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The effect of rosuvastatin on inflammation, matrix turnover and left ventricular remodeling in dilated
Kaspar Broch1, Erik T Askevold2, Erik Gjertsen3
1Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway ; Faculty of Medicine, University of Oslo, Oslo, Norway.
Insights
Rosuvastatin did not improve left ventricular ejection fraction in patients with dilated cardiomyopathy. While it lowered cholesterol, it did not significantly impact inflammation or extracellular matrix remodeling markers.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Dilated cardiomyopathy involves left ventricular enlargement and impaired function.
- Inflammation and extracellular matrix remodeling are implicated in its pathogenesis.
- Statins, like rosuvastatin, may possess anti-inflammatory and matrix-modulating properties.
Purpose of the Study:
- To investigate the effect of rosuvastatin on left ventricular remodeling in dilated cardiomyopathy.
- To determine if rosuvastatin can improve left ventricular ejection fraction.
Main Methods:
- A multicenter, randomized, double-blind, placebo-controlled trial involving 71 patients.
- Patients received either 10 mg rosuvastatin or placebo for six months.
- Left ventricular ejection fraction was assessed via echocardiography and cardiac MRI at baseline and follow-up.
Main Results:
- Left ventricular ejection fraction improved by 5 percentage points overall, with no significant difference between rosuvastatin and placebo groups.
- Rosuvastatin significantly reduced low-density lipoprotein cholesterol but did not affect inflammatory markers or extracellular matrix remodeling.
- No significant difference in left ventricular ejection fraction change was observed between treatment arms.
Conclusions:
- Rosuvastatin treatment does not improve left ventricular ejection fraction in patients with dilated cardiomyopathy.
- The drug's effects on inflammation and matrix remodeling were not substantial enough to alter cardiac function in this cohort.
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.
Materials And 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.
Conclusion:
Treatment with rosuvastatin does not improve left ventricular ejection fraction in patients with dilated cardiomyopathy.
Trial Registration:
ClinicalTrials.gov NCT00505154.
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