Low-dose of Statin Treatment Improves Cerebrovascular Reactivity in Patients With Ischemic Stroke: Single Photon Emission Computed Tomography Analysis
| Autor: | Yoshifumi Hirata, Jun Ichi Kuratsu, Shodo Fujioka, Masaji Murakami |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Statin medicine.drug_class Vasodilation Recurrence Internal medicine medicine.artery medicine Humans Cysteine cardiovascular diseases Myocardial infarction Stroke Aged Aged 80 and over Tomography Emission-Computed Single-Photon Dose-Response Relationship Drug business.industry Rehabilitation Organotechnetium Compounds Cerebral Arteries Middle Aged medicine.disease Surgery Cholesterol Treatment Outcome Cerebral blood flow Simvastatin Cerebrovascular Circulation Middle cerebral artery Cardiology Female Neurology (clinical) Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine Acetazolamide business medicine.drug |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 17:16-22 |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2007.09.005 |
| Popis: | Background Statins, 3-hydroxy-3-methylglutaryl-coenzymeA reductase inhibitors, have pleiotropic effects that are independent of their cholesterol-lowering activities. For example, they improve vascular endothelial function and exert anti-inflammatory effects. In large clinical trials they reduced the incidence of stroke and myocardial infarction; however, little is currently known regarding the mechanism or mechanisms underlying their clinically confirmed stroke protection. Patients and Methods We assessed 10 patients who had experienced a stroke at least 6 months earlier; they received low-dose (5 mg) simvastatin. Using our triple-injection technetium 99m-ethylcysteinate dimer method, we determined their cerebral blood flow and cerebrovascular reactivity. A second assessment of at-rest cerebral blood flow and cerebrovascular reactivity was performed 4 or more months (mean 6 months) after the start of statin administration. We used acetazolamide (1 g) as the vasodilator. The region of interest was the middle cerebral artery territory on a 3-dimensional stereotaxic region of interest template. Results Statin administration did not significantly affect the regional cerebral blood flow at rest. Before statin treatment, the patients' vasoreactivity, determined by the triple-injection technetium 99m-ethylcysteinate dimer method, demonstrated delayed, poor, or near-normal response patterns. Statin treatment improved vasoreactivity in all patients. Their mean serum total cholesterol level before statin administration was 200 mg/dL (range 187-256 mg/dL). Statin treatment significantly reduced their mean serum total cholesterol to 180 mg/dL (range 128-220 mg/dL) ( P Conclusions The clinically confirmed stroke protection activity exerted by statins may be attributable to improved cerebrovascular reactivity. |
| Databáze: | OpenAIRE |
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