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HMG CoA reductase inhibition and left ventricular mass in hypertrophic cardiomyopathy: a randomized
J Bauersachs1, S Störk, M Kung
1Medizinische Klinik und Poliklinik I, Kardiologie, Julius-Maximilians-Universität Würzburg, Josef-Schneider-Strasse 2, 97080 Würzburg, Germany. bauersachs_j@medizin.uni-wuerzburg.de
Insights
This pilot study found that atorvastatin, a statin, did not reduce left ventricular mass in patients with hypertrophic cardiomyopathy over nine months. Further research is needed to explore statin effects in this condition.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Statins are known to reduce cardiomyocyte hypertrophy in animal models.
- Hypertrophic cardiomyopathy is a condition characterized by thickening of the heart muscle.
Purpose of the Study:
- To investigate the effect of atorvastatin, a hydroxymethylglutaryl coenzyme A reductase inhibitor, on left ventricular mass in patients with hypertrophic cardiomyopathy.
- To assess the impact of atorvastatin on cardiac function and collagen metabolism in this patient population.
Main Methods:
- A randomized, placebo-controlled, double-blind pilot study was conducted.
- Patients received either atorvastatin 80 mg daily or a placebo for nine months.
- Left ventricular mass was assessed using cardiac magnetic resonance imaging, with echocardiography used for functional analysis.
Main Results:
- Atorvastatin significantly reduced low-density lipoprotein cholesterol levels.
- No significant difference in left ventricular mass reduction was observed between the atorvastatin and placebo groups.
- Left ventricular volumes, diameters, systolic and diastolic function, and collagen metabolism markers remained unchanged in both groups.
Conclusions:
- Nine-month treatment with atorvastatin 80 mg did not demonstrate a significant effect on reducing left ventricular mass in patients with hypertrophic cardiomyopathy.
- This pilot study suggests that atorvastatin may not be effective for reducing left ventricular mass in this condition.
Background:
Statins reduce cardiomyocyte hypertrophy in animal models of hypertrophic cardiomyopathy, aortic banding and heart failure after myocardial infarction. We investigated the effect of the hydroxymethylglutaryl coenzyme A reductase inhibitor atorvastatin on left ventricular (LV) mass in patients with hypertrophic cardiomyopathy in a randomized placebo-controlled double-blind pilot study.
Materials And Methods:
Patients with hypertrophic cardiomyopathy were randomized to be treated once daily by atorvastatin 80 mg or placebo for nine months. LV mass was assessed by serial cardiac magnetic resonance imaging. LV systolic and diastolic function was determined by echocardiography. Markers of collagen metabolism and inflammation were also assessed.
Results:
Out of 78 screened patients with hypertrophic cardiomyopathy 28 (2 x 14) patients were eligible for randomization. Eleven patients in each group completed the study with cardiac magnetic resonance imaging assessments meeting the evaluation standards at baseline and at follow-up. Low-density lipoprotein cholesterol levels in the atorvastatin group decreased from 3.24 +/- 1.14 mmol L(-1) (125 +/- 44 mg dL(-1)) at baseline to 1.37 +/- 0.49 mmol L(-1) (53 +/- 19 mg dL(-1)) at follow-up (P < 0.001), but were unchanged in the placebo group. Baseline LV mass was 228 +/- 51 g in the placebo and 232 +/- 67 g in the atorvastatin group. The primary endpoint of change in LV mass from baseline to follow-up was 2 +/- 10% in the atorvastatin group versus 0 +/- 13% in the placebo group (P = NS). Parameters of LV volumes and diameters, systolic and diastolic function, and markers of collagen metabolism were also unchanged in both groups.
Conclusion:
In patients with hypertrophic cardiomyopathy, this randomized placebo-controlled double-blind pilot study did not demonstrate an effect of 9-month treatment with atorvastatin 80 mg on LV mass reduction.
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