Abstract
Background
Several studies have shown regional left ventricular (LV) systolic and diastolic changes associated with coronary artery disease (CAD). Statins may have beneficial pleiotropic effects in addition to their lipid‐lowering properties.
Hypothesis
We hypothesized that atorvastatin can improve regional LV systolic and diastolic functions in CAD patients using tissue Doppler imaging (TDI).
Methods
A total of 63 patients with hyperlipemia and CAD were studied. Forty‐three patients were given 10 mg daily of atorvastatin and 20 patients were assigned only a low‐fat diet. Tissue Doppler imaging was applied to evaluate LV peak systolic velocity (VS), early diastolic velocity (VE), and late diastolic velocity (VA) in 18 segments. The mean value of LV peak systolic velocity (VS′), the mean value of early diastolic velocity (VE′), and the mean value of late diastolic velocity (VA′), in 18 segments were calculated.
Results
Compared with the baseline, VS′, and VE′, increased significantly after the therapy in the atorvastatin group (p < 0.05), while there was no change in the control group (p > 0.05). At 6 mo of therapy, a significant reduction in total cholesterol, triglyceride, and low‐density lipoprotein (LDL) cholesterol was observed in the 2 groups (p < 0.05).
Conclusions
These findings demonstrate that atorvastatin can improve regional LV systolic and diastolic functions in CAD patients independent of its lipid‐lowering properties. Copyright © 2008 Wiley Periodicals, Inc.
Keywords: tissue Doppler imaging, atorvastatin, left ventricle, systolic function, diastolic function
Full Text
The Full Text of this article is available as a PDF (102.3 KB).
References
- 1. Yuda S, Fang ZY, Marwick TH: Association of severe coronary stenosis with subclinical left ventricular dysfunction in the absence of infarction. J Am Soc Echocardiogr 2003; 16: 1163–1170. [DOI] [PubMed] [Google Scholar]
- 2. Zubelewicz‐Szkodzinska B, Szkodzinski J, Romanowski W, Blazelonis A, Danikiewicz A, et al.: Simvastatin decreases concentration of interleukin‐2 in hypercholesterolemic patients after treatment for 12 weeks. J Biol Regul Homeost Agents 2004; 18: 295–301. [PubMed] [Google Scholar]
- 3. Treasure CB, Klein JL, Weintraub WS, Talley JD, Stillabower ME, et al.: Beneficial effects of cholesterol‐lowering therapy on the coronary endothelium in patients with coronary artery disease. N Engl J Med 1995; 332: 481–487. [DOI] [PubMed] [Google Scholar]
- 4. Kuryata OV, Yeqorova YV: The influence of low‐dose atorvastatin on lipid levels and endothelial vascular function in patients with significant coronary artery stenosis. Kardiol Pol 2006; 64: 44–48. [PubMed] [Google Scholar]
- 5. Atalar E, Ozamen F, Hazneedaroglu I, Acil T, Ozer N, et al.: Effects of short‐term atorvastatin treatment on global fibrinolytic capacity, and sL‐selection and sFas levels in hyperlipidemic patients with coronary artery disease. Int J Cardiol 2002; 84: 227–231. [DOI] [PubMed] [Google Scholar]
- 6. Bountioukos M, Rizzello V, Krenning BJ, Bax JJ, Kertai MD, et al.: Effect of atorvastatin on myocardial contractile reserve assessed by tissue Doppler imaging in moderately hypercholesterolemic patients without heart disease. Am J Cardiol 2003; 92: 613–616. [DOI] [PubMed] [Google Scholar]
- 7. Fujimoto S, Oki T, Tabata T, Tanaka H, Yamada H, et al.: Novel approach to the quantitation of regional left ventricular systolic and diastolic function using tissue Doppler imaging to create a myocardial velocity profile and gradient. Circ J 2003; 67: 416–422. [DOI] [PubMed] [Google Scholar]
- 8. Lee KW, Blann AD, Lip GY: Impaired tissue Doppler diastolic function in patients with coronary artery disease: relationship to endothelial damage/dysfunction and platelet activation. Am Heart J 2005; 150: 756–766. [DOI] [PubMed] [Google Scholar]
- 9. Govind S, Saha S, Brodin LA, Ramesh SS, Arvind SR, et al.: Impaired myocardial functional reserve in hypertension and diabetes mellitus without coronary artery disease: searching for the possible link with congestive heart failure in the Myocardial Doppler in Diabetes (MYDID) Study DD. Am J Hypertens 2006; 19: 851–857. [DOI] [PubMed] [Google Scholar]
- 10. Rowland T, Heffernan K, Jae SY, Echols G, Fernhall B: Tissue Doppler assessment of ventricular function during cycling in 7‐ to 12‐yr‐old Boys. Med Sci Sports Exerc 2006; 38: 1216–1222. [DOI] [PubMed] [Google Scholar]
- 11. Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, et al.: Implication of recent clinical trials for the national cholesterol education program adult treatment panel DDD guidelines. Circulation 2004; 110: 227–239. [DOI] [PubMed] [Google Scholar]
- 12. Henneman MM, Bax JJ, Schuijf JD, Jukema JW, Holman ER, et al.: Global and regional left ventricular function: a comparison between gated SPECT, 2D echocardiography and multi‐slice computed tomography. Eur J Nucl Med Mol Imaging 2006; 33: 1452–1460. [DOI] [PubMed] [Google Scholar]
- 13. Oguzhan A, Abaci A, Eryol NK, Topsakal R, Seyfeil E: Colour tissue Doppler echocardiographic evaluation of right ventricular function in patients with right ventricular infarction. Cardiology 2003; 100: 41–46. [DOI] [PubMed] [Google Scholar]
- 14. Koyama J, Ray‐Sequin PA, Davidoff R, Falk RH: Usefulness of pulsed tissue Doppler imaging for evaluating systolic and diastolic left ventricular function in patients with AL (primary) amyloidosis. Am J Cardiol 2002; 89: 1067–1071. [DOI] [PubMed] [Google Scholar]
- 15. Kureishi Y, Luo Z, Shiojima I, Bialik A, Fulton D, et al.: The HMG‐CoA reductase inhibitor simvastatin activates the protein kinase Akt and promotes angiogenesis in normocholesterolemic animals. Nat Med 2000; 6: 1004–1010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. Baller D, Notohamiprodjo G, Gleichmann U, Holzinger J, Weise R, et al.: Improvement in coronary flow reserve determined by positron emission tomography after 6 mo of cholesterol‐lowering therapy in patients with early stages of coronary atherosclerosis. Circulation 1999; 99: 2871–2875. [DOI] [PubMed] [Google Scholar]
- 17. Huggins GS, Pasternak RC, Alpert NM, Fischman AJ, Gewirtz H: Effects of short‐term treatment of hyperlipidemia on coronary vasodilator function and myocardial perfusion in regions having substantial impairment of baseline dilator reserve. Circulation 1998; 98: 1291–1296. [DOI] [PubMed] [Google Scholar]
- 18. Sata M, Nishimatsu H, Suzuki E, Sugiura S, Yoshizumi M, et al.: Endothelial nitric oxide synthase is essential for the HMG‐CoA reductase inhibitor cerivastatin to promote collateral growth in response to ischemia. FASEB J 2001; 15: 2530–2532. [DOI] [PubMed] [Google Scholar]
- 19. Pourati I, Kimmelstiel C, Rand W, Karas RH: Statins use is associated with enhanced collateralization of severely diseased coronary arteries. Am Heart J 2003; 146: 876–881. [DOI] [PubMed] [Google Scholar]
- 20. Zoncu S, Pelliccia A, Mercuro G: Assessment of regional systolic and diastolic wall motion velocities in highly trained athletes by pulsed wave Doppler tissue imaging. J Am Soc Echocardiogr 2002; 15: 900–905. [DOI] [PubMed] [Google Scholar]