The Effects Of Rosuvastatin On Cardiac Function And Serum MPO,MMP-9in Patients With Chronic Heart Failure

Objective:Rosuvastatin,the3-hydroxy-3-methyl-glutaric acid mono-acidsecondary (3hydroxy3methylglutaryl coenzyme A, HMGCoA) reductaseinhibitors, because of it’s stronger lipid-lowering effects, less of livermetabolism, it has become a potent clinical lipid-lowering drugs.Currently, alarge number of clinical trials have proved that statins can significantly reducecoronary heart disease incidence and the occurrence of cardiovascular events.Some studies also confirmed the clinical benefit of statins on chronic heartfailure (Congestive Heart Failure, CHF) patients.Therefore,"pleiotropic" ofstatins, such as inhibition of oxidative stress, anti-inflammatory, immuneregulation, improving endothelial function and other beyondcholesterol-lowering effects is gradually being recognized and applied to CHFtreatment. At present, there are sufficient evidences about the increased centralsympathetic nerve activity, excessive activation of neuroendocrine andcytokine participate in and influence the occurrence and development of heartfailure in patients of CHF. In addition, ventricular remodeling effect also playsan important role in the the CHF occurrence and development process.However, there were fewer studies about the effects of statins on ventricularremodeling indicators, such as myeloperoxidase (MPO), metal matrixprotease-9(MMP-9), and the relationship of them between cardiac functionat present.CORONA study showed that rosuvastatin did not significantly reducecardiac death or total mortality, but could significantly reduce the incidence ofhospitalization for CHF. Because the patients with ischemic heart disease andage＞60years were recuited and longer follow-up time (32.8months) in thethe CORONA study, it was unclear whether short-term application ofrosuvastatin could improve CHF cardiac function and what efficacy in patients with CHF of various etiologies (ischemic/nonischemic CHF). Inthis study, we investigated the effects of rosuvastatin on cardiac function andserum MPO, MMP-9levels in patients with chronic heart failure, and tried tofind the relationship between them.Methods：60patients with chronic heart failure were included to thisprospective case-controlled trial,including26cases of ischemic heart disease,34cases of non-ischemic heart disease.30were randomized to receiverosuvastatin10mg/d (statin group), and30served as controls (controlgroup). At baseline and7-10days,6weeks after treatment, the levels of MPOand MMP-9,6-minute walking distance, echocardiography (the size of heartchambers, LVEF) and blood lipids profiles were measured. And the serumMPO and MMP-9levels were used by enzyme-linked immunosorbent assaymethod (ELISA) respectively, echocardiography examination was ferformedby simpson method.Results：6weeks after treatment, LVEF (%), the6-minute walkingdistance of statin group and the6minutes walking distance of control groupwas significantly increased than before treatmen（tP＜0.05）; Although LVEF(%) of control group had increased than before treatment, difference was notsignificant；6weeks after treatment, the added values of LVEF (%) and6minute walking distance in statin group was significantly increasedcompared with those of the control group（P=0.000）. In addition,6weeksafter treatment, the indexes of LV, LA, RA in statin group were significantlyreduced than before treatment（P＜0.05）; but change was not significant forall of them in control group.At7-10days,6weeks after treatment, serum MPO and MMP-9levelsin control group and statin group did not show a significant difference fromthose of before treatment.However, after7-10days and6weeks of treatment,serum MMP-9level in statin group decreased significantly compared withthat of control group (P<0.05), while MPO levels, compared with thecontrol group, had the downward trend, but was not significantly.After6weeks therapy of rosuvastatin, the correlation analysis showed no significant correlation between the rise value of LVEF(%)(ΔLVEF), andthe reduce value of left ventricular (ΔLV) and change of serum of MPO andMMP-9(ΔMPO, ΔMMP-9)(r=-0.048,-0.204,0.212,0.068, P>0.05).Conclusion：After six weeks treatment by rosuvastatin, the serumMMP-9level was significantly reduced; the heart function improvedsignificantly. And there were no significant correlation between theimprovement of heart function and the decreased values of MPO and MMP-9(ΔMPO, ΔMMP-9).