title: Rationale and benefits of trimetazidine by acting on cardiac metabolism in heart failure.
abstract: Heart failure is a systemic and multiorgan syndrome with metabolic failure as a fundamental mechanism. As a consequence of its impaired metabolism, other processes are activated in the failing heart, further exacerbating the progression of heart failure. Recent evidence suggests that modulating cardiac energy metabolism by reducing fatty acid oxidation and/or increasing glucose oxidation represents a promising approach to the treatment of patients with heart failure. Clinical trials have demonstrated that the adjunct of trimetazidine to the conventional medical therapy improves symptoms, cardiac function and prognosis in patients with heart failure without exerting negative hemodynamic effects. This review focuses on the rationale and clinical benefits of trimetazidine by acting on cardiac metabolism in heart failure, and aims to draw attention to the readiness of this agent to be included in all the major guidelines dealing with heart failure.
authors.affiliation: Volgograd Medical University, Cardiology Centre, Volgograd, Russian Federation. Electronic address: yu.lopatin@gmail.com.
authors.forename: Yuri M
authors.initials: YM
authors.lastname: Lopatin
authors.affiliation: IRCCS San Raffaele, Roma, Italy; Cardiovascular & Cell Sciences Institute, St George's University of London, UK.
authors.forename: Giuseppe M C
authors.initials: GM
authors.lastname: Rosano
authors.affiliation: Heart Failure Unit, Istituto Scientifico San Raffaele, Milano, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Fragasso
authors.affiliation: Heritage Medical Research Center, University of Alberta, Edmonton, Canada.
authors.forename: Gary D
authors.initials: GD
authors.lastname: Lopaschuk
authors.affiliation: Medical Faculty, University of Belgrade, Department of Cardiology, University Medical Center, Belgrade, Serbia.
authors.forename: Petar M
authors.initials: PM
authors.lastname: Seferovic
authors.affiliation: Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Luis Henrique W
authors.initials: LH
authors.lastname: Gowdak
authors.affiliation: University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania.
authors.forename: Dragos
authors.initials: D
authors.lastname: Vinereanu
authors.affiliation: Cairo University, Cairo, Egypt.
authors.forename: Magdy Abdel
authors.initials: MA
authors.lastname: Hamid
authors.affiliation: Heart Failure Unit CHR Dubos, Pontoise, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Jourdain
authors.affiliation: Medical University, Clinical Military Hospital, Wroclaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
mesh_terms: D004734:Energy Metabolism; D006333:Heart Failure / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D009206:Myocardium / Q000378:metabolism*; D011379:Prognosis; D016896:Treatment Outcome; D014292:Trimetazidine / Q000493:pharmacokinetics*; D014665:Vasodilator Agents / Q000493:pharmacokinetics
chemical_list: D014665:Vasodilator Agents; D014292:Trimetazidine
keywords: Cardiac energy metabolism; Heart failure; Trimetazidine