Aims: The addition of trimetazidine to standard treatment has been shown to improve left ventricular (LV) function in patients with heart failure. The aim of this study is to non-invasively assess, by means of in vivo (31)P-magnetic resonance spectroscopy ((31)P-MRS), the effects of trimetazidine on LV cardiac phosphocreatine and adenosine triphosphate (PCr/ATP) ratio in patients with heart failure. Methods and results: Twelve heart failure patients were randomized in a double-blind, cross-over study to placebo or trimetazidine (20 mg t.i.d.) for two periods of 90 days. At the end of each period, all patients underwent exercise testing, 2D echocardiography, and MRS. New York Heart Association (NYHA) class, ejection fraction (EF), maximal rate-pressure product, and metabolic equivalent system (METS) were evaluated. Relative concentrations of PCr and ATP were determined by cardiac (31)P-MRS. On trimetazidine, NYHA class decreased from 3.04 (plus or minus) 0.26 to 2.45 (plus or minus) 0.52 (P= 0.005), whereas EF (34 (plus or minus) 10 vs. 39 (plus or minus) 10%, P= 0.03) and METS (from 7.44 (plus or minus) 1.84 to 8.78 (plus or minus) 2.72, P= 0.03) increased. The mean cardiac PCr/ATP ratio was 1.35 (plus or minus) 0.33 with placebo, but was increased by 33% to 1.80 (plus or minus) 0.50 (P= 0.03) with trimetazidine. Conclusion: Trimetazidine improves functional class and LV function in patients with heart failure. These effects are associated to the observed trimetazidine-induced increase in the PCr/ATP ratio, indicating preservation of the myocardial high-energy phosphate levels. (copyright) The European Society of Cardiology 2006. All rights reserved.

Effects of metabolic modulation by trimetazidine on left ventricular function and phosphocreatine/adenosine triphosphate ratio in patients with heart failure / G. Fragasso, G. Perseghin, F. De Cobelli, A. Esposito, A. Palloshi, G. Lattuada, P. Scifo, G. Calori, A. Del Maschio, A. Margonato. - In: EUROPEAN HEART JOURNAL. - ISSN 0195-668X. - 27:8(2006), pp. 942-948. [10.1093/eurheartj/ehi816]

Effects of metabolic modulation by trimetazidine on left ventricular function and phosphocreatine/adenosine triphosphate ratio in patients with heart failure

G. Perseghin
Secondo
;
2006

Abstract

Aims: The addition of trimetazidine to standard treatment has been shown to improve left ventricular (LV) function in patients with heart failure. The aim of this study is to non-invasively assess, by means of in vivo (31)P-magnetic resonance spectroscopy ((31)P-MRS), the effects of trimetazidine on LV cardiac phosphocreatine and adenosine triphosphate (PCr/ATP) ratio in patients with heart failure. Methods and results: Twelve heart failure patients were randomized in a double-blind, cross-over study to placebo or trimetazidine (20 mg t.i.d.) for two periods of 90 days. At the end of each period, all patients underwent exercise testing, 2D echocardiography, and MRS. New York Heart Association (NYHA) class, ejection fraction (EF), maximal rate-pressure product, and metabolic equivalent system (METS) were evaluated. Relative concentrations of PCr and ATP were determined by cardiac (31)P-MRS. On trimetazidine, NYHA class decreased from 3.04 (plus or minus) 0.26 to 2.45 (plus or minus) 0.52 (P= 0.005), whereas EF (34 (plus or minus) 10 vs. 39 (plus or minus) 10%, P= 0.03) and METS (from 7.44 (plus or minus) 1.84 to 8.78 (plus or minus) 2.72, P= 0.03) increased. The mean cardiac PCr/ATP ratio was 1.35 (plus or minus) 0.33 with placebo, but was increased by 33% to 1.80 (plus or minus) 0.50 (P= 0.03) with trimetazidine. Conclusion: Trimetazidine improves functional class and LV function in patients with heart failure. These effects are associated to the observed trimetazidine-induced increase in the PCr/ATP ratio, indicating preservation of the myocardial high-energy phosphate levels. (copyright) The European Society of Cardiology 2006. All rights reserved.
Heart failure; Left ventricular function; Magnetic resonance spectroscopy; Myocardial energetics; Trimetazidine
2006
Article (author)
File in questo prodotto:
Non ci sono file associati a questo prodotto.
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/22008
Citazioni
  • ???jsp.display-item.citation.pmc??? 55
  • Scopus 238
  • ???jsp.display-item.citation.isi??? 192
social impact