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

Abstract

Objectives: To investigate the effect of short-term statin treatment on impaired endothelium-dependent vasodilatation and haemodynamic abnormalities typically occurring in chronic heart failure (CHF). Methods: In a double-blind, crossover study endothelium-dependent vasodilatation was measured in conduit and resistance vessels of 23 patients with non-ischaemic CHF after 6 weeks of placebo and 40 mg atorvastatin. The haemodynamic impact was assessed by cardioendocrine hormones, echocardiography and clinical indicators of CHF. Results: Cholesterol concentrations were population average (low density lipoprotein 3.56 (SEM 0.16) mmol/l, triglycerides 1.70 (0.20) mmol/l and high density lipoprotein 1.17 (0.07) mmol/l). In resistance vessels, the area under the curve ratio during acetylcholine infusion increased from 9.2 (1.9) with placebo to 12.2 (2.1) with statin (p , 0.01). This improvement was reversed during co-infusion with the nitric oxide antagonist N G -monomethyl-L-arginine. In conduit arteries, flow-mediated dilatation increased from 5.64 (SEM 0.88)% with placebo to 6.83 (0.97)% with statin (p , 0.05). Endotheliumindependent vasodilatation did not change (p = 0.68 for conduit and p = 0.45 for resistance vessels). Endothelin 1 and atrial natriuretic peptide (ANP) decreased from 1.57 (0.08) and 51.3 (1.0) with placebo to 1.42 (0.09) pg/ml (p , 0.05) and 42.1 (7.5) pmol/l (p , 0.05), respectively, with statin. Conclusions: In patients with non-ischaemic CHF and population-average cholesterol concentrations, short-term statin treatment improves endothelial function in conduit and resistance vessels and lowers plasma endothelin 1 and ANP concentrations.

Platelet Hyperaggregability: Impaired Responsiveness to Nitric Oxide (“Platelet NO Resistance”) as a Therapeutic Target

“…While statins, in general, ameliorate endothelial dysfunction [68][69][70], there is mixed information about their impact on vascular NO responsiveness. For example, in type 1 diabetes mellitus patients, NTG-mediated dilatation in brachial artery increased after 6 weeks of therapy with atorvastatin (40 mg/ day) [69].…”

Sexual function and obesity

“…However, conflicting results on associations between use of hypolipidemic drugs and ED exist. Recent published studies by Taneva et al, 42 Strey et al 43 and Guven et al 44 suggest that statin therapy improves endothelial function, especially among patients with pre-existing endothelium dysfunction 44 and therefore found a potential positive effect from these compounds.…”

Atorvastatin Improves Endothelial Function and Cardiac Performance in Patients with Dilated Cardiomyopathy: The Role of Inflammation

“…Some clinical trials have found that statins lower serum markers of inflammation [3], improve endothelial and cardiac functions [4], and reduced hospitalization rates in patients with CHF [5]. Some large clinical studies have found that statins do not affect clinical outcomes in patients with ischemic heart failure [6] or chronic heart failure of ischemic or nonischemic etiology [7].…”