1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Vasilissis Sofias 114, TK 115 28 Athens, Greece.
Atherosclerosis. 2013 Apr;227(2):367-72. doi: 10.1016/j.atherosclerosis.2013.01.015. Epub 2013 Jan 21.
Statins, beyond their lipid lowering role, exert beneficial effect on endothelial function in patients with atherosclerosis. Aim of the present study was to examine the short term pleiotropic effects of different doses of atorvastatin treatment, on endothelial function, arterial stiffness and indices of left ventricular remodeling in heart failure (HF) patients.
We studied the effect of 4 weeks administration of atorvastatin in 22 patients with ischemic HF. The study was carried out on two separate arms, one with atorvastatin 40 mg/d and one with atorvastatin 10 mg/d (randomized, double-blind, cross-over design). Endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery and arterial stiffness by augmentation index (AIx). Serum levels of matrix metalloproteinase-9 (MMP-9) and intracellular adhesion molecule-1 (sICAM-1) were measured as biomarkers of left ventricular remodeling and endothelial function, respectively, while, b-type natriuretic peptide (BNP) was measured as a marker of left ventricular function.
Compared to baseline, atorvastatin 40 mg/d significantly improved FMD values (3.18 ± 3.03% vs. 5.98 ± 2.49%, p = 0.001) and AIx values (25.98 ± 8.55% vs. 23.09 ± 8.87%, p = 0.046). In addition, compared to baseline measurements, treatment with atorvastatin 40 mg/d resulted in significantly decreased levels of serum logMMP-9 levels (2.47 ± 0.23 ng/ml vs. 2.39 ± 0.24 ng/ml, p = 0.04) and of logICAM-1 levels (2.46 ± 0.13 ng/ml vs. 2.37 ± 0.16 ng/ml, p < 0.001). No significant changes were found after treatment with atorvastatin 10 mg/d in the aforementioned parameters.
Short term treatment with 40 mg/d of atorvastatin exerts beneficial impact on arterial wall properties and on indices of left ventricle remodeling in heart failure patients.
他汀类药物除了降低血脂作用外，还对动脉粥样硬化患者的内皮功能产生有益影响。本研究的目的是研究不同剂量阿托伐他汀治疗对心力衰竭（HF）患者内皮功能、动脉僵硬度和左心室重构指数的短期多效作用。
我们研究了 22 例缺血性 HF 患者接受 4 周阿托伐他汀治疗的效果。该研究分为两个独立的部分，一部分给予阿托伐他汀 40mg/d，另一部分给予阿托伐他汀 10mg/d（随机、双盲、交叉设计）。通过肱动脉血流介导的扩张（FMD）评估内皮功能，通过增强指数（AIx）评估动脉僵硬度。测量血清基质金属蛋白酶-9（MMP-9）和细胞间黏附分子-1（sICAM-1）水平作为左心室重构和内皮功能的生物标志物，而 B 型利钠肽（BNP）作为左心室功能的标志物。
与基线相比，阿托伐他汀 40mg/d 可显著改善 FMD 值（3.18±3.03%比 5.98±2.49%，p=0.001）和 AIx 值（25.98±8.55%比 23.09±8.87%，p=0.046）。此外，与基线测量相比，阿托伐他汀 40mg/d 治疗可显著降低血清 logMMP-9 水平（2.47±0.23ng/ml 比 2.39±0.24ng/ml，p=0.04）和 logICAM-1 水平（2.46±0.13ng/ml 比 2.37±0.16ng/ml，p<0.001）。阿托伐他汀 10mg/d 治疗后，上述参数无明显变化。
短期 40mg/d 阿托伐他汀治疗对心力衰竭患者的动脉壁特性和左心室重构指数具有有益影响。
