Highlights
- •Pharmacological therapies for HFpEF have not improved the prognosis of patients.
- •Augmented sympathetic nerve activity is associated with HFpEF.
- •We investigated the effects of different types of statins on MSNA in HFpEF with consideration of the statin solubility.
- •Atorvastatin reduced MSNA without affecting baroreflex sensitivity in HFpEF, but rosuvastatin did not.
- •Atorvastatin have a favorable effect on sympathetic nerve activity in HFpEF.
Abstract
Augmented sympathetic nerve activity is associated with heart failure with preserved
left ventricular ejection fraction (HFpEF). Lipophilic statins reduce sympathetic
nerve activity in patients with heart failure with reduced left ventricular ejection
fraction. However, little is known about whether all types of statins, regardless
of solubility, reduce sympathetic nerve activity in HFpEF. We evaluated the effect
of atorvastatin, a lipophilic statin, and rosuvastatin, a hydrophilic statin, on muscle
sympathetic nerve activity (MSNA) in HFpEF patients. This study was conducted as a
prospective, randomized, open-label, crossover trial. Ten HFpEF patients with untreated
hyperlipidemia participated in this study. Subjects were assigned to either the atorvastatin
(lipophilic) or the rosuvastatin (hydrophilic) group with each drug administered for
8 weeks. Atorvastatin and rosuvastatin treatment resulted in a similar reduction in
low-density lipoprotein cholesterol (LDL-C) levels. There was no difference in the
effect of either treatment on blood pressure, heart rate, or left ventricular function.
Atorvastatin significantly decreased MSNA frequency compared with baseline (31.5 ± 6.3
vs. 47.5 ± 10.7 bursts/min, p < 0.01), but rosuvastatin had no effect on MSNA (40.9 ± 7.3 bursts/min).
MSNA was significantly lower in the atorvastatin group than rosuvastatin group (p < 0.05).
However, the reduction in MSNA seen in either group did not correlate with the reduction
in LDL-C. No significant differences were observed in either the baroreflex control
of heart rate or MSNA between the two groups. These results suggest that lipophilic
statins have a favorable effect on sympathetic nerve activity beyond lowering LDL-C
in HFpEF, but hydrophilic statins do not.
Abbreviations:
HFpEF (heart failure with preserved left ventricular ejection fraction), HFrEF (heart failure with reduced left ventricular ejection fraction), MSNA (muscle sympathetic nerve activity), LDL-C (low-density lipoprotein cholesterol), HR (heart rate), BP (blood pressure), LVEF (left ventricular ejection fraction)Keywords
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Article info
Publication history
Published online: April 28, 2018
Accepted:
April 27,
2018
Received in revised form:
April 24,
2018
Received:
February 28,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
