BACKGROUND: At present, no medical therapy is known to affect the progression of rheumatic mitral stenosis (MS). We sought to assess the effect of statin treatment on long-term progression of MS in a large population. METHODS AND RESULTS: From our 20-year database, we identified all patients with rheumatic MS with > or =2 echocardiographies > or =1 year apart. Exclusion criteria were previous intervention on the mitral valve, more than moderate aortic regurgitation, or symptoms at first examination. The study sample included 315 patients (mean age, 61+/-12 years; 224 women); 35 patients (11.1%) were treated with statins, and 280 (88.9%) were not. Mean follow-up period was 6.1+/-4.0 years (range, 1 to 20). The rate of decrease in mitral valve area was significantly lower in the statin group compared with the untreated group (0.027+/-0.056 versus 0.067+/-0.082 cm(2)/y; P=0.005). The annualized change in mean transmitral gradient was lower in statin-treated patients (0.20+/-0.59 versus 0.58+/-0.96 mm Hg/y; P=0.023). The prevalence of fast MS progression (annual change in mitral valve area >0.08 cm(2)) was significantly lower in the statin group (P=0.008). An increase in systolic pulmonary artery pressure of >10 mm Hg was found in 17% of patients in the statin group versus 40% of untreated patients (P=0.045). CONCLUSIONS: Our study shows a significantly slower progression of rheumatic MS in patients treated with statins. These findings could have an important impact in the early medical therapy of patients with rheumatic heart disease.
BACKGROUND: At present, no medical therapy is known to affect the progression of rheumatic mitral stenosis (MS). We sought to assess the effect of statin treatment on long-term progression of MS in a large population. METHODS AND RESULTS: From our 20-year database, we identified all patients with rheumatic MS with > or =2 echocardiographies > or =1 year apart. Exclusion criteria were previous intervention on the mitral valve, more than moderate aortic regurgitation, or symptoms at first examination. The study sample included 315 patients (mean age, 61+/-12 years; 224 women); 35 patients (11.1%) were treated with statins, and 280 (88.9%) were not. Mean follow-up period was 6.1+/-4.0 years (range, 1 to 20). The rate of decrease in mitral valve area was significantly lower in the statin group compared with the untreated group (0.027+/-0.056 versus 0.067+/-0.082 cm(2)/y; P=0.005). The annualized change in mean transmitral gradient was lower in statin-treated patients (0.20+/-0.59 versus 0.58+/-0.96 mm Hg/y; P=0.023). The prevalence of fast MS progression (annual change in mitral valve area >0.08 cm(2)) was significantly lower in the statin group (P=0.008). An increase in systolic pulmonary artery pressure of >10 mm Hg was found in 17% of patients in the statin group versus 40% of untreated patients (P=0.045). CONCLUSIONS: Our study shows a significantly slower progression of rheumatic MS in patients treated with statins. These findings could have an important impact in the early medical therapy of patients with rheumatic heart disease.
Authors: Anne B Rossebø; Terje R Pedersen; Kurt Boman; Philippe Brudi; John B Chambers; Kenneth Egstrup; Eva Gerdts; Christa Gohlke-Bärwolf; Ingar Holme; Y Antero Kesäniemi; William Malbecq; Christoph A Nienaber; Simon Ray; Terje Skjaerpe; Kristian Wachtell; Ronnie Willenheimer Journal: N Engl J Med Date: 2008-09-02 Impact factor: 91.245
Authors: Nalini M Rajamannan; Francesco Antonini-Canterin; Luis Moura; Jose L Zamorano; Raphael A Rosenhek; Patricia Jm Best; Margaret A Lloyd; F Rocha-Goncalves; Sarat Chandra; Ottavio Alfieri; Patrizio Lancellotti; Pilar Tornos; Ragavendra R Baliga; Andrew Wang; Thomas Bashore; S Ramakrishnan; Konstantinos Spargias; Mony Shuvy; Ronen Beeri; Chaim Lotan; Jassim Al Suwaidi; Vinay Bahl; Luc A Pierard; Gerald Maurer; Gian Luigi Nicolosi; Shahbudin H Rahimtoola; K Chopra; Natesa G Pandian Journal: Indian Heart J Date: 2009 Jan-Feb