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J Am Coll Cardiol, 2007; 50:551-557, doi:10.1016/j.jacc.2007.04.050 (Published online 23 July 2007).
© 2007 by the American College of Cardiology Foundation
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PRECLINICAL STUDIES

Chronic Monotherapy With Rosuvastatin Prevents Progressive Left Ventricular Dysfunction and Remodeling in Dogs With Heart Failure

Valerio Zacà, MD, Sharad Rastogi, MD, Makoto Imai, MD, Mengjun Wang, MD, Victor G. Sharov, PhD, Alice Jiang, MD, Sidney Goldstein, MD, FACC and Hani N. Sabbah, PhD, FACC*

Department of Medicine, Division of Cardiovascular Medicine, Henry Ford Heart and Vascular Institute, Henry Ford Health System, Detroit, Michigan.

Manuscript received November 27, 2006; revised manuscript received April 9, 2007, accepted April 10, 2007.

* Reprint requests and correspondence: Dr. Hani N. Sabbah, Cardiovascular Research, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, Michigan 48202. (Email: hsabbah1{at}hfhs.org).

Objectives: This study examined the effects of long-term monotherapy with rosuvastatin (RSV) on the progression of left ventricular (LV) dysfunction and remodeling in dogs with heart failure (HF).

Background: 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors or "statins" possess other noncholesterol-lowering properties that include inhibiting proinflammatory cytokines, attenuating LV hypertrophy, and stimulating the release of bone marrow-derived stem cells (BMSCs).

Methods: Twenty-one dogs with microembolization-induced HF were randomized to 3 months oral monotherapy with low-dose (LD) RSV (0.5 mg/kg once daily, n = 7), high-dose (HD) RSV (3.0 mg/kg once daily, n = 7), or to no therapy (control group, n = 7). The change ({Delta}) from pre- to post-therapy (treatment effect) in LV end-diastolic volume (EDV) and end-systolic volume (ESV) and ejection fraction (EF) was measured. Protein level of tumor necrosis factor (TNF)-{alpha} in LV tissue and the number of circulating Sca-1–positive BMSCs was also determined. Blood and LV tissue from 6 normal dogs was obtained and used for comparison.

Results: There were no differences in {Delta}EDV, {Delta}ESV, and {Delta}EF between control group and LD RSV. In contrast, {Delta}EDV and {Delta}ESV were significantly lower, and {Delta}EF was significantly higher in HD RSV compared with control group. High-dose, but not LD, RSV also normalized protein levels of TNF-{alpha} and was associated with a significant increase in the number of circulating BMSCs.

Conclusions: In dogs with HF, chronic therapy with HD RSV prevents progressive LV dysfunction and dilation. This benefit may be partly derived from normalization of TNF-{alpha} expression and partly from increased mobilization of BMSCs.

Abbreviations and Acronyms
  BMSC = bone marrow-derived stem cell
  CVD = cardiovascular disease
  ECM = extracellular matrix
  EDV = end-diastolic volume
  EF = ejection fraction
  EPC = endothelial progenitor cell
  ESV = end-systolic volume
  HD = high-dose
  HF = heart failure
  HMG-CoA = 3-hydroxy-3-methylglutaryl coenzyme A
  LD = low-dose
  LV = left ventricular/ventricle
  MCSA = myocyte cross-sectional area
  MI = myocardial infarction
  MMP = matrix metalloproteinase
  ODD = oxygen diffusion distance
  RSV = rosuvastatin
  TNF = tumor necrosis factor
  VFIF = volume fraction of interstitial fibrosis
  VFRF = volume fraction of replacement fibrosis




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