/d)治疗,而第 I 组(n = 12)接受等效剂量的载体。两组的梗塞面积(Masson 三色染色切片)相似。与第 I 组相比,治疗组的超声心动图左心室射血分数(LVEF)和分数面积变化(FAC)较高,而左心室舒张末期容积(LVEDV)和左心室收缩末期和舒张末期直径(LVESD 和 LVEDD)较低。在血流动力学方面,阿托伐他汀治疗的大鼠具有更高的 dP/dt(max)、收缩末期弹性(Ees)和前负荷可扩张性工作(PRSW),以及更低的左心室舒张末期压力(LVEDP)。形态计量学上,治疗组的梗塞壁厚度更大。阿托伐他汀治疗改善 LV 功能与羟脯氨酸含量和凋亡心肌细胞核数量减少有关。我们的结论是,梗塞发生期间的阿托伐他汀治疗可显著改善 LV 功能,并限制 MI 后不良的 LV 重构,而不减少梗塞面积。这些有益的效果可能部分归因于心肌纤维化和细胞凋亡的减少。