The Effect of Atorvastatin on Right Ventricular Function in Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Abstract

Objective: Inflammation has an important role in chronic obstructive pulmonary diseases (COPD) and statins are believed to have anti-inflammatory effects beyond low-density lipoprotein cholesterol reduction. This study aimed to assess the effect of statin on the function of the right ventricle and inflammatory markers in COPD patients. Methods: A total of 76 clinically stable COPD patients were included in this randomized, double-blind study. Patients were randomly assigned to receive atorvastatin (40 mg/d) or a placebo over a period of three months. All the patients underwent spirometry, echocardiography, and high-sensitivity C-reactive protein (hsCRP) measurement at baseline and at the end of the study. Right ventricular (RV) systolic function was assessed by echocardiography using the systolic velocity of tricuspid annulus (Sm) and longitudinal strain in the base and mid segments of RV free wall (SRB, SRM). Pulmonary artery pressure (PAP) was estimated by the tricuspid regurgitation gradient. Results: Fifty-five patients (31 in atorvastatin and 24 in the placebo group) completed the course of intervention. Atorvastatin resulted in improvement in RVSB (p = 0.03) and decrease in hsCRP (p = 0.03) compared to placebo group while RV SRM was significantly improved in atorvastatin group (p = 0.01) but this change was not significant between groups (p = 0.44). Conclusion: Statins could improve the prognosis in COPD patients by improving right ventricular hemodynamic.