Effects of statin therapy on cardiac sympathetic nerve activity and left ventricular remodeling in patients with chronic heart failure

Statin therapy reduces enhanced cardiac sympathetic nerve activity (CSNA) in patients with heart disease, and prevents left ventricular (LV) remodeling in chronic heart failure (CHF) patients. We sought to evaluate the effects of statin therapy on CSNA, as evaluated by ¹²³I-metaiodobenzylguanidine (MIBG) scintigraphy, and LV remodeling in CHF patients. This studywas sub-analysis of our previous report of the result that the serial ¹²³I-MIBGstudieswere themost useful prognostic indicator inCHF patients. Patients with CHF (n=208; left ventricular ejection fraction <45%) but no cardiac events for at least 5 months before the study, were identified according to their history of decompensated acute heart failure requiring hospitalization. The patients underwent ¹²³I-MIBGscintigraphy and echocardiography immediately before hospital discharge and after 6 months. The delayed % denervation, delayed heart/mediastinum count (H/M) ratio, and washout rate (WR) were determined by ¹²³I-MIBG scintigraphy. The LV end-diastolic volume (EDV) and end-systolic volume (ESV) were also determined by echocardiography. We selected 164 patients and used propensity scorematching to compare patients who received oral statin (n=82), and those who did not (n=82). The changes in 123I-MIBG scintigraphic parameters improved, and in echocardiographic LVEDV and LVESV reduced in the statin group compared with those in the non-statin group.Moreover, there were significant correlations between changes in the ¹²³I-MIBGscintigraphic findings and those in the LVEDV (% denervation, r=0.534, P<0.001; H/M ratio, r=-0.516, P<0.001; and WR, r=0.558, P<0.001); or the LVESV(% denervation, r=0.479, P<0.001; H/Mratio, r=-0.450, P<0.001; and WR, r=0.520, P<0.001) in the statin group. In contrast, there was no relationship between these parameters in the non-statin group.