Simvastatin May Improve Myocardial Perfusion Abnormality in Slow Coronary Flow

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background: The slow coronary flow (SCF) phenomenon is a coronary microvascular disorder characterized by the delayed passage of contrast in the absence of obstructive epicardial coronary disease. Recent studies showed the possible role of endothelial dysfunction, diffuse atherosclerosis and inflammation in the pathogenesis of this phenomenon. We aimed to investigate the effect of statin on myocardial perfusion in patients with SCF. Methods and Results: The study population consisted of 97 patients with SCF. Coronary flow patterns of the cases are determined by thrombolysis in myocardial infarction (TIMI) frame count method. Single-photon emission computed tomographic myocardial perfusion imaging studies and lipid parameters of the patients were obtained before and after 6 months of simvastatin treatment period. During the study, daily single dose of 40 mg simvastatin has been given to each subject. We found a significant positive correlation between mean TIMI frame count and basal reversibility score (r = 0.84, p = 0.0001). In addition, analysis of the reversibility scores demonstrates that simvastatin treatment has significantly improved the myocardial perfusion abnormality at the end of the follow-up period. Conclusion: Present findings allow us to conclude that simvastatin improved myocardial perfusion in patients with SCF.

Related collections

Most cited references 19

Record: found
Abstract: not found
Article: not found

Angina pectoris and slow flow velocity of dye in coronary arteries--a new angiographic finding.

Mitali A. Tambe, Robert H Zimmerman, E Mascarenhas … (1972)

0 comments Cited 105 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Effects of the 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors, atorvastatin and simvastatin, on the expression of endothelin-1 and endothelial nitric oxide synthase in vascular endothelial cells.

J Antolín, Conrad O Perera, S Lamas … (1998)

Endothelial dysfunction associated with atherosclerosis has been attributed to alterations in the L-arginine-nitric oxide (NO)-cGMP pathway or to an excess of endothelin-1 (ET-1). The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have been shown to ameliorate endothelial function. However, the physiological basis of this observation is largely unknown. We investigated the effects of Atorvastatin and Simvastatin on the pre-proET-1 mRNA expression and ET-1 synthesis and on the endothelial NO synthase (eNOS) transcript and protein levels in bovine aortic endothelial cells. These agents inhibited pre-proET-1 mRNA expression in a concentration- and time-dependent fashion (60-70% maximum inhibition) and reduced immunoreactive ET-1 levels (25-50%). This inhibitory effect was maintained in the presence of oxidized LDL (1-50 microg/ml). No significant modification of pre-proET-1 mRNA half-life was observed. In addition, mevalonate, but not cholesterol, reversed the statin-mediated decrease of pre-proET-1 mRNA levels. eNOS mRNA expression was reduced by oxidized LDL in a dose-dependent fashion (up to 57% inhibition), whereas native LDL had no effect. Statins were able to prevent the inhibitory action exerted by oxidized LDL on eNOS mRNA and protein levels. Hence, these drugs might influence vascular tone by modulating the expression of endothelial vasoactive factors.

0 comments Cited 70 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Slow coronary flow: clinical and histopathological features in patients with otherwise normal epicardial coronary arteries.

P Motta, M Ciavolella, G Scibilia … (1996)

Slow flow of dye in epicardial coronary arteries is not an infrequent finding in patients during routine coronary angiography. Whether this pattern of flow can be reversed by nitroglycerin or dipyridamole and whether this angiographic finding is associated with histopathological abnormalities is unknown. We hypothesized that this abnormality could be associated with small vessel disease of the heart, since the epicardial arteries are usually widely patent. Thus, out of the patients undergoing heart catheterization at our institution during the past 5 years, 10 (7%) presented with chest pain, normal epicardial coronary arteries, and abnormal coronary progression of dye. Rest electrocardiogram (ECG), exercise test, echocardiographic examination, and left ventricular angiogram were normal. Coronary angiography showed slow flow of dye on a total of 20 main coronary vessels, that was not reversed by intracoronary nitroglycerin administration. Six of them underwent dipyridamole intravenous infusion that normalized dye run-off in all affected vessels, for a total of 9 main coronary vessels. Histopathological examination (light and electron microscope) of left ventricular endomyocardial biopsies showed thickening of vessel walls with luminal size reduction, mitochondrial abnormalities, and glycogen content reduction. Normal and pathological zones often coexisted in the same specimen. Thus. In some patients with slow coronary flow and patent coronary arteries, functional obstruction of microvessels seems to be implicated, as it is relieved by dipyridamole infusion. Patchy histopathological abnormalities suggestive of small vessel disease are also detectable and could contribute to increase flow resistance.

0 comments Cited 67 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (publisher-id): CRD

Journal ID (nlm-ta): Cardiology

Journal ID (doi): 10.1159/issn.0008-6312

Title: Cardiology

Publisher: S. Karger AG

ISSN (Print): 0008-6312

ISSN (Electronic): 1421-9751

Publication date Subscription-year: 2008

Publication date (Print): April 2008

Publication date (Electronic): 10 October 2007

Volume: 110

Issue: 1

Pages: 39-44

Affiliations

^aDepartment of Cardiology, Siyami Ersek Cardiac and Thoracic Surgery Center, Istanbul, and ^bDepartment of Cardiology, Pamukkale University School of Medicine, Denizli, Turkey

Article

Publisher ID: 109405 Other ID: Cardiology 2008;110:39–44

DOI: 10.1159/000109405

PubMed ID: 17934268

SO-VID: e59c8b35-b04e-4b70-9ae6-3058d921e0be

License:

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 15 February 2007

Date accepted : 13 April 2007

Page count

Figures: 2, References: 30, Pages: 6

Comments

Comment on this article

scite_

Cited by 13

See all cited by

Most referenced authors 302

See all reference authors

- Version 1

Simvastatin May Improve Myocardial Perfusion Abnormality in Slow Coronary Flow

Read this article at

Abstract

Related collections

Karger: Cardiovascular System

Most cited references 19

Angina pectoris and slow flow velocity of dye in coronary arteries--a new angiographic finding.

Effects of the 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors, atorvastatin and simvastatin, on the expression of endothelin-1 and endothelial nitric oxide synthase in vascular endothelial cells.

Slow coronary flow: clinical and histopathological features in patients with otherwise normal epicardial coronary arteries.

Author and article information

Journal

Affiliations

Article

History

Page count

Categories

Comments

Comment on this article

Similar content 208

Cited by 13

Most referenced authors 302