title: Effect of hydroxymethylglutaryl coenzyme-a reductase inhibitors on the long-term progression of rheumatic mitral valve disease.
abstract: BACKGROUND
  At present, no medical therapy is known to affect the progression of rheumatic mitral stenosis (MS). We sought to assess the effect of statin treatment on long-term progression of MS in a large population.
  
  
  RESULTS
  From our 20-year database, we identified all patients with rheumatic MS with > or =2 echocardiographies > or =1 year apart. Exclusion criteria were previous intervention on the mitral valve, more than moderate aortic regurgitation, or symptoms at first examination. The study sample included 315 patients (mean age, 61+/-12 years; 224 women); 35 patients (11.1%) were treated with statins, and 280 (88.9%) were not. Mean follow-up period was 6.1+/-4.0 years (range, 1 to 20). The rate of decrease in mitral valve area was significantly lower in the statin group compared with the untreated group (0.027+/-0.056 versus 0.067+/-0.082 cm(2)/y; P=0.005). The annualized change in mean transmitral gradient was lower in statin-treated patients (0.20+/-0.59 versus 0.58+/-0.96 mm Hg/y; P=0.023). The prevalence of fast MS progression (annual change in mitral valve area >0.08 cm(2)) was significantly lower in the statin group (P=0.008). An increase in systolic pulmonary artery pressure of >10 mm Hg was found in 17% of patients in the statin group versus 40% of untreated patients (P=0.045).
  
  
  CONCLUSIONS
  Our study shows a significantly slower progression of rheumatic MS in patients treated with statins. These findings could have an important impact in the early medical therapy of patients with rheumatic heart disease.
authors.affiliation: Cardiologia, ARC, Azienda Ospedaliera S. Maria degli Angeli, Via Montereale, 24, 33170 Pordenone, Italy. antonini.canterin@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Antonini-Canterin
authors.forename: Luis M
authors.initials: LM
authors.lastname: Moura
authors.forename: Roxana
authors.initials: R
authors.lastname: Enache
authors.forename: Elisa
authors.initials: E
authors.lastname: Leiballi
authors.forename: Daniela
authors.initials: D
authors.lastname: Pavan
authors.forename: Rita
authors.initials: R
authors.lastname: Piazza
authors.forename: Bogdan A
authors.initials: BA
authors.lastname: Popescu
authors.forename: Carmen
authors.initials: C
authors.lastname: Ginghina
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Nicolosi
authors.forename: Nalini M
authors.initials: NM
authors.lastname: Rajamannan
mesh_terms: D000368:Aged; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016208:Databases, Factual; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015999:Multivariate Analysis; D011669:Pulmonary Wedge Pressure; D012214:Rheumatic Heart Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors