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Improvement of Left Ventricular Remodeling and Function by Hydroxymethylglutaryl Coenzyme A Reductase Inhibition With Cerivastatin in Rats With Heart Failure After Myocardial Infarction

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TLDR
Cerivastatin improved LV remodeling and function in rats with heart failure and was associated with an attenuated LV expression of fetal myosin heavy chain isoenzymes and collagen I.
Abstract
Background Hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) attenuate angiotensin II-induced cellular signaling. Because angiotensin II is involved in left ventricular (LV) remodeling after myocardial infarction (MI), we examined the effects of statin treatment in an experimental model of chronic heart failure after MI. Methods and Results Rats with extensive MI were treated with placebo or cerivastatin (0.3 mg/kg per day) as a dietary supplement or via gavage for 11 weeks starting on the 7th postoperative day. Infarct size and cholesterol levels were similar among all groups. LV cavity area, an index of LV dilatation, was reduced in MI rats on cerivastatin compared with placebo. LV end-diastolic pressure was increased in MI rats on placebo (24.1±4.1 mm Hg versus sham: 5.1±0.3 mm Hg; P <0.01), and it was significantly reduced by cerivastatin treatment (13.7±2.7 mm Hg; P <0.05 versus placebo). Cerivastatin partially normalized LV dP/dtmax and dP/dtmin, indices of LV systolic and diastolic function, which were significantly reduced in MI rats on placebo. Improvement of LV function by cerivastatin was accompanied by a reduced expression of collagen type I and β-myosin heavy chain. LV endothelial nitric oxide synthase was increased, whereas the nitrotyrosine protein level was decreased in MI rats by cerivastatin treatment. Conclusions Cerivastatin improved LV remodeling and function in rats with heart failure. This effect was associated with an attenuated LV expression of fetal myosin heavy chain isoenzymes and collagen I. Statin treatment may retard the progression of chronic heart failure. Received June 1, 2001; revision received July 9, 2001; accepted July 10, 2001.

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Pleiotropic effects of statins

TL;DR: Recent studies indicate that some of the cholesterol-independent or "pleiotropic" effects of statins involve improving endothelial function, enhancing the stability of atherosclerotic plaques, decreasing oxidative stress and inflammation, and inhibiting the thrombogenic response.
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THE CARDIAC FIBROBLAST: Therapeutic Target in Myocardial Remodeling and Failure

TL;DR: Candidate drug therapies that derive benefit from actions on cardiac fibroblasts are summarized, including inhibitors of angiotensin-aldosterone systems, endothelin receptor antagonists, statins, anticytokine therapies, matrix metalloproteinase inhibitors, and novel antifibrotic/anti-inflammatory agents.
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Pathological Ventricular Remodeling Mechanisms: Part 1 of 2

TL;DR: Molecular and cellular mechanisms governing pathological ventricular remodeling are reviewed, including cardiac myocyte growth and death, vascular rarefaction, fibrosis, inflammation, and electrophysiological remodeling.
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Nitric oxide and cardiac function: ten years after, and continuing.

TL;DR: Future therapeutic manipulations of cardiac NO synthesis will necessarily draw on additional characterization of the cellular and molecular determinants for the net effect of this versatile radical on the cardiomyocyte biology.
References
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Journal ArticleDOI

NAD(P)H Oxidase: Role in Cardiovascular Biology and Disease

TL;DR: Vascular NAD(P)H oxidases have been found to be essential in the physiological response of vascular cells, including growth, migration, and modification of the extracellular matrix and have been linked to hypertension and to pathological states associated with uncontrolled growth and inflammation, such as atherosclerosis.
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Left Ventricular Remodeling After Myocardial Infarction Pathophysiology and Therapy

TL;DR: This article will review postinfarction remodeling, pathophysiological mechanisms, and therapeutic intervention in left ventricular remodeling and provide important insights into the remodeling process and a rationale for future therapeutic strategies.
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Post-transcriptional Regulation of Endothelial Nitric Oxide Synthase mRNA Stability by Rho GTPase

TL;DR: Findings indicate that Rho negatively regulates eNOS expression and that HMG-CoA reductase inhibitors up-regulate eN OS expression by blocking Rho geranylgeranylation, which is necessary for its membrane-associated activity.
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Effects of the 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors, atorvastatin and simvastatin, on the expression of endothelin-1 and endothelial nitric oxide synthase in vascular endothelial cells.

TL;DR: Statins were able to prevent the inhibitory action exerted by oxidized LDL on eNOS mRNA and protein levels and might influence vascular tone by modulating the expression of endothelial vasoactive factors.
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Extracellular Matrix Remodeling in Heart Failure A Role for De Novo Angiotensin II Generation

TL;DR: ACE inhibition has proved effective in reducing mortal and morbid events, improving symptomatic status, and attenuating the progressive nature of cardiac failure in symptomatic patients with ventricular diastolic and/or systolic dysfunction in whom activation of the circulating RAAS is present as discussed by the authors.
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