P101	Regression of endothelial dysfunction, vascular and ventricular remodeling - influence of Simvastatin: high resolution ultrasound study.
1J.Petrovic, 1D.Petrovic, 2R.Babic
1Health Centre Studenica, Kraljevo, CS; 2Institute Cardiovascular Dedinje, Belgrade, CS.

Background: Great studies ( 4S, WOSCOPS) show that the reduction of mortality and cardiovascular events is higher than the one which is provide explanation by the regulation of lipid profile. These studies suggest antioxidant effects of statins, and possibility in regression of endothelial dysfunction. Methodology and Results: The study observes secondary prevention in 50 patients with coronary heart disease. We prescribed them Simvastatin 10-40mg, to attain optimal lipid profile. Before the introduction of the therapy, we followed the parameters of vascular mechanic brachial artery in basic conduction, during endothelium-dependent vasodilatation (EDV) (effect of reactive hyperemia) and during endothelium-independent vasodilatation (ENDV) (3 min. after sublingual application 0,4mg nitroglycerin). The control measurements were performed 1, 3 and 6 months after starting of the therapy with Simvastatin. The study following the vascular remodeling internal carotid artery with analysis of Intima-media complex thickness (IMT) as the most valid indicator of vascular remodeling, and left ventricular mass index (LVMI), conceptualize by Deveroux method, as the most valid indicator of ventricular remodeling. In control group are 50 healthy respondents without clinically express cardiovascular disease, and without risk factors (hyperlipidemia) for coronary artery disease, with equal sexual and average age of life with study group. Baseline After 1m. After 3m. After 6m. Control EDV (%) 2.3*1.3 4.5*1.5* 5.8*1.2* 6.6*1.3* 8.2*2.2 ENDV (%) 18.3*2.2 18.4*3.0 17.3*2.8 16.8*2.6 16.2*3.1 IMT (mm) 0.93*0.13 0.92*0.14 0.87*0.14 0.83*0.12* 0.69*0.13 LVMI(gr/m2)129*13 127*16 125*15 120*14 107*11 *:p<0.01 vs. baseline Conclusion: Simvastatin decreases the level of arterial endothelial dysfunction with increasing response to endothelial-dependent vasodilatation, and with decreasing to endothelial-independent vasodilatation (relative unproductive release NO). During the long-term therapy with Simvastatin we notice a tendency of regression vascular and ventricular remodeling in hyperlipidemic patients with coronary heart disease.

Copyright © 2005 S. Karger AG, Basel. Any further use of this abstract requires written permission from the publisher.