[Effect of acetyl-CoA C-acyltransferase inhibitor trimetazidine on parameters of global and local systolic and diastolic functions of left ventricular myocardium in patients with combined postinfarction ischemic syndrome].
OBJECTIVE
To assess effect of trimetazidine on global and regional systolic and diastolic left ventricular function in patients with combined postinfarction ischemic syndrome.


METHODS
Patients (n=32) with healed myocardial infarction and signs of global systolic (ejection fraction 38,5+/-2,7%) and diastolic (EIA=0,88+/-0,03) left ventricular dysfunction confirmed by Doppler echocardiography.


METHODS
Regional systolic and diastolic function was assessed by dobutamine stress echocardiography with Doppler tissue imaging before and after 3 months during which the patients received 60 mg/day of trimetazidine.


RESULTS
The segments with hibernating myocardium were found in every patient. These segments along with segments with scars displayed greatest degree of local systolic and diastolic dysfunction and because of their prevalence made significant contribution to the setting of global diastolic dysfunction. Improvement of global diastolic function at rest after trimetazidine was associated with decrease of total number of ischemic segments (from 80 to 67%) especially of those with hibernation (from 61 to 46%).


CONCLUSIONS
The hibernating myocardium was most sensitive to metabolic intervention and its presence after myocardial infarction predicted improvement after drug treatment of not only systolic but also diastolic left ventricle dysfunction. Restoration of function of hibernating myocardium turned out to be possible not only after myocardial revascularization but also after medical therapy.
Rostov-Don State Medical University, Russia.
A A
AA
Kastanaian
N Iu
NIu
Nelasov
O L
OL
Eroshenko
N B
NB
Kazarian
N V
NV
Drobotia
D000102:Acetyl-CoA C-Acyltransferase / Q000037:antagonists & inhibitors*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects* / Q000502:physiology; D009203:Myocardial Infarction / Q000188:drug therapy / Q000201:enzymology / Q000503:physiopathology*; D013577:Syndrome; D016896:Treatment Outcome; D014292:Trimetazidine / Q000494:pharmacology* / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000494:pharmacology* / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy / Q000201:enzymology / Q000503:physiopathology*
D014665:Vasodilator Agents; D000102:Acetyl-CoA C-Acyltransferase; D014292:Trimetazidine