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Trimetazidine Reduces Endogenous Free Fatty Acid Oxidation and Improves Myocardial Efficiency in Obese Humans.
MedLine Citation:
PMID:  21884010     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction: The metabolic modulator trimetazidine (TMZ) has been suggested to induce a metabolic shift from myocardial fatty acid oxidation (FAO) to glucose utilization, but this mechanism remains unproven in humans. The oxidation of plasma derived FA is commonly measured in humans, whereas the contribution of FA from triglycerides stored in the myocardium has been poorly characterized. Aims: To verify the hypothesis that TMZ induces a metabolic shift, we combined positron emission tomography (PET) and magnetic resonance spectroscopy ((1) H-MRS) to measure myocardial FAO from plasma and intracellular lipids, and myocardial glucose metabolism. Nine obese subjects were studied before and after 1 month of TMZ treatment. Myocardial glucose and FA metabolism were assessed by PET with (18) F-fluorodeoxyglucose and (11) C-palmitate. (1) H-MRS was used to measure myocardial lipids, the latter being integrated into the PET data analysis to quantify myocardial triglyceride turnover. Results: Myocardial FAO derived from intracellular lipids was at least equal to that of plasma FAs (P= NS). BMI and cardiac work were positively associated with the oxidation of plasma derived FA (P≤ 0.01). TMZ halved total and triglyceride-derived myocardial FAO (32.7 ± 8.0 to 19.6 ± 4.0 μmol/min and 23.7 ± 7.5 to 10.3 ± 2.7 μmol/min, respectively; P≤ 0.05). These changes were accompanied by increased cardiac efficiency since unchanged LV work (1.6 ± 0.2 to 1.6 ± 0.1 Watt/g × 10(2) , NS) was associated with decreased work energy from the intramyocardial triglyceride oxidation (1.6 ± 0.5 to 0.4 ± 0.1 Watt/g × 10(2) , P= 0.036). Conclusions: In obese subjects, we demonstrate that myocardial intracellular triglyceride oxidation significantly provides FA-derived energy for mechanical work. TMZ reduced the oxidation of triglyceride-derived myocardial FAs improving myocardial efficiency.
Authors:
Marco Bucci; Ronald Borra; Kjell Någren; Jussi P Pärkkä; Silvia Del Ry; Romina Maggio; Helena Tuunanen; Tapio Viljanen; Manuela Cabiati; Sara Rigazio; Markku Taittonen; Uberto Pagotto; Riitta Parkkola; Lionel H Opie; Pirjo Nuutila; Juhani Knuuti; Patricia Iozzo
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-31
Journal Detail:
Title:  Cardiovascular therapeutics     Volume:  -     ISSN:  1755-5922     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-9-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101319630     Medline TA:  Cardiovasc Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Turku PET Centre, University of Turku, Turku, Finland Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland Department of Clinical Physiology, University of Turku and Turku University Hospital, Turku, Finland Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland Sector of Medicine, Scuola Superiore Sant'Anna, Pisa, Italy Department of Anaesthesiology, University of Turku and Turku University Hospital, Turku, Finland Division of Endocrinology, Dept. of Internal Medicine, University Alma Mater Studiorum, Bologna, Italy Hatter Cardiovascular Research Institute, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa.
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