| Early administration of trimetazidine may prevent or ameliorate diabetic cardiomyopathy. | |
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MedLine Citation:
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PMID: 20932648 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Diabetic cardiomyopathy is a type of cardiac dysfunction resulting from diabetes, independent of vascular or valvular pathology. It clinically manifests initially as asymptomatic diastolic dysfunction and then progresses to symptomatic heart failure. Two major contributors to the development of diabetic cardiomyopathy, which are unique to diabetes, are hyperglycemia and diabetes-related alterations in myocardial metabolism. Diabetes mellitus is characterized by reduced glucose and lactate metabolism and enhanced fatty acid metabolism, which are the early consequences of the disease. Studies on the effect of intensive glucose control on heart failure events in patients with diabetes have been conducted with neutral results. However, no study on the effect of metabolic modulators on the prevention of heart failure has been reported. Trimetazidine, a 3-ketoacyl coenzyme A thiolase (3-KAT) inhibitor, shifts cardiac energy metabolism from free fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3-KAT, and is used clinically as an effective antianginal agent. Studies have shown that trimetazidine improves heart function in patients with idiopathic cardiomyopathy and in diabetic patients with cardiac ischemia or heart failure. In addition to being effective, trimetazidine has only mild side effects. Therefore, instead of routine administration of trimetazidine for the treatment of diabetic cardiomyopathy, we hypothesize that the early application of trimetazidine may prevent or ameliorate diabetic cardiomyopathy. In addition to life style modifications, ACEI, ARB, and beta-blockers, which have been recommended in the past, trimetazidine should be administered to those patients with impaired glucose tolerance or patients in the early course of diabetes. In this way, we may reduce the prevalence of heart failure and improve the long-term survival of patients with diabetes through early normalization of the myocardial substrate metabolism. |
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Authors:
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Wang Wenmeng; Tang Qizhu |
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Publication Detail:
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Type: Journal Article Date: 2010-10-06 |
Journal Detail:
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Title: Medical hypotheses Volume: 76 ISSN: 1532-2777 ISO Abbreviation: Med. Hypotheses Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7505668 Medline TA: Med Hypotheses Country: United States |
Other Details:
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Languages: eng Pagination: 181-3 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Cardiology, Renmin Hospital of Wuhan University, No. 99, Ziyang Road, Wuhan 430060, China; Cardiovascular Research Institute, Wuhan University, No. 99, Ziyang Road, Wuhan 430060, China. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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