title: The effect of rosuvastatin on inflammation, matrix turnover and left ventricular remodeling in dilated cardiomyopathy: a randomized, controlled trial.
abstract: BACKGROUND
  Dilated cardiomyopathy is characterized by left ventricular dilatation and dysfunction. Inflammation and adverse remodeling of the extracellular matrix may be involved in the pathogenesis. Statins reduce levels of low density lipoprotein cholesterol, but may also attenuate inflammation and affect matrix remodeling. We hypothesized that treatment with rosuvastatin would reduce or even reverse left ventricular remodeling in dilated cardiomyopathy.
  
  
  METHODS
  In this multicenter, randomized, double blind, placebo-controlled study, 71 patients were randomized to 10 mg of rosuvastatin or matching placebo. Physical examination, blood sampling, echocardiography and cardiac magnetic resonance imaging were performed at baseline and at six months' follow-up. The pre-specified primary end point was the change in left ventricular ejection fraction from baseline to six months.
  
  
  RESULTS
  Over all, left ventricular ejection fraction improved 5 percentage points over the duration of the study, but there was no difference in the change in left ventricular ejection fraction between patients allocated to rosuvastatin and those allocated to placebo. Whereas serum low density lipoprotein cholesterol concentration fell significantly in the treatment arm, rosuvastatin did not affect plasma or serum levels of a wide range of inflammatory variables, including C-reactive protein. The effect on markers of extracellular matrix remodeling was modest.
  
  
  CONCLUSIONS
  Treatment with rosuvastatin does not improve left ventricular ejection fraction in patients with dilated cardiomyopathy.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00505154.
authors.affiliation: Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway ; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Kaspar
authors.initials: K
authors.lastname: Broch
authors.affiliation: Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway ; Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Erik T
authors.initials: ET
authors.lastname: Askevold
authors.affiliation: Department of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust; Drammen, Norway.
authors.forename: Erik
authors.initials: E
authors.lastname: Gjertsen
authors.affiliation: Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway ; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Thor
authors.initials: T
authors.lastname: Ueland
authors.affiliation: Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Arne
authors.initials: A
authors.lastname: Yndestad
authors.affiliation: Department of Endocrinology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Godang
authors.affiliation: Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Wenche
authors.initials: W
authors.lastname: Stueflotten
authors.affiliation: Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Johanna
authors.initials: J
authors.lastname: Andreassen
authors.affiliation: Department of Radiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Rolf
authors.initials: R
authors.lastname: Svendsmark
authors.affiliation: Department of Radiology, Oslo University Hospital Rikshospitalet, Oslo, Norway ; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Hans-Jørgen
authors.initials: HJ
authors.lastname: Smith
authors.affiliation: Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
authors.forename: Svend
authors.initials: S
authors.lastname: Aakhus
authors.affiliation: Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway ; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway ; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Pål
authors.initials: P
authors.lastname: Aukrust
authors.affiliation: Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway ; Faculty of Medicine, University of Oslo, Oslo, Norway ; K. G. Jebsen Cardiac Research Centre and Center for Heart Failure Research, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Gullestad
mesh_terms: D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy* / Q000503:physiopathology; D008078:Cholesterol, LDL / Q000097:blood; D005109:Extracellular Matrix / Q000187:drug effects / Q000378:metabolism; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007249:Inflammation / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000627:therapeutic use*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium