This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Antonini-Canterin, F. Articles by Nicolosi, G. L. Search for Related Content PubMed Articles by Antonini-Canterin, F. Articles by Nicolosi, G. L. Related Collections Related Articles

FOCUS ISSUE: VALVULAR HEART DISEASE: CLINICAL RESEARCH

Hydroxymethylglutaryl Coenzyme-A Reductase Inhibitors Delay the Progression of Rheumatic Aortic Valve Stenosis

A Long-Term Echocardiographic Study

Francesco Antonini-Canterin, MD^_*,_*, Elisa Leiballi, MD^_*, Roxana Enache, MD, Bogdan A. Popescu, MD, PhD^,, Monica Roca, MD, Eugenio Cervesato, PhD^_*, Rita Piazza, MD^_*, Carmen Ginghin, MD, PhD^, and Gian Luigi Nicolosi, MD^_*

^_* Cardiologia ARC, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy
Prof. Dr. C. C. Iliescu Institute of Cardiovascular Diseases, Bucharest, Romania
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

Manuscript received October 16, 2008; revised manuscript received December 22, 2008, accepted January 5, 2009.

^_* Reprint requests and correspondence: Dr. Francesco Antonini-Canterin, Cardiologia, ARC, Azienda Ospedaliera S. Maria degli Angeli, Via Montereale 24, 33170 Pordenone, Italy (Email: cardiologia{at}aopn.fvg.it).

Objectives: This study sought to assess the effect of hydroxymethylglutaryl coenzyme-A reductase inhibitors (statins) on the progression of rheumatic aortic valve stenosis.

Background: The possible role of statins in slowing the progression of degenerative aortic valve stenosis (AS) is still debated. No information about the role of statin treatment in patients with rheumatic AS is available yet.

Methods: From our 1988 to 2008 echocardiographic database, we retrospectively identified all patients with rheumatic AS, with a baseline peak aortic velocity 1.5 m/s and at least 2 echocardiographic studies 2 years apart. Exclusion criteria were: severe aortic regurgitation, bicuspid aortic valve, and left ventricular ejection fraction <40%.

Results: The study population consisted of 164 patients (30 treated with statins) followed up for 8.5 ± 4.2 years. Peak aortic velocity at baseline was not different in patients treated with statins versus untreated patients (2.3 ± 0.8 m/s vs. 2.3 ± 0.7 m/s, p = 0.84). There were no significant differences in sex, age, or follow-up duration between the 2 groups. Progression of AS severity was slower in patients receiving statins compared with untreated patients (annual change of peak aortic velocity: 0.05 ± 0.07 m/s/year vs. 0.12 ± 0.11 m/s/year, p = 0.001). An annual rate of peak velocity progression 0.1 m/s was found in 10% of statin-treated patients and in 49% of untreated patients (p < 0.0001).

Conclusions: This is the first observation of a positive effect of statin treatment in reducing the progression of rheumatic AS. The underlying mechanisms remain to be clarified.

Key Words: rheumatic aortic valve stenosis • echocardiography • statins

Abbreviations and Acronyms   ACEI = angiotensin-converting enzyme inhibitor   AS = aortic stenosis   CAD = coronary artery disease   CRP = C-reactive protein

Related Articles

Statins in Rheumatic Heart Disease: Taking the Bite Out?

Ori Ben-Yehuda and Anthony N. DeMaria
J. Am. Coll. Cardiol. 2009 53: 1880-1882. [Full Text] [PDF]

This article has been cited by other articles:

				O. Ben-Yehuda and A. N. DeMaria Statins in Rheumatic Heart Disease: Taking the Bite Out? J. Am. Coll. Cardiol., May 19, 2009; 53(20): 1880 - 1882. [Full Text] [PDF]