Influence of atorvastatin treatment on L-arginine cerebrovascular reactivity and flow-mediated dilatation in patients with lacunar infarctions.
OBJECTIVE
In our study we hypothesized that statins improve endothelial function in patients with lacunar infarctions (LI). Cerebral and systemic endothelial function was determined before and after 3-months treatment with atorvastatin.


METHODS
Cerebral endothelial function was determined by L-arginine reactivity and systemic endothelial function by flow-mediated dilatation (FMD) in patients with LI (18 patients, aged 61.1+/-7.6 years), 20 age- and gender-matched patients with similar risk factors (SR) and 19 age- and gender-matched healthy controls. The mean arterial velocity (v(m)) in both middle cerebral arteries was measured by transcranial Doppler sonography before, during and after a 30-minute intravenous infusion of L-arginine. FMD of the brachial artery after hyperaemia was determined. The measurements were repeated after 3-months treatment with 40 mg of atorvastatin per day.


RESULTS
L-arginine reactivity was decreased in LI patients (13.1+/-8.4%) and in patients with SR compared with healthy controls (P < or = 0.01). FMD was more impaired in patients with LI (0.06+/-4.9%) compared with patients with SR and healthy controls (P < or = 0.01). After atorvastatin treatment, L-arginine reactivity and FMD improved in both patients with LI (17.1+/-7.6%; 7.0+/-5.7%) and patients with SR (P < or = 0.01). Previously mildly increased cholesterol values normalized.


CONCLUSIONS
The decreased L-arginine reactivity and FMD improve after atorvastatin treatment in both patients with LI and patients with SR.
Pretnar-Oblak
Janja
J
Ljubljana Medical Centre, Department of Neurology, Zaloska 7, 1000 Ljubljana, Slovenia. janja.pretnar@kclj.si
Sabovic
Miso
M
Sebestjen
Miran
M
Pogacnik
Tomaz
T
Zaletel
Marjan
M
D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001120:Arginine / Q000494:pharmacology*; D000069059:Atorvastatin; D001794:Blood Pressure / Q000187:drug effects; D002245:Carbon Dioxide / Q000097:blood; D002544:Cerebral Infarction / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D015897:Comorbidity; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D018056:Hemorheology; D006538:Heptanoic Acids / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000494:pharmacology* / Q000627:therapeutic use; D012307:Risk Factors; D016037:Single-Blind Method; D017585:Ultrasonography, Doppler, Transcranial; D014664:Vasodilation / Q000187:drug effects* / Q000502:physiology; D014665:Vasodilator Agents / Q000494:pharmacology
D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D014665:Vasodilator Agents; D002245:Carbon Dioxide; D001120:Arginine; D000069059:Atorvastatin