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Statin administration improves vascular function in heart failure with preserved ejection fraction
Journal article   Peer reviewed

Statin administration improves vascular function in heart failure with preserved ejection fraction

Jarred J. Iacovelli, Jeremy K. Alpenglow, Stephen M. Ratchford, Jesse C. Craig, Jonah M. Simmons, Jia Zhao, Van Reese, Kanokwan Bunsawat, Christy L. Ma, John J. Ryan, …
Journal of applied physiology (1985), Vol.136(4), pp.877-888
04/01/2024
DOI: 10.1152/japplphysiol.00775.2023
PMCID: PMC11286274
PMID: 38385181
url
https://www.ncbi.nlm.nih.gov/pmc/articles/11286274View
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Abstract

Heart failure with preserved ejection fraction (HFpEF) is characterized by impaired vascular endothelial function that may be improved by hydroxy-methylglutaryl-CoA (HMG-CoA) reductase enzyme inhibition. Thus, using a parallel, double-blind, placebo-controlled design, this study evaluated the efficacy of 30-day atorvastatin administration (10 mg daily) on peripheral vascular function and biomarkers of inflammation and oxidative stress in 16 patients with HFpEF [Statin: n = 8, 74 +/- 6 yr, ejection fraction (EF) 52-73%; Placebo: n = 8, 67 +/- 9 yr, EF 56-72%]. Flow-mediated dilation (FMD) and sustained-stimulus FMD (SS-FMD) during handgrip (HG) exercise, reactive hyperemia (RH), and blood flow during HG exercise were evaluated to assess conduit vessel function, microvascular function, and exercising muscle blood flow, respectively. FMD improved following statin administration (pre, 3.33 +/- 2.13%; post, 5.23 +/- 1.35%; P < 0.01), but was unchanged in the placebo group. Likewise, SS-FMD, quantified using the slope of changes in brachial artery diameter in response to increases in shear rate, improved following statin administration (pre: 5.31e(-5) +/- 3.85e(-5) mm/s(-1); post: 8.54e(-5) +/- 4.98e(-5) mm/s(-1); P = 0.03), with no change in the placebo group. Reactive hyperemia and exercise hyperemia responses were unchanged in both statin and placebo groups. Statin administration decreased markers of lipid peroxidation (malondialdehyde, MDA) (pre, 0.652 +/- 0.095; post, 0.501 +/- 0.094; P = 0.04), whereas other inflammatory and oxidative stress biomarkers were unchanged. Together, these data provide new evidence for the efficacy of low-dose statin administration to improve brachial artery endothelium-dependent vasodilation, but not microvascular function or exercising limb blood flow, in patients with HFpEF, which may be due in part to reductions in oxidative stress.
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