Intensified Statin Preserves Global Longitudinal Strain in Transplanted Heart

Purpose Left ventricular (LV) global longitudinal strain (GLS) is a robust marker of subclinical myocardial dysfunction. Previous studies showed that as small as 2% reduction in GLS predicted major adverse event in heart transplant (HT) recipients, including cardiac allograft vasculopathy (CAV). Although low intensity statin is commonly used after HT to reduce CAV, the incremental impact of statin intensity on myocardial function is unknown. Methods A single center, retrospective review was conducted in all adult HT recipients between 2012 and 2016. Patients were excluded for: death, LV ejection fraction Results Forty-three HT recipients (low intensity statin, n=21; intensified statin, n=22) comprised the study population. Age, sex, donor age, presence of pre-HT VAD, and immunosuppression regimen were not significantly different between groups. Importantly, GLS was preserved in HT recipients receiving intensified statin (-17.0 ± 3.3 vs. -17.1 ± 2.5%, p=0.62) but significantly reduced in low intensity statin group (-17.5 ± 2.5 vs. -15.8 ± 2.5%, p=0.029, Figure 1A). The degree of GLS reduction was significantly higher during low intensity statin use (1.8 ± 1.5%) in comparison to intensified statin (0.13 ± 2.7%, p=0.044, Figure 1B). Interobserver correlation coefficient was 0.95. Conclusion Intensified statin after HT is associated with preservation of myocardial function during intermediate term follow up, indicating a favorable impact of intensifying statin regimen after HT.