title: Hydroxymethylglutaryl coenzyme-a reductase inhibitors delay the progression of rheumatic aortic valve stenosis a long-term echocardiographic study.
abstract: OBJECTIVE
  This study sought to assess the effect of hydroxymethylglutaryl coenzyme-A reductase inhibitors (statins) on the progression of rheumatic aortic valve stenosis.
  
  
  BACKGROUND
  The possible role of statins in slowing the progression of degenerative aortic valve stenosis (AS) is still debated. No information about the role of statin treatment in patients with rheumatic AS is available yet.
  
  
  METHODS
  From our 1988 to 2008 echocardiographic database, we retrospectively identified all patients with rheumatic AS, with a baseline peak aortic velocity >or=1.5 m/s and at least 2 echocardiographic studies >or=2 years apart. Exclusion criteria were: severe aortic regurgitation, bicuspid aortic valve, and left ventricular ejection fraction <40%.
  
  
  RESULTS
  The study population consisted of 164 patients (30 treated with statins) followed up for 8.5 +/- 4.2 years. Peak aortic velocity at baseline was not different in patients treated with statins versus untreated patients (2.3 +/- 0.8 m/s vs. 2.3 +/- 0.7 m/s, p = 0.84). There were no significant differences in sex, age, or follow-up duration between the 2 groups. Progression of AS severity was slower in patients receiving statins compared with untreated patients (annual change of peak aortic velocity: 0.05 +/- 0.07 m/s/year vs. 0.12 +/- 0.11 m/s/year, p = 0.001). An annual rate of peak velocity progression >or=0.1 m/s was found in 10% of statin-treated patients and in 49% of untreated patients (p < 0.0001).
  
  
  CONCLUSIONS
  This is the first observation of a positive effect of statin treatment in reducing the progression of rheumatic AS. The underlying mechanisms remain to be clarified.
authors.affiliation: Cardiologia ARC, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy. cardiologia@aopn.fvg.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Antonini-Canterin
authors.forename: Elisa
authors.initials: E
authors.lastname: Leiballi
authors.forename: Roxana
authors.initials: R
authors.lastname: Enache
authors.forename: Bogdan A
authors.initials: BA
authors.lastname: Popescu
authors.forename: Monica
authors.initials: M
authors.lastname: Roşca
authors.forename: Eugenio
authors.initials: E
authors.lastname: Cervesato
authors.forename: Rita
authors.initials: R
authors.lastname: Piazza
authors.forename: Carmen
authors.initials: C
authors.lastname: Ginghină
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Nicolosi
mesh_terms: D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D018618:Echocardiography, Doppler, Color / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors