title: Evaluating the effectiveness of rosuvastatin in preventing the progression of diastolic dysfunction in aortic stenosis: A substudy of the aortic stenosis progression observation measuring effects of rosuvastatin (ASTRONOMER) study.
abstract: BACKGROUND
  Tissue Doppler imaging (TDI) is a noninvasive echocardiographic method for the diagnosis of diastolic dysfunction in patients with varying degrees of aortic stenosis (AS). Little is known however, on the utility of TDI in the serial assessment of diastolic abnormalities in AS.
  
  
  OBJECTIVE
  The aim of the current proposal was to examine whether treatment with rosuvastatin was successful in improving diastolic abnormalities in patients enrolled in the Aortic Stenosis Progression Observation Measuring Effects of Rosuvastatin (ASTRONOMER) study.
  
  
  METHODS
  Conventional Doppler indices including peak early (E) and late (A) transmitral velocities, and E/A ratio were measured from spectral Doppler. Tissue Doppler measurements including early (E') and late (A') velocities of the lateral annulus were determined, and E/E' was calculated.
  
  
  RESULTS
  The study population included 168 patients (56 ± 13 years), whose AS severity was categorized based on peak velocity at baseline (Group I: 2.5-3.0 m/s; Group II: 3.1-3.5 m/s; Group III: 3.6-4.0 m/s). Baseline and follow-up hemodynamics, LV dimensions and diastolic functional parameters were evaluated in all three groups. There was increased diastolic dysfunction from baseline to follow-up in each of the placebo and rosuvastatin groups. In patients with increasing severity of AS in Groups I and II, the lateral E' was lower and the E/E' (as an estimate of increased left ventricular end-diastolic pressure) was higher at baseline (p < 0.05). However, treatment with rosuvastatin did not affect the progression of diastolic dysfunction from baseline to 3.5 year follow-up between patients in any of the three predefined groups.
  
  
  CONCLUSIONS
  In patients with mild to moderate asymptomatic AS, rosuvastatin did not attenuate the progression of diastolic dysfunction.
authors.affiliation: Cardiology Division, Department of Internal Medicine, St. Boniface General Hospital, Winnipeg, Manitoba, Canada. djassal@sbgh.mb.ca
authors.forename: Davinder S
authors.initials: DS
authors.lastname: Jassal
authors.forename: Kapil M
authors.initials: KM
authors.lastname: Bhagirath
authors.forename: Erin
authors.initials: E
authors.lastname: Karlstedt
authors.forename: Matthew
authors.initials: M
authors.lastname: Zeglinski
authors.forename: Jean G
authors.initials: JG
authors.lastname: Dumesnil
authors.forename: Koon K
authors.initials: KK
authors.lastname: Teo
authors.forename: James W
authors.initials: JW
authors.lastname: Tam
authors.forename: Kwan L
authors.initials: KL
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018450:Disease Progression; D015150:Echocardiography, Doppler; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage*; D005500:Follow-Up Studies; D054144:Heart Failure, Diastolic / Q000000981:diagnostic imaging / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011743:Pyrimidines / Q000008:administration & dosage*; D000068718:Rosuvastatin Calcium; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000008:administration & dosage*
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium