2016


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2016/№3

Time-related changes in indices of myocardial structure and function during the rosuvastatin treatment in patients with chronic heart failure with preserved and impaired left ventricular ejection fraction

Skibitsky V. V.1, Prasolova S. A.2, Fendrikova A. V.1, Kudryashov E. A.1
1 – State Budgetary Educational Institution of Higher Professional Education, “Kuban State Medical University” of the RF Ministry of Health Care, Sedina 4, Krasnodar 350063
2 – Municipal Budgetary Institution of Health Care, “Krasnodar Municipal Clinical Emergency Hospital”, 40-letiya Pobedy 14, Krasnodar Territory, Krasnodar 350042

Keywords: heart failure, preserved ejection fraction, impaired ejection fraction, myocardial remodeling, dyslipidemia, rosuvastatin

DOI: 10.18087/rhfj.2016.3.2224

Background. Treatment of CHF complicating CVD is an important issue of current cardiology. Aim. To study time-related changes in LV myocardium structure and function, clinical status, and quality of life (QoL) in CHF patients with preserved and impaired LV EF receiving the rosuvastatin treatment. Materials and methods. The study included 130 patients with dyslipidemia and FC I-IV CHF, which had developed due to AH and/or IHD. Patients were divided into two groups: group 1 (n=65) consisting of HF patients with preserved LV EF (HF-PEF; EF >45 %) and group 2 (n=65) consisting of patients with impaired LV EF (HF-IEF; EF <45 %). All patients received rosuvastatin 10-20 mg/day in addition to a standard therapy. The myocardial structural and functional condition was evaluated by results of EchoCG at baseline and after 12 months of treatment. Results. The treatment not including rosuvastatin provided significant regression of remodeling parameters independent on the HF type. At the same time, patients with HF-PEF compared with patients with impaired LV EF showed a significantly greater increase in EF and more pronounced decreases in EDR, EDV, ESV, posterior wall thickness (PWT), LV myocardial mass (MM), and LV MM index (LVMMI). Changes in values of stroke volume (SV) and interventricular septum thickness (IST) did not differ between the groups. Rosuvastatin was more effective in patients with HF-PEF, which was evident as a 2.9 times increased number of patients with normal LV geometry and normalized LV diastolic function in 30.7% of cases and a 2.4 times decreased number of patients with FC III CHF. Supplementing the standard therapy for CHF with rosuvastatin was associated with improvement of QoL independent on the myocardial contractile function. Conclusion. The standard therapy for CHF including rosuvastatin resulted in more pronounced improvements of myocardial structural and functional status and clinical condition of patients with AH and/or stable IHD with preserved LV EF compared with patients with impaired LV EF. Rosuvastatin demonstrated good tolerability and safety in both groups.
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Skibitsky V. V., Prasolova S. A., Fendrikova A. V., Kudryashov E. A. Time-related changes in indices of myocardial structure and function during the rosuvastatin treatment in patients with chronic heart failure with preserved and impaired left ventricular ejection fraction. Russian Heart Failure Journal. 2016;17 (3):181–188

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