Effects of Pitavastatin on Cardiac Structure and Function and on Prevention of Atrial Fibrillation in Elderly Hypertensive Patients

Warita, Shunichiro; Kawasaki, Masanori; Tanaka, Ryuhei; Ono, Katsushige; Kojima, Tai; Hirose, Takahisa; Itō, Makoto; Watanabe, Takatomo; Nishigaki, Kazuhiko; Takemura, Genzou; Noda, Toshiyuki; Watanabe, Soichi; Minatoguchi, Shinya

doi:10.1253/circj.cj-12-0722

Cited by 28 publications

(25 citation statements)

References 35 publications

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“…8 Using this technology, we recently reported that pitavastatin therapy prevented new-onset AF in 220 elderly patients with HTN. 9 The incidence of new-onset AF was relatively lower than expected because the BP levels were adequately controlled. 9 Thus, the aim of the present study was to evaluate the relationship between the BP achieved, the cardiac structure and function and the incidence of new-onset AF in elderly patients with HTN.…”

Section: Introductionmentioning

confidence: 92%

“…The reliability and the reproducibility of the feature-tracking echocardiographic method for the quantification of LA volume (LAV) and function have been established in previous studies. 8,9 Maximum LAV, minimum LAV and LAV just before atrial contraction were obtained from the apical four-chamber view with a frame rate of 55 to 60 frames s À1 using Simpson's method. LA total emptying function (EF), passive EF and active EF were calculated to evaluate phasic and global LA function and were defined as (maximum LAV Àminimum LAV)/maximum LAV Â 100; (maximum LAV Àpre-atrial contraction LAV)/maximum LAV Â 100; and (pre-atrial contraction LAV Àminimum LAV)/pre-atrial contraction LAV Â 100, respectively.…”

Section: Echocardiographymentioning

confidence: 99%

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Association among blood pressure control in elderly patients with hypertension, left atrial structure and function and new-onset atrial fibrillation: a prospective 2-year study in 234 patients

et al. 2013

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We assessed the hypothesis that blood pressure (BP)-lowering therapy has a beneficial effect on left atrial (LA) structure and function and may decrease the incidence of new-onset atrial fibrillation (AF) in elderly patients with hypertension (HTN). We divided 234 subjects ≥65 years old into four groups based on mean office BP achieved: a normotensive group (n=71), a HTN group with good BP control (n=72), a HTN group with poor BP control (n=41) and a HTN group with moderate BP control (n=50). LA volume, emptying function (EF), strain and strain rate (SR) were measured by speckle tracking echocardiography. LA volume, EF, strain and SR in the HTN group with good BP control were better preserved than those parameters in the HTN group with poor BP control. The incidence of new-onset AF during 2 years was significantly higher in the HTN group with poor BP control (hazard ratio: 7.015; 95% confidence interval: 2.433-20.22; P<0.001). In multivariate Cox regression analysis that included the difference in echocardiographic parameters between baseline and follow-up, both age and being in the HTN group with poor BP control were independent predictors of new-onset AF. In multivariate Cox regression analysis that included only parameters at baseline, ratio of the peak early transmitral flow velocity (E) to the peak early myocardial tissue velocity (E/e') was an independent predictor of new-onset AF. The incidence of new-onset AF depended on the long-term level of BP control rather than short-term changes in LA structure and function. Poor BP control increased the risk of new-onset AF in elderly patients with HTN.

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Section: Introductionmentioning

confidence: 92%

Section: Echocardiographymentioning

confidence: 99%

Association among blood pressure control in elderly patients with hypertension, left atrial structure and function and new-onset atrial fibrillation: a prospective 2-year study in 234 patients

et al. 2013

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“…Variables and risk factors were selected for the final model based on clinical relevance 1,15,16 and statistical significance (defined as P<0.01). Details on the bootstrap modeling are presented in Annex S1.…”

Section: Model Derivationmentioning

confidence: 99%

Incident Atrial Fibrillation Hazard in Hypertensive Population

et al. 2015

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Determining the risk of atrial fibrillation within the hypertensive population without ischemic vascular disease would aid in decision making on preventive approaches. Accordingly, we aimed to estimate the risk of incident atrial fibrillation in this population. We conducted an historical cohort study between July 1, 2006, and December 31, 2011, using anonymized longitudinal patient information from primary care and hospital discharge records contained in the System for the Development of Research in Primary Care database. We included 255 440 hypertensive patients, aged ≥55 years at the time of study entry. Individuals with previous atrial fibrillation, ischemic heart disease, stroke, and peripheral artery disease were excluded. To build the incident atrial fibrillation risk function, a derivation and a validation cohort were defined, representing 60% and 40% of the entire database, respectively, and a Cox proportional hazards model was fitted. Atrial fibrillation incidence was 7.24 per 1000 person-years (95% confidence interval, 7.08–7.40). The final model included age, weight, total cholesterol, heart failure, valvular heart disease, and antihypertensive treatment. Its concordance index (standard error) was 0.769 (0.004) and 0.768 (0.005) in the derivation and validation datasets, respectively. This research provides a tool, built with variables from daily clinical practice, that can be readily used in the primary care setting to predict atrial fibrillation incidence in the hypertensive population without ischemic vascular disease. The tool may help tailor individualized diagnostic and preventive care decisions.

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“…One study found that pitavastatin had a beneficial effect on LV diastolic function [6]. Additionally, several studies have found a survival benefit in patients with HFpEF who are receiving statin therapy [7,8,9], which mainly exerts a competitive inhibition on HMGR in the mevalonate pathway.…”

Section: Introductionmentioning

confidence: 99%

Alteration of Mevalonate Pathway Related Enzyme Expressions in Pressure Overload-Induced Cardiac Hypertrophy and Associated Heart Failure with Preserved Ejection Fraction

Chen

Zhong

Yang³

et al. 2013

Cell Physiol Biochem

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Background: Abnormalities of the mevalonate pathway, an important cellular metabolic pathway, are common in many diseases including cardiovascular disease. The mevalonate pathway related enzyme expressions in pressure overload-induced cardiac hypertrophy and associated diastolic dysfunction remains largely unknown. This study aims to investigate whether the expression of mevalonate pathway related enzyme is altered during the progression of cardiac hypertrophy and associated diastolic dysfunction induced by pressure overload. Methods: Male Sprague-Dawley (SD) rats were randomly divided into two groups: the suprarenal abdominal aortic coarctation (AAC) group and the sham group. Results: Histological and echocardiographic assessments showed that there was a significant cardiovascular remodeling in the AAC group compared with the sham group after 3 weeks post-operatively, and the left ventricular (LV) diastolic function was reduced at 8 and 14 weeks post-operatively in the AAC group, without any change in systolic function during the study. The tissue of the heart and the abdominal aorta proximal to the coarctation showed over-expression of several enzymes, including 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGR), farnesyl diphosphate synthase (FDPS), farnesyltransferase-α (FNTA), farnesyltransferase-β (FNTB), geranylgeranyltransferase type I (GGTase-I) and the activation of their downstream proteins was enhanced. Conclusions: AAC induced compensatory LV hypertrophy to decompensatory diastolic dysfunction, accompanied by altered expression of several key enzymes in the mevalonate pathway.

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Effects of Pitavastatin on Cardiac Structure and Function and on Prevention of Atrial Fibrillation in Elderly Hypertensive Patients

Cited by 28 publications

References 35 publications

Association among blood pressure control in elderly patients with hypertension, left atrial structure and function and new-onset atrial fibrillation: a prospective 2-year study in 234 patients

Association among blood pressure control in elderly patients with hypertension, left atrial structure and function and new-onset atrial fibrillation: a prospective 2-year study in 234 patients

Incident Atrial Fibrillation Hazard in Hypertensive Population

Alteration of Mevalonate Pathway Related Enzyme Expressions in Pressure Overload-Induced Cardiac Hypertrophy and Associated Heart Failure with Preserved Ejection Fraction

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