Article

Effects of combined administration of low dose atorvastatin and vitamin E on inflammatory markers and endothelial function in patients with heart failure.

Cardiology Unit, Hippokration Hospital, Athens University Medical School, A Cardiology Department, Greece.
European Journal of Heart Failure (impact factor: 4.9). 01/2006; 7(7):1126-32. DOI:10.1016/j.ejheart.2005.03.007 pp.1126-32
Source: PubMed

ABSTRACT Heart failure has been associated with impaired endothelial function, increased inflammatory process and elevated oxidative stress status. Both statins and vitamin E separately improve endothelial function in patients with hypercholesterolemia and/or advanced atherosclerosis.
To evaluate the effect of atorvastatin alone or in combination with vitamin E on endothelial function and serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and vascular cells adhesion molecule (sVCAM-1) in patients with ischemic heart failure.
Thirty-eight male patients with ischemic cardiomyopathy were randomly divided into three groups and received either atorvastatin 10 mg/day (n = 14), a combination of atorvastatin 10 mg/day plus vitamin E 400 IU/day (n = 12), or no statin or antioxidant treatment (n=12, controls) for 4 weeks. Forearm blood flow (FBF) was measured using venous occlusion strain-gauge plethysmography. Forearm vasodilatory response to reactive hyperemia (RH%) or to nitrate (NTG%) was defined as the percent change of FBF from rest to the maximum flow during reactive hyperemia or after nitrate administration, respectively.
RH% was significantly improved in both the atorvastatin-treated (p < 0.01) and atorvastatin plus vitamin E groups (p < 0.05), but the increase was significantly higher in the atorvastatin-treated group (p < 0.05). Serum levels of IL-6, TNF-alpha and sVCAM-1 were decreased in the atorvastatin-treated group (p < 0.05 for all), but remained unaffected in the other two groups (p = NS for all).
Low dose atorvastatin treatment improves endothelial function and reduces the expression of proinflammatory cytokines and adhesion molecules in patients with ischemic heart failure, an effect partly depressed by vitamin E.

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Keywords

adhesion molecules
 
antioxidant treatment
 
atorvastatin 10 mg/day
 
Forearm blood flow
 
Forearm vasodilatory response
 
inflammatory process
 
ischemic cardiomyopathy
 
ischemic heart failure
 
Low dose atorvastatin treatment
 
male patients
 
nitrate administration
 
oxidative stress status
 
percent change
 
reactive hyperemia
 
serum levels
 
tumor necrosis factor alpha
 
vascular cells adhesion molecule
 
venous occlusion strain-gauge plethysmography
 
vitamin E 400 IU/day
 
vitamin E groups
 

Dimitris Tousoulis