Early impairment of left ventricular function in hypercholesterolemia and its reversibility after short term treatment with rosuvastatin A preliminary echocardiographic study.
BACKGROUND
Hypercholesterolemia contributes to coronary heart disease but little is known about its direct effect on myocardial function. We evaluated left ventricular function using echocardiography and the effect of treatment with rosuvastatin in a group of patients with primary hypercholesterolemia.


RESULTS
Thirty-three patients with primary hypercholesterolemia (HC) and without evidence of coronary heart disease and 25 aged matched healthy volunteers (C) were submitted to conventional echocardiography, pulsed wave tissue Doppler imaging (PWTDI), color Doppler myocardial imaging (CDMI) and integrated backscatter (IBS). Echocardiographic evaluation was repeated after 6 months of treatment with rosuvastatin (10mg/day) in 17 patients. Compared with C, patients with HC showed lower E/A ratio (p<0.0001) and higher Tei index mit (p<0.0001), as well as lower PW TDI E/A both at septum (p<0.0001) and at lateral level (p<0.0001) and higher modified Tei index both at septal annulus (p<0.0001) and lateral annulus (p<0.0001). Integrated backscatter parameters were significantly reduced in patients with HC (CVIsept p<0.0001 and CVI post wall p<0.05). CDMI derived indices in the two groups were not different. After 6 months of Rosuvastatin treatment a significant reduction of LDL cholesterol levels (51%, p<0.0001) was registered in HC patients together with a significant improvement of longitudinal global systolic and diastolic function (Tei index) and myocardial intrinsic contractility (CVI).


CONCLUSIONS
These data suggest that in patients with hypercholesterolemia exists an early cardiomyopathy characterized by systolic and diastolic dysfunction. That could produce a substratum for an "impaired preconditioning". Rosuvastatin seems able to revert systolic abnormalities.
Talini
Enrica
E
Cardiac Thoracic and Vascular Department, University of Pisa, Italy. e.talini@yahoo.it
Di Bello
Vitantonio
V
Bianchi
Cristina
C
Palagi
Caterina
C
Delle Donne
Maria Grazia
MG
Penno
Giuseppe
G
Nardi
Carmela
C
Canale
Maria Laura
ML
Del Prato
Stefano
S
Mariani
Mario
M
Miccoli
Roberto
R
D000328:Adult; D001783:Blood Flow Velocity; D003720:Densitometry; D003971:Diastole; D018618:Echocardiography, Doppler, Color; D005464:Fluorobenzenes / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D006937:Hypercholesterolemia / Q000150:complications* / Q000188:drug therapy*; D008875:Middle Aged; D010865:Pilot Projects; D011743:Pyrimidines / Q000008:administration & dosage*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage*; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*
D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium