Effects of Atorvastatin Treatment on Left Ventricular Diastolic Function in Peritoneal Dialysis Patients
Status:
Unknown status
Trial end date:
2015-10-01
Target enrollment:
Participant gender:
Summary
Background
Heart failure is the final consequence of various heart disease and is also the leading cause
of mortality worldwide. Diastolic dysfunction refers to an abnormality of diastolic
distensibility, filling, or relaxation of the left ventricle. Patients with hypertensive left
ventricular hypertrophy and an echocardiogram showing a normal ejection fraction and abnormal
left ventricular filling can be said to have diastolic dysfunction. If pulmonary edema or
effort dyspnea developed in such a patient. The term diastolic heart failure would be
appropriate.
Pathology leading to diastolic heart failure include: impaired relaxation, increased passive
stiffness, endocardial and pericardial disorders, microvascular flow and neurohormonal
regulation. Among them, the association of pro-inflammatory system and diastolic dysfunction
are already established. The investigators therefore hypothesized that the change of serum
inflammatory markers might be associated with the change of left ventricular diastolic
function and the investigators thus conducted a randomized case-control trial with this
regard.
Method and materials
This is a case-control randomized study. The definition of left ventricular diastolic
function is according to Guideline from the ACC and AHA. The investigators will evaluate left
ventricular diastolic function noninvasively by echocardiography before and after the
intervention. Exclusion criteria include coronary artery disease, significant valvular heart
disease, cardiomyopathy, pericardial disease and renal insufficiency. The investigators would
like to enroll 50 cases and the same numbers of the controls. The inclusion criteria are
subjects who underwent peritoneal dialysis at the investigators hospital for more than 6
months with higher pro-inflammation serum cytokine levels (C-reactive protein > 0.2mg/dL).
Atorvastatin (40mg/day) would be given to those who were allocated to the intervention group.
The investigators will than follow up cardiac diastolic function by echocardiography and also
the change of serum markers. The investigators would also genotype the
inflammation-associated genes and their promoter region and find the association between
genetic polymorphisms and the treatment effects of statins.