The effects of short term statin treatment on left ventricular function and inflammatory markers in patients with chronic heart failure

Background: Statins may provide additional benefits in patients with cardiac failure due to their pleiotropic effects besides their cholesterol-lowering actions. In this study, we aimed to evaluate the impact of 12-week fluvastatin therapy on the inflammatory cytokines and the ventricular performance markers in patients with heart failure. Methods and results: Fourty chronic heart failure patients, twenty with idiopathic dilated cardiomyopathy (DCM group) and 20 with ischemic cardiomyopathy (ICM group), for whom statin treatment was indicated according to Adult Treatment Panel III were included to this open label and prospective study. After a 12-week treatment with fluvastatin 80 mg/day; clinical functional capacity, echocardiographic indices of cardiac performance and inflammatory markers were evaluated. After the treatment, functional capacity (in DCM group: 2.05 +/- 0.4 versus 1.65 +/- 0.6, p = 0.005; in ICM group: 2.25 +/- 0.5 versus 1.8 +/- 0.6, p= 0.003), left ventricular ejection fraction, LVEF (from 30 +/- 5% to 33 +/- 5%, p= 0.001 in DCM and 29 +/- 4% to 31 +/- 5%, p= 0.001 in ICM group) and tissue Doppler mitral annular systolic velocity, Sm (5.8 +/- 1 cm/s to 7 +/- 1 cm/s, p= 0.001 in DCM and 5.4 +/- 0.8 cm/s to 7 +/- 1 cm/s, p= 0.001 in ICM group) improved. Tumor necrosis factor-alpha and interleukin-6 levels decreased, but no significant changes in high sensitive C-reactive protein and brain natriuretic peptide levels were detected with the fluvastatin treatment in both groups. Conclusion: Fluvastatin improved cardiac functions and the clinical symptoms in HF patients with either idiopathic dilated or ischemic etiology. This positive effect of fluvastatin which might be secondary to inflammatory modulation was more marked in patients with ischemic etiology. Statins in HF deserves special attention by means of further large-scale trials. (c) 2007 Elsevier Ireland Ltd. All rights reserved.