Improvement in the function of hibernating myocardium in a patient with heart failure due to coronary artery disease receiving high-dose simvastatin.
We report the case of a 70-year-old man with a history of myocardial infarction and coronary artery bypass grafting, presenting with signs and symptoms of heart failure. Cardiac magnetic resonance imaging demonstrated a small amount of scarring in the anteroseptal wall, moderate left ventricular enlargement, and a left ventricular ejection fraction of 26%. Patient was started on simvastatin 20 mg daily, gradually increased to 80 mg daily, which were maintained for another 4 weeks. Twelve weeks after the initial presentation, the patient experienced a marked improvement in his symptoms. Repeat cardiac magnetic resonance imaging showed global improvement in left ventricular contractility, with ejection fraction of 36% and end-diastolic volume decreasing from 230 to 153 ml. We speculate that high-dose statin therapy had a significant role in improving the ventricular function in our patient by improving the endothelial flow. This hypothesis is presently being tested in a larger prospective trial.
Gheorghiade
Mihai
M
Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. m-gheorghiade@northwestern.edu
Klein
Liviu
L
Stone
Neil J
NJ
Bonow
Robert O
RO
Kim
Raymond J
RJ
D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004305:Dose-Response Relationship, Drug; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects; D017682:Myocardial Stunning / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D019821:Simvastatin / Q000008:administration & dosage*; D013318:Stroke Volume / Q000187:drug effects; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin