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[Effect of simvastatin therapy on endothelial function of hypercholesteremic patients with syndrome X]
1Belügyminisztérium Központi Kórház és Intézményei, III. Belgyógyászati és Kardiológia Osztály, Budapest. dr.fabian.emilia@ihklinika.hu
Insights
Chronic statin therapy improved endothelial function and exercise capacity in patients with cardiac syndrome X. This treatment reduced cholesterol and enhanced flow-mediated dilation (FMD), indicating better vascular health.
Area of Science:
- Cardiology
- Vascular Medicine
- Pharmacology
Background:
- Cardiac Syndrome X is characterized by reduced coronary circulation and impaired systemic endothelial function.
- Hypercholesterolemia is a common comorbidity in these patients.
- Exercise-induced ST segment depression indicates myocardial ischemia.
Purpose of the Study:
- To evaluate the impact of chronic statin therapy on exercise-induced ST segment depression.
- To assess the effect of statins on systemic endothelial function in Cardiac Syndrome X patients.
- To investigate changes in flow-mediated dilation (FMD) following simvastatin treatment.
Main Methods:
- 25 hypercholesterolemic patients with Cardiac Syndrome X underwent assessment of FMD via brachial artery ultrasound.
- Patients received 20 mg of simvastatin daily for 12 weeks.
- Exercise electrocardiography (ECG) and vascular ultrasound studies were repeated post-treatment.
Main Results:
- Simvastatin significantly reduced total serum cholesterol and increased HDL levels.
- Brachial artery FMD significantly increased post-treatment, indicating improved endothelial function.
- Ischemia-free stress test duration also significantly increased.
Conclusions:
- Chronic statin therapy demonstrates beneficial effects on both systemic and coronary endothelial function.
- Statin treatment can improve exercise capacity and reduce ischemic events in Cardiac Syndrome X.
- Simvastatin is an effective therapeutic option for managing hypercholesterolemia and improving vascular health in these patients.
Introduction:
Cardiac syndrome X patients often have both reduced coronary circulation and impaired systemic endothelial function.
Aims:
The aim of our study was to assess the effect of chronic statin therapy on exercise-induced "ischemic like" ST segment depression and on systemic endothelial function in cardiac syndrome X patients with hypercholesterolemia.
Patients/Methods:
In 25 hypercholesterolemic patients (15 males, mean age 55 +/- 3 years) with a normal coronary angiogram and positive exercise ECG test (> 0.1 mV ST segment depression) the flow mediated dilatation (FMD) was assessed by measuring the change in brachial artery diameter in response to hyperemic flow by vascular ultrasound. All patients were treated with 20 mg simvastatin in duration of 12 weeks. Following the treatment the exercise ECG and the vascular ultrasound studies were repeated.
Results:
There was a significant decrease in total serum cholesterol level (baseline = 5.82 +/- 0.19 mmol/L vs. study end = 4.49 +/- 0.17 mmol/L, p < 0.01) and significant increase in the serum HDL level (baseline = 1.05 +/- 0.16 mmol/L vs. study end = 1.11 +/- 0.14 mmol/L, p < 0.01) following the statin treatment. Parallelly brachial artery FMD increased significantly (baseline = 3.97 +/- 0.91% vs. study end = 6.84 +/- 0.89%, p < 0.05). Responses to nitroglycerin were similar during the time course of the study. The ischemia free stress test time was also higher at the study end (baseline = 5.18 +/- 2.01 min vs. study end = 6.01 +/- 1.94 min, p < 0.001).
Conclusions:
The chronic statin therapy exerts beneficial effects both on systemic and coronary endothelial function in hypercholesterolemic patients with cardiac syndrome X.