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Published on: November 10, 2017
Simvastatin preserves diastolic function in experimental hypercholesterolemia independently of its lipid lowering
Dallit Mannheim1, Joerg Herrmann, Piero O Bonetti
1Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
Insights
Simvastatin prevents diastolic dysfunction in hypercholesterolemia by reducing myocardial fibrosis and promoting angiogenesis, independent of its lipid-lowering effects.
Area of Science:
- Cardiovascular Research
- Pharmacology
- Experimental Medicine
Background:
- Diastolic dysfunction affects 40% of heart failure patients.
- It is linked to myocardial fibrosis and cardiovascular risk factors.
Purpose of the Study:
- To investigate if simvastatin improves diastolic dysfunction in experimental hypercholesterolemia (HC).
Main Methods:
- Pigs were fed normal, HC, or HC with simvastatin diets for 12 weeks.
- Cardiac function was assessed using electron beam computed tomography (EBCT).
- Myocardial vascular fraction and collagen content were quantified.
Main Results:
- Simvastatin treatment restored cardiac early diastolic filling in HC pigs.
- Myocardial collagen content was reduced by simvastatin.
- Simvastatin decreased myocardial vascular fraction, suggesting reduced angiogenesis.
Conclusions:
- Simvastatin prevents diastolic dysfunction in experimental HC, independent of lipid reduction.
- Beneficial effects are partly due to decreased myocardial fibrosis and angiogenesis.
Objective:
Isolated diastolic dysfunction is present in 40% of heart failure patients. It has been attributed to myocardial fibrosis and related to cardiovascular risk factor exposure. We hypothesized that simvastatin will improve these dynamics in experimental hypercholesterolemia (HC).
Methods:
Three groups of pigs were studied after 12 weeks of normal (N) diet, HC diet, or HC diet with simvastatin (80 mg/day) treatment. Cardiac function was assessed by electron beam computed tomography (EBCT) and percentage of myocardium occupied by microvessels (myocardial vascular fraction) was calculated by micro-CT. Collagen content was determined by Sirius red staining and confirmed by a quantitative, hydroxyoproline-based assay.
Results:
Compared with N, LDL serum concentration was higher in HC and HC+simvastatin (1.0±0.1 vs. 7.9±1.7 and 9.6±1.2 mmol/L, p<0.05 for both). Cardiac early diastolic filling was reduced in HC compared with N (102.4±11.3 vs. 151.1±12.1 mL/s; p<0.05) but restored in HC+simvastatin (176.8±21.3 mL/s, p<0.05 vs. HC). Compared with N, myocardial vascular fraction was higher in HC but not in HC+simvastatin (1.98±0.84 vs. 4.48±0.31 and 2.95±0.95%; p<0.05 for HC vs. N). Myocardial collagen content was higher in HC than in HC+simvastatin and N (4.72±1.03 vs. 1.62±0.12 and 1.21±0.24% area staining; p<0.05 for HC vs. N), which was attributable mainly to an increase in collagen III (2.90±0.48 vs. 1.62±0.12 and 1.21±0.24% area staining; p<0.05 for HC vs. N).
Conclusions:
Simvastatin is able to prevent diastolic dysfunction in experimental HC independent of its lipid lowering effect. This beneficial effect is, at least partially, due to a decrease in myocardial fibrosis and angiogenesis.
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