No significant effect of high dose statin on biventricular longitudinal myocardial strain: a six-month study in the primary prevention of coronary heart disease

Aim. Тo evaluate the impact of intensive statin therapy on subclinical left (LV) and right ventricular (RV) function using advanced speckle-tracking echocardiography (STE) in patients without coronary artery disease receiving statin for primary prevention.
Material and methods. This single-center prospective study enrolled patients who were planned to initiate high-intensity statin therapy (atorvastatin 40-80 mg or rosuvastatin 20-40 mg) for primary prevention. A total of 38 patients (mean age 51.5±7.6 years; 36.8% male) with low-density lipoprotein cholesterol (LDL-C) levels ≥160 mg/dl and no history of coronary artery disease, heart failure, or hypertension were included. Conventional echocardiography and two-dimensional STE were performed at baseline (before therapy initiation) and at a 6-month follow-up. LV global longitudinal strain (LV-GLS) and RV global longitudinal strain (RV-GLS) were calculated to detect subtle myocardial changes.
Results. After six months of intensive therapy, a significant reduction in LDL-C (200.5±39.8 to 97.5±29.3 mg/dl; p<0.001) and triglycerides (p=0.001) was observed. Despite significant increases in creatine kinase (p=0.014) and liver enzymes (asparagine aminotransferase: p=0.049, alanine aminotransferase: p=0.036) within the normal-to-borderline range, no clinical myopathy occurred. Echocardiographic analysis showed no significant differences in LV-GLS (-19.2±2.3% vs. -19.4±1.7%; p=0.569) or RV-GLS (-19.2±4.2% vs. -19.5±4.4%; p=0.553) between baseline and follow-up. Similarly, diastolic function parameters (e’, E/e’ ratio) and ejection fraction remained stable throughout the study period.
Conclusion. Six months of high-dose statin therapy did not significantly alter biventricular strain parameters in patients without preexisting coronary artery disease. These findings suggest that intensive short-term statin use is not associated with adverse effects on myocardial mechanical function. The stability of strain values, despite lipid reduction and mild enzyme elevations, supports the myocardial safety profile of intensive statin therapy in a primary prevention population.

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