Do Statins Have a Role in the Management of Diastolic Dysfunction?

Diastolic dysfunction of the left ventricle is an increasingly recognized clinical entity that may in some cases cause overt congestive heart failure. Currently, treatment of these patients is based on limited studies in patients with symptomatic heart failure. HMG-CoA reductase inhibitor (statin) drugs, which are primarily used for the treatment of hyperlipidemia, have been shown to have additional pharmacologic properties that may be beneficial in other disease states such as heart failure. Here, we wish to review the current knowledge of the mechanism of action of statins and the probable implications for asymptomatic patients with diastolic dysfunction. We discuss the causes and settings of diastolic dysfunction, the potential role of statin therapy in the treatment of diastolic dysfunction, and potential mechanisms by which statins may show benefit. The use of statins in the setting of diastolic dysfunction, both for treatment of established heart failure as well as to prevent progression of subclinical disease to overt symptomatic expression, is an area of substantial research interest with direct clinical application.