BACKGROUND:Hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) have been shown to reduce sympathetic nervous system (SNS) activation in experimental heart failure (HF). However, this potential mechanism of action of statins in HF has not been well studied in humans. METHODS AND RESULTS:Twenty-six patients with nonischemic systolic HF (left ventricular ejection fraction [LVEF] ≤35%) were randomized to atorvastatin (10 mg) or placebo for 3 months. Pre- and posttreatment testing included echocardiography, laboratory assays, quality of life (QOL) questionnaires, and peroneal nerve muscle sympathetic nerve activity (MSNA) via microneurography. Eighteen subjects hadtechnically adequate MSNA tracings before and after treatment. The cohort was 65% male, 81% New York Heart Association functional class II, LVEF 26 ± 6%, and low-density lipoprotein cholesterol (LDL-C) 108 ± 26 mg/dL. Baseline MSNA was 41 ± 2 bursts/min. LDL-C significantly decreased in the atorvastatin (-36.8%) versus the placebo (-0.1%) group (P < .0001). However, there was no significant change in MSNA (-16.2% vs -2.5%), LVEF, B-type natriuretic peptide, or QOL score in the atorvastatin compared with the placebo group. CONCLUSIONS: Short-term statin therapy in patients with nonischemic HF does not result in a significant decrease in SNS activation as measured by MSNA. These findings are consistent with the neutral outcomes of large clinical trials of statins in HF. Copyright Â
RCT Entities:
BACKGROUND: Hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) have been shown to reduce sympathetic nervous system (SNS) activation in experimental heart failure (HF). However, this potential mechanism of action of statins in HF has not been well studied in humans. METHODS AND RESULTS: Twenty-six patients with nonischemic systolic HF (left ventricular ejection fraction [LVEF] ≤35%) were randomized to atorvastatin (10 mg) or placebo for 3 months. Pre- and posttreatment testing included echocardiography, laboratory assays, quality of life (QOL) questionnaires, and peroneal nerve muscle sympathetic nerve activity (MSNA) via microneurography. Eighteen subjects had technically adequate MSNA tracings before and after treatment. The cohort was 65% male, 81% New York Heart Association functional class II, LVEF 26 ± 6%, and low-density lipoprotein cholesterol (LDL-C) 108 ± 26 mg/dL. Baseline MSNA was 41 ± 2 bursts/min. LDL-C significantly decreased in the atorvastatin (-36.8%) versus the placebo (-0.1%) group (P < .0001). However, there was no significant change in MSNA (-16.2% vs -2.5%), LVEF, B-type natriuretic peptide, or QOL score in the atorvastatin compared with the placebo group. CONCLUSIONS: Short-term statin therapy in patients with nonischemic HF does not result in a significant decrease in SNS activation as measured by MSNA. These findings are consistent with the neutral outcomes of large clinical trials of statins in HF. Copyright Â
Authors: Srikanth Sola; Muhammad Q S Mir; Stamatios Lerakis; Neeraj Tandon; Bobby V Khan Journal: J Am Coll Cardiol Date: 2005-12-20 Impact factor: 24.094
Authors: Henry Krum; Emma Ashton; Christopher Reid; Victor Kalff; Jim Rogers; John Amarena; Bhuwan Singh; Andrew Tonkin Journal: J Card Fail Date: 2007-02 Impact factor: 5.712
Authors: Stefan D Anker; Andrew L Clark; Ralf Winkler; Christian Zugck; Mariantonietta Cicoira; Piotr Ponikowski; Constantinos H Davos; Waldemar Banasiak; Piero Zardini; Markus Haass; Jochen Senges; Andrew J S Coats; Philip A Poole-Wilson; Bertram Pitt Journal: Int J Cardiol Date: 2006-07-17 Impact factor: 4.164
Authors: John Kjekshus; Eduard Apetrei; Vivencio Barrios; Michael Böhm; John G F Cleland; Jan H Cornel; Peter Dunselman; Cândida Fonseca; Assen Goudev; Peer Grande; Lars Gullestad; Ake Hjalmarson; Jaromir Hradec; András Jánosi; Gabriel Kamenský; Michel Komajda; Jerzy Korewicki; Timo Kuusi; François Mach; Vyacheslav Mareev; John J V McMurray; Naresh Ranjith; Maria Schaufelberger; Johan Vanhaecke; Dirk J van Veldhuisen; Finn Waagstein; Hans Wedel; John Wikstrand Journal: N Engl J Med Date: 2007-11-05 Impact factor: 91.245
Authors: JoAnne Micale Foody; Rahman Shah; Deron Galusha; Frederick A Masoudi; Edward P Havranek; Harlan M Krumholz Journal: Circulation Date: 2006-02-20 Impact factor: 29.690
Authors: Shekhar H Deo; James P Fisher; Lauro C Vianna; Areum Kim; Anand Chockalingam; Matthew C Zimmerman; Irving H Zucker; Paul J Fadel Journal: Am J Physiol Heart Circ Physiol Date: 2012-06-01 Impact factor: 4.733
Authors: Muhammad Ismail Shawish; Bahador Bagheri; Vijaya M Musini; Stephen P Adams; James M Wright Journal: Cochrane Database Syst Rev Date: 2021-01-22