Document Detail

Treatment of pediatric pulmonary hypertension with simvastatin: An observational study.
MedLine Citation:
PMID:  20967835     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Animal studies and an adult human case series suggest that statins may have a role in the treatment of pulmonary hypertension. We reviewed the results of empirical therapy for children at Primary Children's Medical Center to determine whether simvastatin had a favorable effect on non-invasive estimates of pulmonary arterial pressure.
MATERIALS AND METHODS: The medical records of children with pulmonary hypertension who were treated with simvastatin were reviewed. Mean measurements of the gradient of tricuspid valve regurgitation before and after treatment were compared by a paired t-test. A favorable response to simvastatin was defined as a 20% decrease in the average measurement of the gradient of tricuspid valve regurgitation or a 20% decrease in right ventricular anterior wall thickness when tricuspid valve regurgitation resolved during treatment. Potential factors associated with a favorable response to simvastatin were identified with a Fisher exact test.
RESULTS: Twelve children, 4-15 years of age, had adequate Doppler velocity waveforms to reliably measure gradients of tricuspid valve regurgitation during a period of 1 year before treatment. Eleven patients had gradients of tricuspid valve regurgitation that could be measured during a period of 1 year after treatment. Patients were treated with simvastatin 0.09-0.28 mg/kg/day. Collectively, there was no difference between the average measurements of the gradient of tricuspid valve regurgitation before and after treatment (66 ± 21 mmHg vs. 63 ± 28 mmHg). Three of the five patients with clinical findings consistent with alveolar hypoxia and none of the seven patients without clinical findings consistent with alveolar hypoxia had a favorable response to treatment with simvastatin (P = 0.05).
CONCLUSION: Simvastatin may decrease pulmonary arterial pressure in a subset of patients with pulmonary hypertension. Pediatr Pulmonol. 2011; 46:261-265. © 2011 Wiley-Liss, Inc.
Wilson T King; Ronald W Day
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Publication Detail:
Type:  Journal Article     Date:  2010-10-21
Journal Detail:
Title:  Pediatric pulmonology     Volume:  46     ISSN:  8755-6863     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2013-10-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  261-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Wiley-Liss, Inc.
Division of Pediatric Cardiology, University of Utah, Salt Lake City, Utah.,
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