Document Detail


Clinical benefits of a metabolic approach in the cardiac rehabilitation of patients with coronary artery disease.
MedLine Citation:
PMID:  16931203     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients referred for cardiac rehabilitation may benefit from combining trimetazidine with exercise training because both treatments produce synergic benefits on the cardiovascular system. There is evidence that trimetazidine improves left ventricular (LV) function in patients with ischemic and diabetic cardiomyopathy by shifting the cellular energy substrate reference from fatty acids to glucose oxidation, and that this effect is associated with a better outcome. Recently, results have demonstrated that trimetazidine improves radial artery endothelium-dependent relaxation related to its antioxidant properties. Similarly, exercise training has been demonstrated to improve diastolic filling and systolic function in patients with ischemic cardiomyopathy, in relation to enhanced perfusion and contractility of dysfunctional myocardium. Patients with viable myocardium, in theory, should have the greatest benefits because trimetazidine improves contractility of dysfunctional hibernating/stunned myocardium, whereas exercise has documented efficacy in improving endothelial vasomotor response of coronary arteries, stimulating coronary collateral circulation and small vessel growth, improving LV function, and increasing functional capacity. At present, there are no published reports about the efficacy of the combination of trimetazidine with exercise training. In this article, we discuss the rationale for using trimetazidine in cardiac rehabilitation, the identification of patients referred for cardiac rehabilitation who might benefit the most from the addition of trimetazidine to standard therapy, and the documented benefits.
Authors:
Romualdo Belardinelli; Francesca Lacalaprice; Ernesto Faccenda; Loretta Volpe
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Publication Detail:
Type:  Journal Article; Review     Date:  2006-07-24
Journal Detail:
Title:  The American journal of cardiology     Volume:  98     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-25     Completed Date:  2006-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  25J-33J     Citation Subset:  AIM; IM    
Affiliation:
Struttura di Cardiologia Riabilitativa e Preventiva, Presidio Cardiologico GM Lancisi, Ancona, Italy. r.belardinelli@fastnet.it
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MeSH Terms
Descriptor/Qualifier:
Coronary Circulation / drug effects
Coronary Disease / metabolism,  physiopathology,  rehabilitation*
Humans
Myocardium / metabolism
Treatment Outcome
Trimetazidine / therapeutic use*
Vasodilator Agents / therapeutic use*
Ventricular Function, Left / drug effects,  physiology
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 5011-34-7/Trimetazidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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