Effect of partial inhibition of fatty acid oxidation by trimetazidine on whole body energy metabolism in patients with chronic heart failure

Objective: Trimetazidine may have beneficial effects on left ventricular (LV) function in patients with systolic heart failure. The authors assessed whether long-term addition of trimetazidine to conventional treatment could improve, along with LV function, resting whole body energy metabolism in patients with chronic systolic heart failure. Design: Single blind randomised study. Setting: University Hospital. Patients: 44 patients with systolic heart failure receiving full medical treatment. Interventions: Indirect calorimetry and two-dimensional echocardiography at baseline and after 3 months. Main outcome measures: Whole body resting energy expenditure (REE), percentage of predicted REE, LV ejection fraction (EF), NYHA class, quality of life. Results: Trimetazidine increased EF compared with conventional therapy alone (from 3568% to 42611% vs from 3567% to 36±6%; p=0.02, analysis of variance for repeated measures). NYHA class and quality of life also improved compared with conventional therapy (p