Beneficial effects of atorvastatin on myocardial regions with initially low vasodilatory capacity at various stages of coronary artery disease
| Autor: | Ewa Pulawski, Peter Wielepp, Dieter Horstkotte, D. Baller, Ulrich Gleichmann, Wolfgang Burchert |
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| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Atorvastatin Coronary Artery Disease Coronary artery disease Ventricular Dysfunction Left Coronary Circulation Internal medicine medicine Humans Pyrroles Radiology Nuclear Medicine and imaging Myocardial infarction Radionuclide Imaging Coronary atherosclerosis Aged business.industry Coronary flow reserve General Medicine Middle Aged medicine.disease Coronary Vessels Vasodilation Stenosis Treatment Outcome medicine.anatomical_structure Heptanoic Acids Disease Progression Exercise Test Vascular resistance Cardiology Female Coronary vasodilator Hydroxymethylglutaryl-CoA Reductase Inhibitors business Blood Flow Velocity medicine.drug |
| Zdroj: | European Journal of Nuclear Medicine and Molecular Imaging. 32:1371-1377 |
| ISSN: | 1619-7089 1619-7070 |
| DOI: | 10.1007/s00259-005-1828-6 |
| Popis: | The aim of this study was to analyse non-invasively the regional effect of therapy with an HMG-CoA reductase inhibitor on myocardial blood flow in patients with coronary artery disease (CAD) with special reference to segments with initially substantially impaired vasodilation.The study included 26 patients with untreated hypercholesterolaemia. Coronary angiography revealed CAD in nine patients with stenosis50% and wall irregularities or minimal stenosis30% in 17 patients. Before and 4.6+/-1.8 months after atorvastatin therapy, ( 13)N-ammonia positron emission tomography (PET) studies were performed at rest and under pharmacological stress. Minimum coronary vascular resistance (MCR) and coronary flow reserve (CFR) were determined. Segments were divided into those with normal or near-normal (MBF during adenosineor =2.0 ml/min/g) and those with abnormal (MBF2.0 ml/min/g) vasodilator flow response. In CAD patients, 156 segments were analysed, 85 of which had abnormal MBF; in the non-obstructive group, 59 of 297 segments had abnormal MBF.LDL cholesterol decreased after atorvastatin therapy from 186+/-43 mg/dl to 101+/-26 mg/dl (p0.001). In normal segments no significant changes in MBF, CFR and MCR were found. However, initially abnormal segments showed significant improvements in MCR (15%, p0.0001) and MBF during adenosine (30%, p0.0001) after therapy.The improvement in regional coronary vasodilator function after atorvastatin in patients with coronary atherosclerosis may be caused, at least in part, by increased flow-mediated (endothelium-dependent) dilation of the total arteriolar and arterial vascular system. These data further support the concept of non-invasive management of stable CAD by statin therapy and life-style modification guided by PET. |
| Databáze: | OpenAIRE |
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