[Effect of simvastatin therapy on endothelial function of hypercholesteremic patients with syndrome X].
BACKGROUND
Cardiac syndrome X patients often have both reduced coronary circulation and impaired systemic endothelial function.


OBJECTIVE
The aim of our study was to assess the effect of chronic statin therapy on exercise-induced "ischemic like" ST segment depression and on systemic endothelial function in cardiac syndrome X patients with hypercholesterolemia.


METHODS
In 25 hypercholesterolemic patients (15 males, mean age 55 +/- 3 years) with a normal coronary angiogram and positive exercise ECG test (> 0.1 mV ST segment depression) the flow mediated dilatation (FMD) was assessed by measuring the change in brachial artery diameter in response to hyperemic flow by vascular ultrasound. All patients were treated with 20 mg simvastatin in duration of 12 weeks. Following the treatment the exercise ECG and the vascular ultrasound studies were repeated.


RESULTS
There was a significant decrease in total serum cholesterol level (baseline = 5.82 +/- 0.19 mmol/L vs. study end = 4.49 +/- 0.17 mmol/L, p < 0.01) and significant increase in the serum HDL level (baseline = 1.05 +/- 0.16 mmol/L vs. study end = 1.11 +/- 0.14 mmol/L, p < 0.01) following the statin treatment. Parallelly brachial artery FMD increased significantly (baseline = 3.97 +/- 0.91% vs. study end = 6.84 +/- 0.89%, p < 0.05). Responses to nitroglycerin were similar during the time course of the study. The ischemia free stress test time was also higher at the study end (baseline = 5.18 +/- 2.01 min vs. study end = 6.01 +/- 1.94 min, p < 0.001).


CONCLUSIONS
The chronic statin therapy exerts beneficial effects both on systemic and coronary endothelial function in hypercholesterolemic patients with cardiac syndrome X.
Fábián
Emília
E
Belügyminisztérium Központi Kórház és Intézményei, III. Belgyógyászati és Kardiológia Osztály, Budapest. dr.fabian.emilia@ihklinika.hu
Varga
Albert
A
D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001916:Brachial Artery / Q000187:drug effects / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood; D004562:Electrocardiography; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D017566:Microvascular Angina / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D019821:Simvastatin / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects
D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol; D019821:Simvastatin