The effect of trimetazidine on left ventricular systolic function and physical tolerance in patients with ischaemic cardiomyopathy.
OBJECTIVE
Trimetazidine (TMZ) is the first of novel antianginal drugs with a cardioprotective effect, selectively inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase. This study tested the hypothesis that the cytoprotective beneficial effect of this agent can lead to the improvement of left ventricular (LV) systolic function and tolerance to physical activity in patients with ischaemic cardiomyopathy.


RESULTS
In 82 consecutive patients with ischaemic cardiomyopathy, a subgroup of patients (n = 42) was assigned to receive a modified form of TMZ (35 mg twice daily) in addition to the conventional therapy for the duration of three months. All patients underwent clinical, echocardiographic examination and a six-minute walk test at baseline and after a three-month treatment. The therapy with TMZ significantly improved the functional class in these patients. Left ventricular ejection fraction (LVEF) increased by 3.5 +/- 6.72% (from 34.5 +/- 3.8% to 38.0 +/- 4.8%) in the TMZ group vs. 0.8 +/- 8.06% (from 32.4 +/- 5.6% to 33.2 +/- 5.8%) in the control group (P = 0.05). The tolerance to physical activity improved by 30.0 +/- 20.7 m in the TMZ group (from 215 +/- 17.5 m to 245 +/- 20.7 m) vs. 2.0 +/- 18.85 m (from 208.2 +/- 12.4 m to 210.2 +/- 14.2 m) in the control group (P < 0.001).


CONCLUSIONS
A therapeutic intervention with TMZ in conjunction with the standard therapy, over a three-month period, is associated with an increase in LVEF and improved tolerance to physical activity in patients with ischaemic cardiomyopathy.
Sisakian
Hamayak
H
Department of Internal Diseases Diagnostics and Cardiology, University Hospital No 1, Yerevan State Medical University, Yerevan, Armenia. hamayak_sisakyan@hotmail.com
Torgomyan
Adrina
A
Barkhudaryan
Anush
A
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology*; D002316:Cardiotonic Agents / Q000494:pharmacology*; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000503:physiopathology; D006352:Heart Ventricles / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D017202:Myocardial Ischemia / Q000503:physiopathology*; D011446:Prospective Studies; D013318:Stroke Volume / Q000187:drug effects; D013599:Systole / Q000187:drug effects; D014292:Trimetazidine / Q000494:pharmacology*; D014665:Vasodilator Agents / Q000494:pharmacology*
D002316:Cardiotonic Agents; D014665:Vasodilator Agents; D014292:Trimetazidine