Short-term statin therapy improves endothelial function and neurohormonal imbalance in normocholesteraemic patients with non-ischaemic heart failure

Christopher H Strey ¹, Joanna M Young ², John H Lainchbury ², Christopher M Frampton ², M Gary Nicholls ³, A Mark Richards ² and Russell S Scott ^2*

¹ Addenbrooke's Hospital, United Kingdom
² Christchurch Hospital and Christchurch School of Medicine and Health Sciences, New Zealand
³ United Arab Emirates University, United Arab Emirates

^* To whom correspondence should be addressed. E-mail: russel.scott{at}chmeds.ac.nz.

Accepted 9 May 2006

Abstract

Aims: To investigate the effect of short-term statin therapy on impaired endothelium-dependent vasodilatation and hemodynamic abnormalities typically occurring in chronic heart failure (CHF).

Methods: In a double-blind, cross-over study we measured endothelium-dependent vasodilatation in conduit and resistance vessels of 23 patients with non-ischemic CHF after 6 weeks placebo and 40mg atorvastatin therapy. The hemodynamic impact was assessed by cardioendocrine hormones, echocardiography and clinical indicators of CHF.

Results: Cholesterol levels were population average (LDL 3.56±0.16mmol/L, triglycerides 1.70±0.20 mmol/L, HDL 1.17±0.07mmol/L). In resistance vessels, the area under the curve ratio during acetylcholine infusion increased from 9.2±1.9 on placebo to 12.2±2.1 on statin therapy (p<0.01). This improvement was reversed during co-infusion with the nitric oxide antagonist L-NMMA. In conduit arteries, flow mediated dilation increased from 5.64±0.88% on placebo to 6.83±0.97% on statin therapy (p<0.05). Endothelium-independent vasodilatation did not change (p=0.45 for conduit and p=0.68 for resistance vessels). Endothelin-1 and atrial natriuretic peptide (ANP) decreased from 1.57±0.08 and 51.3±1.0 on placebo to 1.42±0.09pg/ml (p<0.05) and 42.1±7.5pmol/L (p<0.05) on statin therapy.

Conclusions: In patients with non-ischemic CHF and population average cholesterol levels short-term statin therapy improves endothelial function in conduit- and resistance vessels and lowers plasma endothelin-1 and ANP levels.

Keywords: brachial ultrasound, endothelial function, forearm plethysmography, heart failure, statin therapy

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Paulsen, L., Holm, C., Bech, J. N., Starklint, J., Pedersen, E. B. (2008). Effects of statins on renal sodium and water handling: Acute and short-term effects of atorvastatin on renal haemodynamics, tubular function, vasoactive hormones, blood pressure and pulse rate in healthy, normocholesterolemic humans. Nephrol Dial Transplant 23: 1556-1561 [Abstract] [Full Text]  
• Leite-Moreira, A F, Castro-Chaves, P (2006). Heart failure: statins for all?. Heart 92: 1537-1538 [Full Text]