Improvement in the function of hibernating myocardium in a patient with heart failure due to coronary artery disease receiving high-dose simvastatin.

We report the case of a 70-year-old man with a history of myocardial infarction and coronary artery bypass grafting, presenting with signs and symptoms of heart failure. Cardiac magnetic resonance imaging demonstrated a small amount of scarring in the anteroseptal wall, moderate left ventricular enlargement, and a left ventricular ejection fraction of 26%. Patient was started on simvastatin 20 mg daily, gradually increased to 80 mg daily, which were maintained for another 4 weeks. Twelve weeks after the initial presentation, the patient experienced a marked improvement in his symptoms. Repeat cardiac magnetic resonance imaging showed global improvement in left ventricular contractility, with ejection fraction of 36% and end-diastolic volume decreasing from 230 to 153 ml. We speculate that high-dose statin therapy had a significant role in improving the ventricular function in our patient by improving the endothelial flow. This hypothesis is presently being tested in a larger prospective trial.

Duke Scholars

Author Raymond J. Kim Medicine, Cardiology