Atorvastatin therapy during the peri-infarct period attenuates left ventricular dysfunction and remodeling after

Xian-Liang Tang1, Santosh K Sanganalmath, Hiroshi Sato

  • 1Division of Cardiovascular Medicine and Institute of Molecular Cardiology, University of Louisville, Louisville, Kentucky, United States of America.

Plos One
|October 8, 2011
PubMed

Insights

Atorvastatin therapy initiated around myocardial infarction (MI) improved cardiac function and limited adverse remodeling. These benefits occurred independently of infarct size, suggesting reduced fibrosis and apoptosis contribute to improved heart health post-MI.

Area of Science:

  • Cardiovascular Research
  • Pharmacology
  • Cardiac Physiology

Background:

  • Statins offer cardiovascular benefits, but their role during the peri-infarct period is not fully understood.
  • Myocardial infarction (MI) leads to adverse cardiac remodeling, fibrosis, and apoptosis, impacting long-term heart function.

Purpose of the Study:

  • To evaluate the effects of atorvastatin on cardiac function, remodeling, fibrosis, and apoptosis following myocardial infarction (MI).

Main Methods:

  • Rats were subjected to permanent coronary occlusion and treated with atorvastatin or vehicle before and after MI.
  • Cardiac function was assessed using echocardiography and hemodynamic measurements.
  • Infarct size, fibrosis (hydroxyproline content), and apoptosis were quantified morphometrically.

Main Results:

  • Atorvastatin treatment improved left ventricular ejection fraction (LVEF) and fractional area change (FAC), while reducing left ventricular end-diastolic volume (LVEDV) and diameters.
  • Hemodynamic parameters such as dP/dt(max), end-systolic elastance (Ees), and preload recruitable stroke work (PRSW) were improved, with lower LVEDP.
  • Atorvastatin reduced myocardial fibrosis and cardiomyocyte apoptosis without altering infarct size.

Conclusions:

  • Peri-infarct atorvastatin therapy significantly improves left ventricular function and limits adverse remodeling after MI.
  • These beneficial effects are independent of infarct size reduction.
  • Decreased myocardial fibrosis and apoptosis likely contribute to the salubrious outcomes of atorvastatin treatment.

Related Concept Videos

Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...