Early impairment of left ventricular function in hypercholesterolemia and its reversibility after short term treatment with rosuvastatin A preliminary echocardiographic study

• Published in: Atherosclerosis Vol. 197; no. 1; pp. 346 - 354
• Main Authors: TALINI, Enrica, DI BELLO, Vitantonio, MICCOLI, Roberto, BIANCHI, Cristina, PALAGI, Caterina, DELLE DONNE, Maria Grazia, PENNO, Giuseppe, NARDI, Carmela, CANALE, Maria Laura, DEL PRATO, Stefano, MARIANI, Mario
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier 01.03.2008
• Subjects: Adult; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Flow Velocity; Cardiology. Vascular system; Cardiovascular system; Densitometry; Diastole; Echocardiography, Doppler, Color; Fluorobenzenes - administration & dosage; Follow-Up Studies; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Hypercholesterolemia - complications; Hypercholesterolemia - drug therapy; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Pilot Projects; Pyrimidines - administration & dosage; Rosuvastatin Calcium; Sulfonamides - administration & dosage; Systole; Vasodilator agents. Cerebral vasodilators; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - drug therapy; Ventricular Dysfunction, Left - etiology; Short term; Doppler ultrasound study; Lipids; Cardiovascular disease; Hyperlipoproteinemia; Rosuvastatin; Lipoprotein; Hypocholesterolemic agent; Vascular disease; HMG-CoA reductase inhibitor; Atherosclerosis; Dyslipemia; Left ventricle performance; Statins; Sonography; Echocardiography; Enzyme; Color; Enzyme inhibitor; Metabolic diseases; Statin derivative; Cholesterol; Hypercholesterolemia; Treatment; Hydroxymethylglutaryl-CoA reductase; Reversibility; Integrated backscatter; Oxidoreductases; Color Doppler myocardial imaging; Antilipemic agent
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2007.05.024

Hypercholesterolemia contributes to coronary heart disease but little is known about its direct effect on myocardial function. We evaluated left ventricular function using echocardiography and the effect of treatment with rosuvastatin in a group of patients with primary hypercholesterolemia. Thirty-three patients with primary hypercholesterolemia (HC) and without evidence of coronary heart disease and 25 aged matched healthy volunteers (C) were submitted to conventional echocardiography, pulsed wave tissue Doppler imaging (PWTDI), color Doppler myocardial imaging (CDMI) and integrated backscatter (IBS). Echocardiographic evaluation was repeated after 6 months of treatment with rosuvastatin (10mg/day) in 17 patients. Compared with C, patients with HC showed lower E/A ratio (p<0.0001) and higher Tei index mit (p<0.0001), as well as lower PW TDI E/A both at septum (p<0.0001) and at lateral level (p<0.0001) and higher modified Tei index both at septal annulus (p<0.0001) and lateral annulus (p<0.0001). Integrated backscatter parameters were significantly reduced in patients with HC (CVIsept p<0.0001 and CVI post wall p<0.05). CDMI derived indices in the two groups were not different. After 6 months of Rosuvastatin treatment a significant reduction of LDL cholesterol levels (51%, p<0.0001) was registered in HC patients together with a significant improvement of longitudinal global systolic and diastolic function (Tei index) and myocardial intrinsic contractility (CVI). These data suggest that in patients with hypercholesterolemia exists an early cardiomyopathy characterized by systolic and diastolic dysfunction. That could produce a substratum for an "impaired preconditioning". Rosuvastatin seems able to revert systolic abnormalities.