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Beneficial effects of atorvastatin on myocardial regions with initially low vasodilatory capacity at various stages of coronary artery disease

Abstract

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 stenosis >50% and wall irregularities or minimal stenosis <30% in 17 patients. Before and 4.6{+-}1.8 months after atorvastatin therapy,{sup 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 adenosine {>=}2.0 ml/min/g) and those with abnormal (MBF<2.0 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 (p<0.001). In normal segments no significant changes in MBF, CFR and MCR were found. However, initially abnormal segments showed significant improvements in MCR (15%, p<0.0001) and MBF during adenosine (30%, p<0.0001) after therapy. The improvement in regional coronary vasodilator function  More>>
Authors:
Wielepp, Peter; [1]  Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)]; Baller, Detlev; [2]  Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)]; Gleichmann, Ulrich; Pulawski, Ewa; Horstkotte, Dieter; [2]  Burchert, Wolfgang [1] 
  1. Ruhr-University Bochum, Institute of Molecular Biophysics, Radiopharmacy and Nuclear Medicinea, Bad Oeynhausen (Germany)
  2. Ruhr-University Bochum, Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)
Publication Date:
Dec 01, 2005
Product Type:
Journal Article
Resource Relation:
Journal Name: European Journal of Nuclear Medicine and Molecular Imaging; Journal Volume: 32; Journal Issue: 12
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR DISEASES; COST BENEFIT ANALYSIS; MYOCARDIAL INFARCTION; MYOCARDIUM; POSITRON COMPUTED TOMOGRAPHY; VASCULAR DISEASES
OSTI ID:
20688010
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1619-7070; TRN: DE06F0741
Availability:
Available from: http://dx.doi.org/10.1007/s00259-005-1828-6
Submitting Site:
DEN
Size:
page(s) 1371-1377
Announcement Date:
Mar 09, 2006

Citation Formats

Wielepp, Peter, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)], Baller, Detlev, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)], Gleichmann, Ulrich, Pulawski, Ewa, Horstkotte, Dieter, and Burchert, Wolfgang. Beneficial effects of atorvastatin on myocardial regions with initially low vasodilatory capacity at various stages of coronary artery disease. Germany: N. p., 2005. Web. doi:10.1007/s00259-005-1828-6.
Wielepp, Peter, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)], Baller, Detlev, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)], Gleichmann, Ulrich, Pulawski, Ewa, Horstkotte, Dieter, & Burchert, Wolfgang. Beneficial effects of atorvastatin on myocardial regions with initially low vasodilatory capacity at various stages of coronary artery disease. Germany. doi:10.1007/s00259-005-1828-6.
Wielepp, Peter, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)], Baller, Detlev, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)], Gleichmann, Ulrich, Pulawski, Ewa, Horstkotte, Dieter, and Burchert, Wolfgang. 2005. "Beneficial effects of atorvastatin on myocardial regions with initially low vasodilatory capacity at various stages of coronary artery disease." Germany. doi:10.1007/s00259-005-1828-6. https://www.osti.gov/servlets/purl/10.1007/s00259-005-1828-6.
@misc{etde_20688010,
title = {Beneficial effects of atorvastatin on myocardial regions with initially low vasodilatory capacity at various stages of coronary artery disease}
author = {Wielepp, Peter, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)], Baller, Detlev, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen (Germany)], Gleichmann, Ulrich, Pulawski, Ewa, Horstkotte, Dieter, and Burchert, Wolfgang}
abstractNote = {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 stenosis >50% and wall irregularities or minimal stenosis <30% in 17 patients. Before and 4.6{+-}1.8 months after atorvastatin therapy,{sup 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 adenosine {>=}2.0 ml/min/g) and those with abnormal (MBF<2.0 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 (p<0.001). In normal segments no significant changes in MBF, CFR and MCR were found. However, initially abnormal segments showed significant improvements in MCR (15%, p<0.0001) and MBF during adenosine (30%, p<0.0001) 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. (orig.)}
doi = {10.1007/s00259-005-1828-6}
journal = {European Journal of Nuclear Medicine and Molecular Imaging}
issue = {12}
volume = {32}
place = {Germany}
year = {2005}
month = {Dec}
}