title: Beneficial effects of trimetazidine treatment on exercise tolerance and B-type natriuretic peptide and troponin T plasma levels in patients with stable ischemic cardiomyopathy.
abstract: BACKGROUND
  In patients with ischemic cardiomyopathy, mortality rate and quality of life are unsatisfactory. We investigated the effects of the metabolic agent trimetazidine (TMZ) on exercise tolerance and prognostic markers B-type natriuretic peptide (BNP) and cardiac troponin T (cTnT) plasma levels.
  
  
  METHODS
  Fifty patients with ischemic cardiomyopathy were randomized either to receive TMZ (20 mg, TID) in addition to their conventional treatment (TMZ group, n = 25) or to continue their usual drug therapy (control group, n = 25) for 6 months. Patients were evaluated at baseline, at 1 month, and at 6 months (echocardiography and 6-minute walking test). At enrollment and at the end of follow-up, blood testing was performed for determination of BNP and cTnT plasma levels.
  
  
  RESULTS
  After 6 months, no significant New York Heart Association class changes occurred in all patients (P = NS). In the TMZ group, a significant increase of exercise tolerance (P < .01) was detected, whereas left ventricular ejection fraction was unchanged (28% +/- 4%, 29% +/- 5%, and 32% +/- 5% at baseline, at 1 month, and at 6 months, respectively; P = NS). In the TMZ group, BNP was significantly reduced (6 months, 135 +/- 22 vs 252 +/- 44 pg/mL; P < .001), whereas it was significantly increased in controls (6 months, 288 +/- 46 vs 239 +/- 59 pg/mL; P < .02); cTnT significantly (P < .001) reduced during TMZ treatment, whereas it was unchanged in the control group.
  
  
  CONCLUSIONS
  Six-month TMZ treatment improves exercise tolerance and reduces plasma levels of BNP and cTnT in patients with compensated ischemic cardiomyopathy.
authors: Department of Cardiology, Centre for Study and Treatment of Congestive Heart Failure, Villa Pini d'Abruzzo Clinic, Chieti, Italy. dinapoli@unich.it
authors: Pericle
authors: P
authors: Di Napoli
authors: Paolo
authors: P
authors: Di Giovanni
authors: Marta Assunta
authors: MA
authors: Gaeta
authors: Giuseppina
authors: G
authors: D'Apolito
authors: Antonio
authors: A
authors: Barsotti
mesh_terms: D017079:Exercise Tolerance / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D014292:Trimetazidine / Q000627:therapeutic use*; D020107:Troponin T / Q000097:blood*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D020107:Troponin T; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D014292:Trimetazidine