Statins improve myocardial perfusion in metabolic syndrome patients who have perfusion defects on myocardial perfusion imaging and angiographically normal coronary arteries

摘要

Objective: Previous studies in hypercholesterolemic patients with coronary artery disease (CAD) have demonstrated that lipid lowering therapy restores coronary endothelium dependent vasodilatation and increases myocardial perfusion. However, there is not enough data showing the effects of statins on myocardial perfusion in metabolic syndrome (MetS) patients who have perfusion abnormalities but not evident CAD, which are attributed to microvascular dysfunction. We aimed to evaluate whether or not statin therapy improves myocardial perfusion, as assessed by Technetium (Tc)-99m single-photon emission computed tomography (SPECT), in patients with MetS and angiographically normal epicardial coronary anatomy. Materials and Methods: The study population consisted of 55 selected patients (mean age: 52, 72% female) with MetS who have perfusion defect on exercise stress Tc-99m SPECT and normal coronary arteries. Patients were treated with 20 mg atorvastatin for six months regardless of baseline lipid levels and SPECT study was repeated after the therapy. The summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS), and left ventricular (LV) volumes and ejection fractions (EF) at rest and stress were obtained. Results: We found significant improvements in SSS, SRS and SDS after six months of statin therapy (p =0.001, 0.001 and 0.002, respectively). In addition, end-diastolic volumes at rest and stress, and stroke volume at rest were significantly decreased (p = 0.001, 0.001 and 0.026, respectively). Also, LV EF at stress was significantly increased (p = 0.035). Conclusions: Statin therapy in patients with MetS who have perfusion defects on Tc-99m SPECT and normal coronary arteries produces significant improvements in myocardial perfusion abnormalities. Corresponding Author: Taner Ulus, MD; e-mail: tanerulus@hotmail.com