Immunological Aspects of the Statins' Function in Patients with Heart Failure:A Report from the

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The annual meeting of the Heart Failure Association of ESC in Lisbon,in June 2005,was exceptionally successful.There were many very interesting presentations and workshops with the unique title:Statins in heart failure-Cholesterol-lowering is not the only goal.Heart failure (HF) is a progressive disease with coronary artery disease(CAD) as the most often underlying etiology.Treatment to prevent progression of heart failure has been targeted toreverse the consequences of HF and to a less extent the cause-the atherosclerotic plaque itself.On the average50% of patients with heart failure are treated with lipid intervention.Lipid-lowering treatment with statins clearlyreduces morbidity and mortality of patients with documented CAD.Since the prevalent etiology of heart failure isCAD,its prevention may reduce heart failure progression.However,recent studies suggest that pleiotropic effectsof statins are more important than the influence related to their cholesterol lowering mechanism.Furthermore it issuggested that low levels of circulating lipoproteins and cholesterol may be independent predictors of impairedoutcome in patients with heart failure.There are some possible explanations for this finding.High levels ofcholesterol can be beneficial to heart failure patients;cholesterol-rich serum lipoproteins are able to modulateinflammatory immune function because they bind and detoxify bacterial lipopolysaccharide,a very strongstimulator of the release of proinflammatory cytokines that promote heart failure progression and death.Socurrent recommendations strongly emphasize that the aim of treatment of HF is not to lower cholesterol.Cellular& Molecular Immunology.2005;2(6):433-437. The annual meeting of the Heart Failure Association of ESC in Lisbon, in June 2005, was exceptionally successful. There were many very interesting presentations and workshops with the unique title: Statins in heart failure-Cholesterol-lowering is not the only goal. Heart failure (HF) is a progressive disease with coronary artery disease (CAD) as the most often underlying etiology. Treatment to prevent progression of heart failure has been targeted toreverse the consequences of HF and to a less extent the cause-the atherosclerotic plaque itself. On the average50% of patients with heart failure are treated with lipid intervention. Lipid-lowering treatment with statins clearlyreduces morbidity and mortality of patients with documented CAD. Since the prevalent etiology of heart failure isCAD, its prevention may reduce heart failure progression. studies suggest that pleiotropic effects of statins are more important than the influence related to their cholesterol lowering mechanism.Further more it issuggested that low levels of circulating lipoproteins and cholesterol may be independent predictors of impaired outcome in patients with heart failure. there are some possible explanations for this finding. High levels of cholesterol may be beneficial to heart failure patients; cholesterol-rich serum lipoproteins are able to modulateinflammatory immune function because they bind and detoxify bacterial lipopolysaccharide, a very strong stimulator of the release of proinflammatory cytokines that promote heart failure progression and death. Current Recommendations strongly emphasize that the aim of treatment of HF is not to lower cholesterol. Cellular & Molecular Immunology. 2005; 2 (6): 433-437.
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