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Titolo:
Delayed response of myocardial flow reserve to lipid-lowering therapy withfluvastatin
Autore:
Guethlin, M; Kasel, AM; Coppenrath, K; Ziegler, S; Delius, W; Schwaiger, M;
Indirizzi:
Tech Univ Munich, Nukl Med Klin, D-81675 Munich, Germany Tech Univ MunichMunich Germany D-81675 ed Klin, D-81675 Munich, Germany Tech,Univ Munich, Abt Kardiol, Klinikum Munchen Bogenhausen, D-81675 Munich Tech Univ Munich Munich Germany D-81675 chen Bogenhausen, D-81675 Munich
Titolo Testata:
CIRCULATION
fascicolo: 4, volume: 99, anno: 1999,
pagine: 475 - 481
SICI:
0009-7322(19990202)99:4<475:DROMFR>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
POSITRON EMISSION TOMOGRAPHY; CORONARY-ARTERY DISEASE; BLOOD-FLOW; NONINVASIVE QUANTIFICATION; VASCULAR REACTIVITY; N-13 AMMONIA; ENDOTHELIUM; SEVERITY; ATHEROSCLEROSIS; STENOSIS;
Keywords:
lipids; fluvastatin; blood flow; PET; adenosine;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Schwaiger, M Tech Univ Munich, Nukl Med Klin, Ismaninger Str 22, D-81675 Munich, Germany Tech Univ Munich Ismaninger Str 22 Munich Germany D-81675 ny
Citazione:
M. Guethlin et al., "Delayed response of myocardial flow reserve to lipid-lowering therapy withfluvastatin", CIRCULATION, 99(4), 1999, pp. 475-481

Abstract

Background-Lipid-lowering therapy can improve endothelial function in patients with coronary artery disease (CAD) and hypercholesterolemia. Little isknown about induced changes in myocardial microcirculation. This study prospectively investigated the temporal effects of lipid-lowering therapy withfluvastatin on coronary flow and flow reserve (CFR) in patients with CAD assessed by PET. Methods and Results-In an open clinical trial, CFR was studied in 15 patients with angiographically documented multivessel CAD and hypercholesterolemia (LDL >160 mg/dL). Dynamic N-13-labeled ammonia PET imaging in conjunction with adenosine was used to assess regional and global CFR at baseline as well as at 2 and 6 months during treatment with fluvastatin (60 to 80 mg/d), Despite a rapid decrease in total cholesterol (29+/-6%) and LDL (37+/-9%), myocardial blood flow at rest and during stress was unchanged after 2 months of treatment (2.7+/-0.9 versus 2.5+/-0.6 mt g(-1). min(-1)). At 6 months, stress blood flow as well as CFR increased significantly (3.4+/-1.0 mL .g(-1) . min(-1)). No change in hemodynamic parameters was noted during theentire study. Nine of 15 patients increased CFR by >20%. All responders demonstrated improvement in anginal symptoms, whereas nonresponders stated nochange (n=4) or worsening of symptoms (n=2). The improvement in CFR was not related to the amount of lipid lowering and was independent of the severity of stenoses. Conclusions-Improvement in stress blood flow and CFR is delayed compared with the lipid-lowering effect of fluvastatin, suggesting a slow recovery ofthe vasodilatory response to adenosine.

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Documento generato il 29/01/20 alle ore 19:02:34