Abstract
The impact of statin therapy on vascular reactivity in patients with Heart Failure with Preserved Ejection Fraction
Physiology (Bethesda, Md.), Vol.38(S1)
05/2023
DOI: 10.1152/physiol.2023.38.S1.5729999
Abstract
Abstract only Background: HFpEF is characterized by peripheral vascular dysfunction, which likely underlies clinical presentations such as dyspnea on exertion and severe exercise intolerance in this population. HMG-CoA reductase inhibitors, also known as “statins,” can exert beneficial pleiotropic effects on the vasculature that may be related to improvements in nitric oxide (NO) signalling. However, it has yet to be investigated whether statin therapy can improve vascular function in patients with HFpEF. We hypothesized that 30-day statin therapy would improve upper limb conduit vessel and microvascular function, as determined by brachial artery flow-mediated dilation (FMD) and reactive hyperemia (RH), respectively, and improve locomotor muscle microvascular responsiveness, as determined by passive limb movement (PLM). Methods: Using a double-blind, parallel design, patients with HFpEF were studied before and after randomization to 30 days of statin therapy (atorvastatin, 10 mg; QD, n = 4) or placebo ( n = 3). FMD, RH, and PLM testing was performed via ultrasonography according to published guidelines. Results: Compared to baseline values, FMD tended to improve following statin therapy (2.8 ± 2.4% to 4.7 ± 1.5%, day 0 to day 30, P=0.06), with no change following placebo (P=0.87). FMD adjusted for shear also tended to improve following statin therapy (0.09 ± 0.08AU to 0.15 ± 0.03AU, day 0 to day 30, P=0.07), with no change following placebo (P=0.79). RH was unchanged following both statin (P=0.24) and placebo (P=0.31) interventions. PLM AUC appeared to improve following statin therapy (98 ± 62ml to 184 ± 111ml, day 0 to day 30, P=0.22), with no change following placebo (P=0.64). The peak blood flow response to PLM was unchanged in both statin (P=0.31) and placebo (P=0.28) groups. Conclusions: While no statistically significant differences were observed, qualitative analyses suggest that statin therapy may improve upper limb conduit vessel function and locomotor muscle microvascular responsiveness in patients with HFpEF, supporting the potential efficacy of this drug class to improve vascular function. These improvements in vascular reactivity provide preliminary evidence for improved NO bioavailability that may translate to improvements in functional capacity and exercise tolerance in this patient group. Funded in part by grants from the U.S. Department of Veteran’s Affairs (1I01CX002152, D.W.W., 1IK2RX003670, K.B.) and the National Institutes of Health (5T32HL139451, K.B.). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.
Details
- Title: Subtitle
- The impact of statin therapy on vascular reactivity in patients with Heart Failure with Preserved Ejection Fraction
- Creators
- Jarred Iacovelli - University of UtahJeremy Alpenglow - University of UtahKanokwan Bunsawat - University of UtahChristy Ma - Department of Internal Medicine, Salt Lake City, Utah, United StatesJohn Ryan - University of UtahD Wray - University of Utah
- Resource Type
- Abstract
- Publication Details
- Physiology (Bethesda, Md.), Vol.38(S1)
- DOI
- 10.1152/physiol.2023.38.S1.5729999
- ISSN
- 1548-9213
- eISSN
- 1548-9221
- Publisher
- AMER PHYSIOLOGICAL SOC; Rockville
- Grant note
- U.S. Department of Veteran's Affairs: 1I01CX002152, 1IK2RX003670 National Institutes of Health: 5T32HL139451
Funded in part by grants from the U.S. Department of Veteran's Affairs (1I01CX002152, D.W.W., 1IK2RX003670, K.B.) and the National Institutes of Health (5T32HL139451, K.B.).
- Language
- English
- Date published
- 05/2023
- Academic Unit
- Health, Sport, and Human Physiology
- Record Identifier
- 9984958338402771
Metrics
1 Record Views