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Effects of trimetazidine in non-ischemic heart failure: A randomized study.
MedLine Citation:
PMID:  24412523     Owner:  NLM     Status:  Publisher    
AIMS: Heart failure (HF) is associated with changes in myocardial metabolism that lead to impairment of contractile function. Trimetazidine (TMZ) modulates cardiac energetic efficiency and improves outcomes in ischemic heart disease. We evaluate the effects of TMZ on left ventricular ejection fraction (LVEF), cardiac metabolism, exercise capacity, O2 uptake and quality of life (QoL) in patients with non-ischemic HF.
METHODS AND RESULTS: Randomized, double-blind study. Sixty patients with stable non-ischemic HF under optimal medical therapy were included. Patients were randomized to TMZ 35 mg p.o. bid or placebo for 6 months. LVEF, 6-minute walk test (6MWT), maximum O2 uptake in cardiopulmonary exercise test ,different markers of metabolism, oxidative stress and endothelial function as well as quality of life were assessed at baseline and after TMZ treatment. LV peak glucose uptake was evaluated using the maximum standardized uptake value (SUV) by 18-fluorodeoxyglucose positron emission tomography ((18)FDG PET). Etiology was idiopathic in 85% and hypertensive in 15%. Both groups were similar in age, functional class, LVEF and levels of N-terminal pro-BNP at baseline. After 6 months of TMZ treatment, no changes were observed in LVEF (31 ± 10 vs. 34 ± 8% respectively, p = 0.8), 6MWT (443 ± 25 vs. 506 ± 79 meters, p=0.03), maximum O2 uptake (19.1 ± 5.0 vs 23.0 ± 7.2 mL/kg/min, p=0.11), functional class (percentage of patients in functional class I/II/III/IV 10/3753/0 in TMZ vs. 7/40/50/3 in placebo, p=0.14) or QoL (32±26 vs. 24±18 points, p = 0.25) . In the subgroup of patients evaluated with (18)FDG PET, no significant differences were observed in SUV between both groups (7.0 ± 3.6 vs. 8.2 ± 3.4 respectively; p = 0.47).
CONCLUSIONS: In patients with non-ischemic HF, the addition of TMZ to optimal medical treatment does not result in significant changes of LVEF, exercise capacity, O2 uptake or quality of life.
J L Winter; P F Castro; J C Quintana; R Altamirano; A Enriquez; H E Verdejo; J E Jalil; R Mellado; R Concepción; P Sepúlveda; V Rossel; L Sepúlveda; M Chiong; L García; S Lavandero
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-1-9
Journal Detail:
Title:  Journal of cardiac failure     Volume:  -     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2014-1-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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