简介：TheannualmeetingoftheHeartFailureAssociationofESCinLisbon,inJune2005,wasexceptionallysuccessful.Thereweremanyveryinterestingpresentationsandworkshopswiththeuniquetitle:StatinsinheartfailureCholesterol-loweringisnottheonlygoalHeartfailure(HF)isaprogressivediseasewithcoronaryarterydisease(CAD)asthemostoftenunderlyingetiology.TreatmenttopreventprogressionofheartfailurehasbeentargetedtoreversetheconsequencesofHFandtoalessextentthecause-theatheroscleroticplaqueitself.Ontheaverage50%ofpatientswithheartfailurearetreatedwithlipidintervention.Lipid-loweringtreatmentwithstatinsclearlyreducesmorbidityandmortalityofpatientswithdocumentedCAD.SincetheprevalentetiologyofheartfailureisCAD,itspreventionmayreduceheartfailureprogression.However,recentstudiessuggestthatpleiotropiceffectsofstatinsaremoreimportantthantheinfluencerelatedtotheircholesterolloweringmechanism.Furthermoreitissuggestedthatlowlevelsofcirculatinglipoproteinsandcholesterolmaybeindependentpredictorsofimpairedoutcomeinpatientswithheartfailure.Therearesomepossibleexplanationsforthisfinding.Highlevelsofcholesterolcanbebeneficialtoheartfailurepatients;cholesterol-richserumlipoproteinsareabletomodulateinflammatoryimmunefunctionbecausetheybindanddetoxifybacteriallipopolysaccharide,averystrongstimulatorofthereleaseofproinflammatorycytokinesthatpromoteheartfailureprogressionanddeath.SocurrentrecommendationsstronglyemphasizethattheaimoftreatmentofHFisnottolowercholesterol.