title: Influence of atorvastatin treatment on L-arginine cerebrovascular reactivity and flow-mediated dilatation in patients with lacunar infarctions.
abstract: 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.
authors.affiliation: Ljubljana Medical Centre, Department of Neurology, Zaloska 7, 1000 Ljubljana, Slovenia. janja.pretnar@kclj.si
authors.forename: Janja
authors.initials: J
authors.lastname: Pretnar-Oblak
authors.forename: Miso
authors.initials: M
authors.lastname: Sabovic
authors.forename: Miran
authors.initials: M
authors.lastname: Sebestjen
authors.forename: Tomaz
authors.initials: T
authors.lastname: Pogacnik
authors.forename: Marjan
authors.initials: M
authors.lastname: Zaletel
mesh_terms: 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
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D014665:Vasodilator Agents; D002245:Carbon Dioxide; D001120:Arginine; D000069059:Atorvastatin