By MD., FAC.C Zagazig University. 1.Improve endothelial function 2.Stimulate angiogenesis 3.Mobilize bone-marrow derived stem cells 4.Reduce systemic.

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Presentation transcript:

By MD., FAC.C Zagazig University

1.Improve endothelial function 2.Stimulate angiogenesis 3.Mobilize bone-marrow derived stem cells 4.Reduce systemic inflammation and control it (Zaca et al., JACC, 2007) Statins

Statins may slow lung function decline : To less than half as much annual decline over 10 years.To less than half as much annual decline over 10 years. Alexeeff. SE et al., Am. J. Respir. Crit. Care. Med. October 12/2007

Cardiovascular mortality is increased in CHF patients with CRP>3 mg/L especially in ischemic cardiomyopathy. The impact of CRP is independent of usual prognostic parameters. (Lamblin N. Monguet et al., EHJ, 2005) CRP and CHF

Copyright ©2001 American College of Cardiology Foundation. Restrictions may apply. Tsutamoto, T. et al. J Am Coll Cardiol 2001;37: Plasma oxidized low density lipoprotein (oxLDL) concentrations in the aortic root (AO), coronary sinus (CS) and femoral vein (FV) in 8 control subjects and in 22 patients with dilated cardiomyopathy

Copyright ©2001 American College of Cardiology Foundation. Restrictions may apply. Tsutamoto, T. et al. J Am Coll Cardiol 2001;37: Correlation between the transcardiac gradient of plasma tumor necrosis factor-alpha (TNF-alpha) and the transcardiac gradient of plasma oxidized low density lipoprotein (oxLDL) in patients with dilated cardiomyopathy

Copyright ©2007 American College of Cardiology Foundation. Restrictions may apply. Zaca, V. et al. J Am Coll Cardiol 2007;50: TNF-{alpha} and MMP-2

Copyright ©2007 American College of Cardiology Foundation. Restrictions may apply. Zaca, V. et al. J Am Coll Cardiol 2007;50: Magnitude of Circulating BMSCs

Copyright ©2007 American College of Cardiology Foundation. Restrictions may apply. Zaca, V. et al. J Am Coll Cardiol 2007;50: Ventriculographic Measures of LV Function and Size

Copyright ©2007 American Heart Association Khush, K. K. et al. Circulation 2007;115: Proportion of patients in the 10- and 80-mg arms of TNT hospitalized with HF during follow-up

Copyright ©2007 American Heart Association Khush, K. K. et al. Circulation 2007;115: Proportion of patients with and without a history of HF in the 10- and 80-mg arms of TNT experiencing hospitalization for HF during follow-up

Ongoing trials 1.UNIVERSE (Rousvastatin impact on ventricular remodeling lipids and cytokines) Echo and biomarkers study. 2.GISSI-HF : Rousvastatin and fish oil on CHF of any etiology. 3.CORONA (10 mg Rousvastatin for 5 years in ischemic cardiomyopthy).

Conclusion 1.Statins :  Oxidative stress,  CRP,  IL-6,  TNF- , mobilize bone marrow derived stem cells, and improve CHF. 2.Reverse remodeling occurs in ischemic and nonischemic cardiomyopathy. 3.Statins benefit is additive to ACE-I and ARB’s in CHF. 4.Higher doses seems to be more effective.