IMPROVEMENT OF MYOCARDIAL PERFUSION BY SHORT-TERM FLUVASTATIN THERAPY IN CORONARY-ARTERY DISEASE

被引:99
作者
EICHSTADT, HW
ESKOTTER, H
HOFFMANN, I
AMTHAUER, HW
WEIDINGER, G
机构
[1] SANDOZ PHARMA AG,NURNBERG,GERMANY
[2] FREE UNIV BERLIN,UNIV HOSP RUDOLF VIRCHOW,DEPT CARDIOL,D-13353 BERLIN,GERMANY
[3] FREE UNIV BERLIN,UNIV HOSP RUDOLF VIRCHOW,DEPT RADIOL,D-13353 BERLIN,GERMANY
关键词
D O I
10.1016/S0002-9149(05)80033-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients with hypercholesterolemia have impaired coronary and peripheral endothelial function. In patients with coronary artery disease, intracoronary acetylcholine infusion or mental stress causes paradoxical vasoconstriction, whereas lowering cholesterol restores endothelial function. The impact of lipid lowering by fluvastatin on myocardial perfusion in hypercholesterolemic patients with perfusion abnormalities was assessed by thallium-201 single photon-emission computed tomography (SPECT). A total of 22 patients were treated with fluvastatin (40 mg once daily) for 6 weeks, followed by 40 mg twice daily if low density lipoprotein cholesterol (LDL-C) levels were decreased by less than or equal to 30%. During the 12-week treatment period, myocardial perfusion was measured by quantitative SPECT after standardized stress testing at baseline and after 12 weeks. Preliminary results for 17 male patients (mean age, 59.3 +/- 6.7 years) are presented here. LDL-C-decreased from 191 +/- 26 to 146 +/- 28 mg/dL (p <0.001). In ischemic segments myocardial perfusion increased by 30% (280 +/- 100 to 365 +/- 110 counts per matrix; p <0.001). In normal segments perfusion increased by only 5% (451 +/- 74 to 473 +/- 69 counts per matrix; p <0.005). The change in perfusion rate between ischemic and normal segments was significant (p <0.005). In conclusion, LDL-C lowering with short-term fluvastatin therapy improved myocardial perfusion, especially in areas of ischemia. This suggests that improvement is due to functional restoration of coronary endothelium by fluvastatin, before anatomic regression of stenosis can occur following long-term treatment.
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页码:A122 / A125
页数:4
相关论文
共 16 条
  • [1] EFFECTS OF THERAPY WITH CHOLESTYRAMINE ON PROGRESSION OF CORONARY ARTERIOSCLEROSIS - RESULTS OF THE NHLBI TYPE-II CORONARY INTERVENTION STUDY
    BRENSIKE, JF
    LEVY, RI
    KELSEY, SF
    PASSAMANI, ER
    RICHARDSON, JM
    LOH, IK
    STONE, NJ
    ALDRICH, RF
    BATTAGLINI, JW
    MORIARTY, DJ
    FISHER, MR
    FRIEDMAN, L
    FRIEDEWALD, W
    DETRE, KM
    EPSTEIN, SE
    [J]. CIRCULATION, 1984, 69 (02) : 313 - 324
  • [2] LIPID-LOWERING AND PLAQUE REGRESSION - NEW INSIGHTS INTO PREVENTION OF PLAQUE DISRUPTION AND CLINICAL EVENTS IN CORONARY-DISEASE
    BROWN, BG
    ZHAO, XQ
    SACCO, DE
    ALBERS, JJ
    [J]. CIRCULATION, 1993, 87 (06) : 1781 - 1791
  • [3] REGRESSION OF CORONARY-ARTERY DISEASE AS A RESULT OF INTENSIVE LIPID-LOWERING THERAPY IN MEN WITH HIGH-LEVELS OF APOLIPOPROTEIN-B
    BROWN, G
    ALBERS, JJ
    FISHER, LD
    SCHAEFER, SM
    LIN, JT
    KAPLAN, C
    ZHAO, XQ
    BISSON, BD
    FITZPATRICK, VF
    DODGE, HT
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1990, 323 (19) : 1289 - 1298
  • [4] BENEFICIAL-EFFECTS OF COLESTIPOL-NIACIN ON CORONARY ATHEROSCLEROSIS - A 4-YEAR FOLLOW-UP
    CASHINHEMPHILL, L
    MACK, WJ
    POGODA, JM
    SANMARCO, ME
    AZEN, SP
    BLANKENHORN, DH
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1990, 264 (23): : 3013 - 3017
  • [5] ENDOTHELIAL FUNCTION IN HUMAN CORONARY-ARTERIES INVIVO - FOCUS ON HYPERCHOLESTEROLEMIA
    DREXLER, H
    ZEIHER, AM
    [J]. HYPERTENSION, 1991, 18 (04) : 90 - 99
  • [6] CORRECTION OF ENDOTHELIAL DYSFUNCTION IN CORONARY MICROCIRCULATION OF HYPERCHOLESTEROLEMIC PATIENTS BY L-ARGININE
    DREXLER, H
    ZEIHER, AM
    MEINZER, K
    JUST, H
    [J]. LANCET, 1991, 338 (8782-3) : 1546 - 1550
  • [7] REDUCTION IN SERUM-CHOLESTEROL WITH PRAVASTATIN IMPROVES ENDOTHELIUM-DEPENDENT CORONARY VASOMOTION IN PATIENTS WITH HYPERCHOLESTEROLEMIA
    EGASHIRA, K
    HIROOKA, Y
    KAI, H
    SUGIMACHI, M
    SUZUKI, S
    INOU, T
    TAKESHITA, A
    [J]. CIRCULATION, 1994, 89 (06) : 2519 - 2524
  • [8] EICHSTAEDT H, 1981, ADV CLIN CARDIOL, V2, P180
  • [9] ATHEROSCLEROSIS OR LIPOPROTEIN-INDUCED ENDOTHELIAL DYSFUNCTION - POTENTIAL MECHANISMS UNDERLYING REDUCTION IN EDRF/NITRIC OXIDE ACTIVITY
    FLAVAHAN, NA
    [J]. CIRCULATION, 1992, 85 (05) : 1927 - 1938
  • [10] BY HOW MUCH AND HOW QUICKLY DOES REDUCTION IN SERUM-CHOLESTEROL CONCENTRATION LOWER RISK OF ISCHEMIC-HEART-DISEASE
    LAW, MR
    WALD, NJ
    THOMPSON, SG
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 1994, 308 (6925): : 367 - 373