title: Dose-dependent effects of short term atorvastatin treatment on arterial wall properties and on indices of left ventricular remodeling in ischemic heart failure.
abstract: OBJECTIVE
  Statins, beyond their lipid lowering role, exert beneficial effect on endothelial function in patients with atherosclerosis. Aim of the present study was to examine the short term pleiotropic effects of different doses of atorvastatin treatment, on endothelial function, arterial stiffness and indices of left ventricular remodeling in heart failure (HF) patients.
  
  
  METHODS
  We studied the effect of 4 weeks administration of atorvastatin in 22 patients with ischemic HF. The study was carried out on two separate arms, one with atorvastatin 40 mg/d and one with atorvastatin 10 mg/d (randomized, double-blind, cross-over design). Endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery and arterial stiffness by augmentation index (AIx). Serum levels of matrix metalloproteinase-9 (MMP-9) and intracellular adhesion molecule-1 (sICAM-1) were measured as biomarkers of left ventricular remodeling and endothelial function, respectively, while, b-type natriuretic peptide (BNP) was measured as a marker of left ventricular function.
  
  
  RESULTS
  Compared to baseline, atorvastatin 40 mg/d significantly improved FMD values (3.18 ± 3.03% vs. 5.98 ± 2.49%, p = 0.001) and AIx values (25.98 ± 8.55% vs. 23.09 ± 8.87%, p = 0.046). In addition, compared to baseline measurements, treatment with atorvastatin 40 mg/d resulted in significantly decreased levels of serum logMMP-9 levels (2.47 ± 0.23 ng/ml vs. 2.39 ± 0.24 ng/ml, p = 0.04) and of logICAM-1 levels (2.46 ± 0.13 ng/ml vs. 2.37 ± 0.16 ng/ml, p < 0.001). No significant changes were found after treatment with atorvastatin 10 mg/d in the aforementioned parameters.
  
  
  CONCLUSIONS
  Short term treatment with 40 mg/d of atorvastatin exerts beneficial impact on arterial wall properties and on indices of left ventricle remodeling in heart failure patients.
authors: 1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Vasilissis Sofias 114, TK 115 28 Athens, Greece. drtousoulis@hotmail.com
authors: Dimitris
authors: D
authors: Tousoulis
authors: Evangelos
authors: E
authors: Oikonomou
authors: Gerasimos
authors: G
authors: Siasos
authors: Christine
authors: C
authors: Chrysohoou
authors: Marina
authors: M
authors: Zaromitidou
authors: Stamatis
authors: S
authors: Kioufis
authors: Konstantinos
authors: K
authors: Maniatis
authors: Polychronis
authors: P
authors: Dilaveris
authors: Antigoni
authors: A
authors: Miliou
authors: Stavroula
authors: S
authors: Michalea
authors: Athanasios G
authors: AG
authors: Papavassiliou
authors: Christodoulos
authors: C
authors: Stefanadis
mesh_terms: D000368:Aged; D001158:Arteries / Q000187:drug effects*; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000378:metabolism; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects*; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011758:Pyrroles / Q000627:therapeutic use*; D012044:Regression Analysis; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D020097:Natriuretic Peptide, Brain; D018799:Intercellular Adhesion Molecule-1; D000069059:Atorvastatin; D020780:Matrix Metalloproteinase 9