title: Treatment with atorvastatin is associated with a better prognosis in chronic heart failure with systolic dysfunction: results from The Daunia Heart Failure Registry.
abstract: BACKGROUND
  Few works have evaluated the effect of statins on left ventricular dysfunction in patients with chronic heart failure (CHF), by using tissue Doppler imaging (TDI). We therefore aimed to investigate whether atorvastatin treatment may influence prognosis and myocardial performance evaluated by TDI in subjects with CHF.
  
  
  METHODS
  Five hundred thirty-two consecutive CHF outpatients enrolled in a local registry, the Daunia Heart Failure Registry, were prospectively analysed. 195 patients with CHF and left ventricular ejection fraction (LVEF) ≤40 %, either in treatment with atorvastatin (N: 114) or without statins (N: 81), underwent TDI examination. Adverse events were evaluated during follow-up.
  
  
  RESULTS
  The atorvastatin group showed a lower incidence of adverse events (cardiac death: 0 % vs 7 %, p < 0.01), and better TDI performance (E/E' 15 ± 5.7 vs 18 ± 8.3, p < 001) than controls. Ischaemic CHF patients in treatment with atorvastatin also showed a lower incidence of adverse events (death: 10 % vs 26 %, p < 0.05; sustained ventricular arrhythmias: 5 % vs 19 %, p < 0.05, cardiac death: 0 vs 8 %, p < 0.05) and better TDI performance (E/E' ratio: 15.00 ± 5.68 vs 19.72 ± 9.14, p < 0.01; St: 353.70 ± 48.96 vs 303.33 ± 68.52 msec, p < 0.01) than controls. The association between atorvastatin and lower rates of cardiac death remained statistically significant even after correction in a multivariable analysis (RR 0.83, 95 % CI 0.71-0.96, p < 0.05 in CHF with LVEF ≤40 %; RR 0.77, 95 % CI 0.62-0.95, p < 0.05 in ischaemic CHF with LVEF ≤40 %).
  
  
  CONCLUSIONS
  Treatment with atorvastatin in outpatients with systolic CHF is associated with fewer cardiac deaths, and a better left ventricular performance, as assessed by TDI.
authors.affiliation: Department of Cardiology, University of Foggia, "Ospedali Riuniti" OO.RR, viale L Pinto, 1, 71100, Foggia, Italy, opsfco@tin.it.
authors.forename: M
authors.initials: M
authors.lastname: Correale
authors.forename: A
authors.initials: A
authors.lastname: Totaro
authors.forename: T
authors.initials: T
authors.lastname: Passero
authors.forename: S
authors.initials: S
authors.lastname: Abruzzese
authors.forename: F
authors.initials: F
authors.lastname: Musaico
authors.forename: A
authors.initials: A
authors.lastname: Ferraretti
authors.forename: R
authors.initials: R
authors.lastname: Ieva
authors.forename: M
authors.initials: M
authors.lastname: Di Biase
authors.forename: N D
authors.initials: ND
authors.lastname: Brunetti