Does high dose statin pretreatment affect global strains in patients undergoing valve replacement

Purpose To study the effect of rosuvastatin 40 mg (initiated 7 days prior to surgery) in patients undergoing valve replacement (VR) for rheumatic mitral valve disease on left ventricular (LV) strain and biomarker release kinetics. Methods In this randomized study, cardiac biomarkers viz. troponin I...

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Veröffentlicht in:Indian journal of thoracic and cardiovascular surgery 2024-05, Vol.40 (3), p.300-310
Hauptverfasser: Prajapathi, Sudesh, Kapoor, Aditya, Agarwal, Surendra Kumar, Tewari, Prabhat, Pande, Shantanu, Chandra, Bipin, Sahu, Ankit, Khanna, Roopali, Kumar, Sudeep, Garg, Naveen, Tewari, Satyendra
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container_end_page 310
container_issue 3
container_start_page 300
container_title Indian journal of thoracic and cardiovascular surgery
container_volume 40
creator Prajapathi, Sudesh
Kapoor, Aditya
Agarwal, Surendra Kumar
Tewari, Prabhat
Pande, Shantanu
Chandra, Bipin
Sahu, Ankit
Khanna, Roopali
Kumar, Sudeep
Garg, Naveen
Tewari, Satyendra
description Purpose To study the effect of rosuvastatin 40 mg (initiated 7 days prior to surgery) in patients undergoing valve replacement (VR) for rheumatic mitral valve disease on left ventricular (LV) strain and biomarker release kinetics. Methods In this randomized study, cardiac biomarkers viz. troponin I (TnI), Creatine kinase MB (CK-MB), N-terminal pro B-type natriuretic peptide (NTPBNP) were measured before surgery; and 8, 24 and 48 h postoperatively. Global LV (circumferential, global circumferential strain (GCS); longitudinal, GLS; radial, global radial strain (GRS)) strains were measured preoperatively; and 48 h and 30 days postoperatively. Results Following VR, Global Longitudinal Strain (GLS), Global Circumferential Strain (GCS) and Global Radial Strain (GRS) declined at 48 h in both statin loaded (SL) and non loaded (NL) groups. The % decline in strain was significantly lower in SL group (% change in GLS 35.8% vs 38.8%, GCS 34% vs 44.1%, GRS 45.7% vs 52.6%; p 
doi_str_mv 10.1007/s12055-023-01652-y
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Methods In this randomized study, cardiac biomarkers viz. troponin I (TnI), Creatine kinase MB (CK-MB), N-terminal pro B-type natriuretic peptide (NTPBNP) were measured before surgery; and 8, 24 and 48 h postoperatively. Global LV (circumferential, global circumferential strain (GCS); longitudinal, GLS; radial, global radial strain (GRS)) strains were measured preoperatively; and 48 h and 30 days postoperatively. Results Following VR, Global Longitudinal Strain (GLS), Global Circumferential Strain (GCS) and Global Radial Strain (GRS) declined at 48 h in both statin loaded (SL) and non loaded (NL) groups. The % decline in strain was significantly lower in SL group (% change in GLS 35.8% vs 38.8%, GCS 34% vs 44.1%, GRS 45.7% vs 52.6%; p &lt; 0.001). All strain values improved at 30 days with higher improvement in SL group (GLS -15.92 ± 2.00% vs -12.6 ± 1.66%, GCS -15.12 ± 2.93% vs -13.04 ± 2.44%; GRS 22.12 ± 6.85% vs 19.32 ± 6.48%). While TnI, CKMB, NTPBNP increased following surgery, values at 8, 24 and 48 h were lower in the SL vs. NL group. Mean change (baseline to peak biomarker value) was also significantly lower in SL group. The SL group had shorter hospital and Intensive Care Unit (ICU) stay . On Receiver Operating Characteristic Curve (ROC) analysis, baseline GCS ≤ 14% best predicted postoperative 30 day Left Ventricular Ejection Fraction (LVEF) ≤ 50% . Conclusion Pre-operative high dose rosuvastatin was “cardioprotective” with favorable effect on LV global strain and release kinetics of biomarkers. These cut-offs (described for the first time for rheumatic VR) can be used as prognostic predictors.</description><identifier>ISSN: 0970-9134</identifier><identifier>EISSN: 0973-7723</identifier><identifier>DOI: 10.1007/s12055-023-01652-y</identifier><identifier>PMID: 38681712</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Cardiac Surgery ; Medicine ; Medicine &amp; Public Health ; Original Article ; Surgery ; Thoracic Surgery ; Vascular Surgery</subject><ispartof>Indian journal of thoracic and cardiovascular surgery, 2024-05, Vol.40 (3), p.300-310</ispartof><rights>Indian Association of Cardiovascular-Thoracic Surgeons 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c298t-be9b8121a8ecd07e707c9dd457ad30da376e6f38f1758f0d01710739e9172083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12055-023-01652-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12055-023-01652-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38681712$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prajapathi, Sudesh</creatorcontrib><creatorcontrib>Kapoor, Aditya</creatorcontrib><creatorcontrib>Agarwal, Surendra Kumar</creatorcontrib><creatorcontrib>Tewari, Prabhat</creatorcontrib><creatorcontrib>Pande, Shantanu</creatorcontrib><creatorcontrib>Chandra, Bipin</creatorcontrib><creatorcontrib>Sahu, Ankit</creatorcontrib><creatorcontrib>Khanna, Roopali</creatorcontrib><creatorcontrib>Kumar, Sudeep</creatorcontrib><creatorcontrib>Garg, Naveen</creatorcontrib><creatorcontrib>Tewari, Satyendra</creatorcontrib><title>Does high dose statin pretreatment affect global strains in patients undergoing valve replacement</title><title>Indian journal of thoracic and cardiovascular surgery</title><addtitle>Indian J Thorac Cardiovasc Surg</addtitle><addtitle>Indian J Thorac Cardiovasc Surg</addtitle><description>Purpose To study the effect of rosuvastatin 40 mg (initiated 7 days prior to surgery) in patients undergoing valve replacement (VR) for rheumatic mitral valve disease on left ventricular (LV) strain and biomarker release kinetics. Methods In this randomized study, cardiac biomarkers viz. troponin I (TnI), Creatine kinase MB (CK-MB), N-terminal pro B-type natriuretic peptide (NTPBNP) were measured before surgery; and 8, 24 and 48 h postoperatively. Global LV (circumferential, global circumferential strain (GCS); longitudinal, GLS; radial, global radial strain (GRS)) strains were measured preoperatively; and 48 h and 30 days postoperatively. Results Following VR, Global Longitudinal Strain (GLS), Global Circumferential Strain (GCS) and Global Radial Strain (GRS) declined at 48 h in both statin loaded (SL) and non loaded (NL) groups. The % decline in strain was significantly lower in SL group (% change in GLS 35.8% vs 38.8%, GCS 34% vs 44.1%, GRS 45.7% vs 52.6%; p &lt; 0.001). All strain values improved at 30 days with higher improvement in SL group (GLS -15.92 ± 2.00% vs -12.6 ± 1.66%, GCS -15.12 ± 2.93% vs -13.04 ± 2.44%; GRS 22.12 ± 6.85% vs 19.32 ± 6.48%). While TnI, CKMB, NTPBNP increased following surgery, values at 8, 24 and 48 h were lower in the SL vs. NL group. Mean change (baseline to peak biomarker value) was also significantly lower in SL group. The SL group had shorter hospital and Intensive Care Unit (ICU) stay . On Receiver Operating Characteristic Curve (ROC) analysis, baseline GCS ≤ 14% best predicted postoperative 30 day Left Ventricular Ejection Fraction (LVEF) ≤ 50% . Conclusion Pre-operative high dose rosuvastatin was “cardioprotective” with favorable effect on LV global strain and release kinetics of biomarkers. 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Methods In this randomized study, cardiac biomarkers viz. troponin I (TnI), Creatine kinase MB (CK-MB), N-terminal pro B-type natriuretic peptide (NTPBNP) were measured before surgery; and 8, 24 and 48 h postoperatively. Global LV (circumferential, global circumferential strain (GCS); longitudinal, GLS; radial, global radial strain (GRS)) strains were measured preoperatively; and 48 h and 30 days postoperatively. Results Following VR, Global Longitudinal Strain (GLS), Global Circumferential Strain (GCS) and Global Radial Strain (GRS) declined at 48 h in both statin loaded (SL) and non loaded (NL) groups. The % decline in strain was significantly lower in SL group (% change in GLS 35.8% vs 38.8%, GCS 34% vs 44.1%, GRS 45.7% vs 52.6%; p &lt; 0.001). All strain values improved at 30 days with higher improvement in SL group (GLS -15.92 ± 2.00% vs -12.6 ± 1.66%, GCS -15.12 ± 2.93% vs -13.04 ± 2.44%; GRS 22.12 ± 6.85% vs 19.32 ± 6.48%). While TnI, CKMB, NTPBNP increased following surgery, values at 8, 24 and 48 h were lower in the SL vs. NL group. Mean change (baseline to peak biomarker value) was also significantly lower in SL group. The SL group had shorter hospital and Intensive Care Unit (ICU) stay . On Receiver Operating Characteristic Curve (ROC) analysis, baseline GCS ≤ 14% best predicted postoperative 30 day Left Ventricular Ejection Fraction (LVEF) ≤ 50% . Conclusion Pre-operative high dose rosuvastatin was “cardioprotective” with favorable effect on LV global strain and release kinetics of biomarkers. These cut-offs (described for the first time for rheumatic VR) can be used as prognostic predictors.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>38681712</pmid><doi>10.1007/s12055-023-01652-y</doi><tpages>11</tpages></addata></record>
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subjects Cardiac Surgery
Medicine
Medicine & Public Health
Original Article
Surgery
Thoracic Surgery
Vascular Surgery
title Does high dose statin pretreatment affect global strains in patients undergoing valve replacement
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