doi: 10.1161/hs1201.099663
(Stroke. 2001;32:2817.)
© 2001 American Heart Association, Inc.
Original Contributions |
Pravastatin Improves Cerebral Vasomotor Reactivity in Patients With Subcortical Small-Vessel Disease
From the Departments of Neurology (P.S., F.M., A.R., H.S., M.S.) and Neuroradiology (H.L.), Johann Wolfgang Goethe-University, Frankfurt am Main, Germany.
Correspondence to Dr Philipp Sterzer, Department of Neurology, Johann Wolfgang Goethe-University, Schleusenweg 2-16, D-60528 Frankfurt am Main, Germany. E-mail sterzer{at}em.uni-frankfurt.de
Background and Purpose— Recent investigations have suggested an important role of statins in the prevention of stroke and dementia independent of their lipid-lowering properties. Using transcranial Doppler sonography (TCD), we examined acetazolamide reactivity as a marker of cerebral vasoreactivity in patients with subcortical small-vessel disease before and after pravastatin treatment.
Methods— In 16 patients (mean age 68±10 years) with subcortical small-vessel disease, cerebral vasomotor reactivity was tested using TCD insonating the middle cerebral artery. Cerebral blood flow velocity (CBFV) increase after bolus injection of 1 g acetazolamide was determined before and after 2-month treatment with pravastatin sodium 20 mg daily.
Results— Relative CBFV increase was significantly greater after pravastatin treatment (41.9±23.7% versus 55.7±18.3%, P=0.004). Comparison of CBFV at rest before and after treatment with pravastatin did not show significant differences. There was a strong negative correlation between the pravastatin-induced enhancement of vasomotor reactivity and the pretreatment CBFV increase (ß=-0.64, P=0.019). No associations were found between the effect of pravastatin on vasomotor reactivity and pretreatment levels or changes of LDL cholesterol.
Conclusions— This pilot study provides the first evidence for a significant improvement of cerebral vasomotor reactivity by statin therapy in patients with cerebral small-vessel disease. The results may help to elucidate the preventive effect of statins and provide insights into the pathophysiology of cerebral small-vessel disease.
Key Words: endothelium • HMG-CoA reductase inhibitors • small-vessel disease • ultrasonography • vasomotor reactivity
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