Effects of rosuvastatin on coronary flow reserve and metabolic mismatch in patients with heart failure (from the CORONA Study).
In patients with heart failure (HF), statin treatment might improve myocardial perfusion, but could also have detrimental effects on myocardial metabolism. A predefined substudy of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA) trial sought to determine the effects of statin treatment on myocardial blood flow reserve and cardiac metabolism. Sixteen patients with HF (New York Heart Association class II or III) were randomized to rosuvastatin 10 mg/day (n = 8) or placebo treatment (n = 8). At baseline and after 6 months of treatment, nitrogen-13 ammonia at rest and after dipyridamole stress and 18-fluorodeoxyglucose positron emission tomography were performed. Rosuvastatin treatment significantly lowered total (-36%, p <0.01) and low-density lipoprotein (-47%, p <0.001) cholesterol and C-reactive protein levels (-36%, p <0.05). Myocardial perfusion reserve (ratio) changed from 1.64 +/- 0.90 to 1.30 +/- 0.37 in placebo-treated and from 1.51 +/- 0.18 to 1.55 +/- 0.34 in rosuvastatin-treated patients (p = NS). Metabolic mismatch changed from 4.25 +/- 2.37% to 4.38 +/- 3.81% in placebo-treated and from 5.13 +/- 2.75% to 3.50 +/- 2.73% in rosuvastatin-treated patients (p = NS). In conclusion, changes regarding myocardial perfusion and metabolic mismatch after 6 months of rosuvastatin treatment in patients with HF did not suggest any beneficial or adverse effects in this pilot study, although due to the small numbers of patients small effects might have been missed.
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. p.van.der.harst@thorax.umcg.nl
Pim
P
van der Harst
Riemer H J A
RH
Slart
Rene A
RA
Tio
Peter H J M
PH
Dunselman
Antoon T M
AT
Willemsen
Ad F M
AF
van den Heuvel
Adriaan A
AA
Voors
Dirk J
DJ
van Veldhuisen
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000096:biosynthesis; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003326:Coronary Circulation / Q000187:drug effects*; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use*; D019788:Fluorodeoxyglucose F18; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D009426:Netherlands; D010865:Pilot Projects; D011743:Pyrimidines / Q000627:therapeutic use*; D019275:Radiopharmaceuticals; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use*; D014055:Tomography, Emission-Computed; D014665:Vasodilator Agents
D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008074:Lipoproteins; D011743:Pyrimidines; D019275:Radiopharmaceuticals; D013449:Sulfonamides; D014665:Vasodilator Agents; D019788:Fluorodeoxyglucose F18; D004176:Dipyridamole; D000068718:Rosuvastatin Calcium; D002097:C-Reactive Protein