The effect of rosuvastatin on inflammation, matrix turnover and left ventricular remodeling in dilated cardiomyopathy: a randomized, controlled trial

• Published in: PloS one 2014-02, Vol.9 (2), p.e89732-e89732
• Main Authors: Broch, Kaspar, Askevold, Erik T, Gjertsen, Erik, Ueland, Thor, Yndestad, Arne, Godang, Kristin, Stueflotten, Wenche, Andreassen, Johanna, Svendsmark, Rolf, Smith, Hans-Jørgen, Aakhus, Svend, Aukrust, Pål, Gullestad, Lars
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antilipemic agents; Beta blockers; Biology; Blood tests; C-reactive protein; Cardiology; Cardiomyopathy; Cardiomyopathy, Dilated - drug therapy; Cardiomyopathy, Dilated - physiopathology; Cardiovascular disease; Cholesterol; Cholesterol, LDL - blood; Congestive cardiomyopathy; Coronary vessels; Dilated cardiomyopathy; Drug dosages; Echocardiography; Extracellular matrix; Extracellular Matrix - drug effects; Extracellular Matrix - metabolism; Female; Fluorobenzenes - therapeutic use; Heart; Heart diseases; Heart failure; Heart Failure - drug therapy; Heart Failure - etiology; Hospitals; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Inflammation; Inflammation - drug therapy; Internal medicine; Magnetic resonance; Magnetic resonance imaging; Male; Medical research; Medicine; Middle Aged; NMR; Nuclear magnetic resonance; Pathogenesis; Patients; Proteins; Pyrimidines - therapeutic use; Randomization; Rosuvastatin; Rosuvastatin Calcium; Serum levels; Statins; Sulfonamides - therapeutic use; Ventricle; Ventricular Function, Left - drug effects; Ventricular Remodeling - drug effects
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0089732

Dilated cardiomyopathy is characterized by left ventricular dilatation and dysfunction. Inflammation and adverse remodeling of the extracellular matrix may be involved in the pathogenesis. Statins reduce levels of low density lipoprotein cholesterol, but may also attenuate inflammation and affect matrix remodeling. We hypothesized that treatment with rosuvastatin would reduce or even reverse left ventricular remodeling in dilated cardiomyopathy. In this multicenter, randomized, double blind, placebo-controlled study, 71 patients were randomized to 10 mg of rosuvastatin or matching placebo. Physical examination, blood sampling, echocardiography and cardiac magnetic resonance imaging were performed at baseline and at six months' follow-up. The pre-specified primary end point was the change in left ventricular ejection fraction from baseline to six months. Over all, left ventricular ejection fraction improved 5 percentage points over the duration of the study, but there was no difference in the change in left ventricular ejection fraction between patients allocated to rosuvastatin and those allocated to placebo. Whereas serum low density lipoprotein cholesterol concentration fell significantly in the treatment arm, rosuvastatin did not affect plasma or serum levels of a wide range of inflammatory variables, including C-reactive protein. The effect on markers of extracellular matrix remodeling was modest. Treatment with rosuvastatin does not improve left ventricular ejection fraction in patients with dilated cardiomyopathy. ClinicalTrials.gov NCT00505154.