| Comparison of trimetazidine with atenolol in patients with syndrome X: effects on diastolic function and exercise tolerance. | |
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MedLine Citation:
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PMID: 10687257 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Trimetazidine has been shown to improve anginal symptoms without altering hemodynamic variables in patients with coronary artery disease. The aim of this study was to compare the effect of trimetazidine and atenolol upon symptoms, resting left ventricular filling dynamics and exercise tolerance. METHODS: Sixteen patients (3 males, 13 females, mean age 62 +/- 7 years) were randomized to receive trimetazidine for 2 weeks (20 mg 3 times daily) or atenolol (100 mg daily), according to a double-blind, randomized, cross-over, placebo-controlled design. At the end of each treatment period patients underwent symptom-limited exercise testing, an echocardiogram and a Doppler assessment of transmitral flow pattern. Daily life anginal symptoms were annotated on a diary throughout the study. Two patients discontinued trimetazidine because of severe palpitations and only 14 patients completed the study. RESULTS: Atenolol significantly reduced the number of anginal episodes as compared to placebo or trimetazidine (0.44 +/- 0.53, 4.8 +/- 4, 2.9 +/- 4.9, p < 0.01). On atenolol, the exercise test was negative in 8 patients, but none of the patients had a negative test while on trimetazidine. Atenolol increased both time to 1 mm ST segment depression (668 +/- 213 vs 838 +/- 81 s, p < 0.05) and Doppler-derived indices of ventricular filling (E/A ratio 0.87 +/- 0.20 vs 1.21 +/- 0.26, p < 0.05). CONCLUSIONS: These results confirm the beneficial effects of atenolol in improving symptoms, exercise performance and diastolic function in syndrome X patients. Trimetazidine did not exert any significant effect on any of the analyzed variables. Since trimetazidine has been previously shown to improve myocardial ischemia in patients with overt coronary artery disease to a similar extent of beta-blockers, it is likely that other mechanisms are responsible for angina in patients with syndrome X. |
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Authors:
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F Leonardo; G Fragasso; E Rossetti; P Dabrowski; P Pagnotta; G M Rosano; S L Chierchia |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Cardiologia (Rome, Italy) Volume: 44 ISSN: 0393-1978 ISO Abbreviation: Cardiologia Publication Date: 1999 Dec |
Date Detail:
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Created Date: 2000-03-15 Completed Date: 2000-03-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8506637 Medline TA: Cardiologia Country: ITALY |
Other Details:
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Languages: eng Pagination: 1065-9 Citation Subset: IM |
Affiliation:
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Divisione di Cardiologia, Ospedale Civile Cervesi, Cattolica, RN. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use* Aged Atenolol / therapeutic use* Cross-Over Studies Diastole / drug effects Double-Blind Method Echocardiography, Doppler / drug effects, methods, statistics & numerical data Exercise Test / drug effects, methods, statistics & numerical data Exercise Tolerance / drug effects* Female Humans Male Microvascular Angina / diagnosis, drug therapy*, physiopathology Middle Aged Trimetazidine / therapeutic use* Vasodilator Agents / therapeutic use* Ventricular Function, Left / drug effects |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Vasodilator Agents; 29122-68-7/Atenolol; 5011-34-7/Trimetazidine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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