Delayed Response of Myocardial Flow Reserve to Lipid-Lowering Therapy With Fluvastatin

1999 
Background—Lipid-lowering therapy can improve endothelial function in patients with coronary artery disease (CAD) and hypercholesterolemia. Little is known about induced changes in myocardial microcirculation. This study prospectively investigated the temporal effects of lipid-lowering therapy with fluvastatin on coronary flow and flow reserve (CFR) in patients with CAD assessed by PET. Methods and Results—In an open clinical trial, CFR was studied in 15 patients with angiographically documented multivessel CAD and hypercholesterolemia (LDL >160 mg/dL). Dynamic 13N-labeled ammonia PET imaging in conjunction with adenosine was used to assess regional and global CFR at baseline as well as at 2 and 6 months during treatment with fluvastatin (60 to 80 mg/d). Despite a rapid decrease in total cholesterol (29±6%) and LDL (37±9%), myocardial blood flow at rest and during stress was unchanged after 2 months of treatment (2.7±0.9 versus 2.5±0.6 mL · g−1 · min−1). At 6 months, stress blood flow as well as CFR incre...
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