Effect of atorvastatin on exercise tolerance in patients with diastolic dysfunction and exercise-induced hypertension / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of atorvastatin on exercise tolerance in patients with diastolic dysfunction and exercise-induced hypertension.</p><p><b>METHODS</b>A randomized, double-blind, placebo-controlled prospective study was performed. Sixty patients with diastolic dysfunction (mitral flow velocity E/A <1) and exercise-induced hypertension (SBP>200 mm Hg) treated with atorvastatin (20 mg q.d) or placebo for 1 year. Cardiopulmonary exercise test and exercise blood pressure measurement were performed. Plasma B-natriuretic peptide (BNP) concentration at rest and at peak exercise, plasma high sensitive-C reaction protein (hs-CRP) and endothelin (ET) concentration were determined at baseline and after treatment.</p><p><b>RESULTS</b>After treatment by atorvastatin, the resting SBP, pulse pressure, the peak exercise SBP and BNP were significantly decreased; and the exercise time, metabolic equivalent, maximal oxygen uptake and anaerobic threshold were increased. All of these parameters had significant differences with baseline levels (P<0.05) and the rest pulse pressure, the peak exercise SBP and BNP, and the exercise time had significant differences compared with placebo treatment (P<0.05). Plasma concentrations of hs-CRP and ET were markedly reduced by atorvastatin treatment compared with baseline and placebo (P<0.05). No difference in above parameters was found before and after placebo treatment (P>0.05).</p><p><b>CONCLUSION</b>In patients with diastolic dysfunction at rest and exercise-induced hypertension, atorvastatin can effectively reduce plasma hs-CRP and ET level, lower blood pressure and peak exercise SBP, decrease peak exercise plasma BNP concentration, and ultimately improve exercise tolerance.</p>

Relationship of collagen content, intimal thickening and angiotensin II level of iliac arteries after balloon injury in rabbits / 浙江大学学报·医学版

OBJECTIVE: To investigate the relationship of collagen content intimal thickening and angiotensin II level of iliac arteries after balloon injury in rabbits. METHODS Fifty male New Zealand white rabbits were randomly devided into 6 groups: losartan groups, benazapril groups and control groups for 4 weeks or 8 weeks. Every rabbit underwent endothelial debridement of the right iliac artery. lorsartan (15 mg/kg/d) and benazapril (5 mg/kg/d) were orally administrated respectively in losartan groups and benazepril groups from 5 days before until 4 weeks or 8 weeks after balloon injury. RESULTS: Collagen content and intimal area of rabbit iliac arteries were increased after balloon injury. After intervention for 4 weeks with losartan and benazapril, collagen content was decreased in losartan and benazapril groups than in control group 23.58+/-6.16 % and 22.67+/-10.20 % compared with 35.20+/-7.25 % respectively, P<0.05. After intervention for 8 weeks, collagen content was significantly decreased (20.69+/-11.16)% and 25.41+/-11.00 % compared with 42.69+/-13.99 % respectively, P<0.05; Intimal area and intimal to medial area ratio were also decreased in losartan and benazapril groups than in control group; Lumen area was increased in losartan and benazapril groups than in control group(0.79+/-0.25)mm2 and (0.76+/-0.28)mm2 compared with (0.62+/-0.27)mm2 P<0.05; Tissue angiotensin II level was increased in losartan group (516.31+/-70.79)pg/mg.pro compared with (410.72+/-100.11)pg/mg.pro, P<0.05, and decreased in benazapril group than in control group (340.62+/-67.69)pg/mg.pro compared with (410.72+/-100.11)pg/mg.pro, P<0.05. There were close correlation between tissue angiotensin II level and intimal area, or between tissue angiotensin II level and intimal to medial area ratio, or and collagen content in benazapril group, respectively, P<0.05. Conclusion (1) Collagen protein is a dynamic participant in vascular injury. (2) Tissue renin angiotensin system may play an important role in collagen accumulation, intimal thickening and vascular injury after angioplasty. (3) Losartan and benazapril reduce vascular collagen content and inhibit intimal thickening after balloon injury.