Beneficial Effects of Pitavastatin, a 3-Hydroxy-3-Methylglutaryl Coenzyme a Reductase Inhibitor, on Cardiac Function in Ischemic and Nonischemic Heart Failure

Abstract

SUMMARYHMG-CoA reductase inhibitors (statins) have recently been reported to improve cardiac function, and decrease the incidence of heart failure (HF) in hyperlipidemic patients. However, evidence for statin treatment in patients with HF remains a subject of debate. Thus, a study was initiated to examine the effects of pitavastatin on cardiac function evaluated by echocardiographic findings and plasma brain natriuretic peptide (BNP) levels in patients with HF. Twenty-three patients with HF were treated with pitavastatin 1-2 mg/ day in addition to standard therapy for 7.5 ± 3.8 months. Left ventricular end-diastolic dimension (LVDd) and left ventricular end-systolic dimension (LVDs) were determined by echocardiography. Left ventricular ejection fraction (LVEF) was calculated using Teichholz's formula. Serum lipid and plasma BNP levels were also measured. During the follow-up period, LVEF was increased from 42 ± 11 to 48 ± 13% (P = 0.002). LVDs was reduced from 43 ± 10 to 40 ± 10 mm (P < 0.001), while there was no change in LVDd. E/A (n = 10) and deceleration time (n = 7), obtained in some patients, did not change significantly (0.89 ± 0.33 to 0.77 ± 0.17%, and 215 ± 46 to 227 ± 72 msec, respectively). In addition, the plasma BNP level was moderately, but significantly decreased from 94 ± 78 to 70 ± 56 pg/mL (P = 0.005). In subgroup analysis, LVEF was improved in both patients with ischemic and nonischemic HF. There was no significant correlation between the percent change in serum total cholesterol and the percent change in LVEF by pitavastatin treatment. Serum total cholesterol, LDL-cholesterol, and triglycerides decreased by 21%, 30%, and 15%, respectively, and HDL-cholesterol increased by 12%. Pitavastatin improved cardiac function in patients with HF, which generally worsens with time. The results suggest that pitavastatin may be beneficial for treatment of HF. (Int Heart J 2008; 49: 49-58)

Beneficial effects of statin treatment on coronary microvascular dysfunction and left ventricular remodeling in patients with acute myocardial infarction

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Pitavastatin-attenuated cardiac dysfunction in mice with dilated cardiomyopathy via regulation of myocardial calcium handling proteins

“…It has been also reported that statins could ameliorate B type natriuretic peptide (BNP) up-regulation (10) and exert a therapeutic effect in myocarditis and postmyocarditis dilated cardiomyopathy (11). Pitavastatin has been reported to exert a preventive effect on pressure overload-induced heart failure (12) and ischemic heart failure (13). However, in a PEARL study (14), pitavastatin did not reduce cardiac death or hospitalization in patients with left ventricular ejection fraction (LVEF) < 30 %.…”

Place of pitavastatin in the statin armamentarium: promising evidence for a role in diabetes mellitus

“…In a small study (n = 23), administration of pitavastatin 1–2 mg/day for 7.5 months significantly increased left ventricular ejection fraction (LVEF) from 42 to 48%, and significantly decreased the plasma brain natriuretic peptide (BNP) level from 94 to 70 pg/mL 107. It has also been reported that there was an inverse correlation between atorvastatin-induced changes in CoQ10 and BNP,108 that CoQ10 level was an independent predictor of mortality in chronic heart failure,109 and that the CoQ10 level in myocardial tissue was lower in patients of NYHA class IV than in patients of NYHA class I 110.…”