ABSTRACT
Dilated cardiomyopathy (DCM) is associated with increased inflammatory response reflected among other markers in high-sensitivity C-reactive protein (hsCRP) and soluble interleukin-2 receptor (sIL-2R) levels. We examined prospectively 60 consecutive patients with DCM. Of them, 30 were dyslipidemic (group I) and 30 normolipidemic (group II). Group I patients were randomized to either simvastatin therapy (20 mg/day, group Ia, n = 15) or hypolipidemic diet therapy (group Ib, n = 15). Patients were re-evaluated 6 months later. High-sensitivity C-reactive protein and sIL-2R levels were significantly higher in group I compared with group II patients (19.5 ± 3.4 vs 3.03 ± 3.5 mg/L, P = .01, 1137 ± 441 vs 599 ± 235 pg/mL, P = .001, respectively). There was a significant correlation between sIL-2R and hsCRP levels in dyslipidemic patients but not in normolipidemic patients. Significant reduction of hsCRP and sIL-2R levels was observed only in group Ia patients. Patients with DCM having dyslipidemia have increased inflammatory response, which is reduced after 6 months of statin therapy.
Subject(s)
Cardiomyopathy, Dilated/complications , Dyslipidemias/complications , Dyslipidemias/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Inflammation/drug therapy , Inflammation/etiology , Simvastatin/therapeutic use , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
We present our preliminary clinical experience with the initial and repetitive administration of the novel inotropic agent levosimendan in a cohort of 20 patients with end-stage heart failure who were acutely decompensated or whose symptoms were refractory to the usual pharmacological treatments thus necessitating hospitalization. Repetitive levosimendan infusions were administered to 9 patients (minimum 2, maximum 8 pulses). The effects of this therapy on the symptomatic status, vital signs, hemodynamic performance and clinical outcomes are discussed.
