Influence of atorvastatin treatment on L-ariginine cerebrovascular reactivity and flow-mediated dilatation in patients with lacunar infarctions

Background and Purpose-In our study we hypothesized that statins improve endothelial function in patients with lacunar infarctions (LI). Cerebral and systemic endothelial function was determined before and after 3-months treatment with atorvastatin. Methods-Cerebral endothelial function was determined by L-arginine reactivity and systemic endothelial function by flow-mediated dilatation (FMD) in patients with LI (18 patients, aged 61.1 +/- 7.6 years), 20 age- and gender-matched patients with similar risk factors (SR) and 19 age- and gender-matched healthy controls. The mean arterial velocity (v.) in both middle cerebral arteries was measured by transcranial Doppler sonography before, during and after a 30-minute intravenous infusion of L-arginine. FMD of the brachial artery after hyperaemia was determined. The measurements were repeated after 3-months treatment with 40 mg of atorvastatin per day. Results-L-arginine reactivity was decreased in LI patients (13.1 +/- 8.4%) and in patients with SR compared with healthy controls (P <= 0.01). FMD was more impaired in patients with LI (0.06 +/- 4.9%) compared with patients with SR and healthy controls (P <= 0.01). After atorvastatin treatment, L-arginine reactivity and FMD improved in both patients with LI (17.1 +/- 7.6%; 7.0 +/- 5.7%) and patients with SR (P <= 0.01). Previously mildly increased cholesterol values normalized. Conclusion-The decreased L-arginine reactivity and FMD improve after atorvastatin treatment in both patients with LI and patients with SR.