Trimetazidine improves left ventricular function and quality of life in elderly patients with coronary artery disease

Cristiana Vitale, Mauricio Wajngaten, Barbara Sposato, Otavio Gebara, Paola Rossini, Massimo Fini, Maurizio Volterrani, Giuseppe M C Rosano

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Abstract

Elderly patients have an increased incidence of ischaemic dilated cardiomyopathy often related to diffuse coronary artery disease. Trimetazidine protects ischaemic myocardium by improving the myocardial energy utilisation during myocardial ischaemia. Aim of the present study was to evaluate the effects of trimetazidine on left ventricular (LV) function in elderly patients with ischaemic heart disease and reduced LV function. Forty seven elderly patients (40 males and 7 females, mean age 78 ± 3 years) were randomised to receive, in addition to standard therapy, either trimetazidine or placebo and were evaluated by echocardiography at baseline and after 6 months. Trimetazidine and placebo had no effect on either blood pressure or heart rate (SBP 2 ± 5 vs 4 ± 6 mmHg, DBP -1 ± 6 vs 3 ± 4 mmHg, HR -3 ± 7 vs 5 ± 9 bpm, trimetazidine and placebo compared to baseline, respectively). At the end of the study patients randomised to trimetazidine showed a significant greater left ventricular function and smaller left ventricular diastolic and systolic diameters and volume indices compared to patients receiving placebo (LVEF: 34.4 ± 2.3% vs 27 ± 2.8%, p <0.0001; LVEDD: 58.6 ± 1.9 mm vs 64 ± 1.7 mm, p <0.0001; LVESD: 44.5 ± 1.1 vs 50 ± 0.8 mm, p <0.0001). A significant smaller wall motion score index was detected in trimetazidine-treated patients compared to those allocated to placebo (1.24 ± 0.12 vs 1.45 ± 0.19, p <0.01), the percentage change in LVEF compared to baseline was also significantly greater in trimetazidine-treated patients. Diastolic function significantly improved in the trimetazidine group while it remained unchanged in the placebo group. At follow-up evaluation, patients receiving trimetazidine showed a greater improvement in angina and NYHA class than patients allocated to placebo. Quality of life significantly improved in all patients treated with trimetazidine while remained unchanged in those allocated to placebo. In elderly patients with ischaemic cardiomyopathy trimetazidine in addition to standard medical therapy has a beneficial effect on LV systolic and diastolic function, and improves quality of life.

Original languageEnglish
Pages (from-to)1814-1821
Number of pages8
JournalEuropean Heart Journal
Volume25
Issue number20
DOIs
Publication statusPublished - Oct 2004

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Trimetazidine
Left Ventricular Function
Coronary Artery Disease
Quality of Life
Placebos
Myocardial Ischemia
Dilated Cardiomyopathy
Cardiomyopathies

Keywords

  • Ischaemic heart disease
  • Left ventricular function
  • Trimetazidine

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{9e59a6285f8343fc87d6d467c4e3b832,
title = "Trimetazidine improves left ventricular function and quality of life in elderly patients with coronary artery disease",
abstract = "Elderly patients have an increased incidence of ischaemic dilated cardiomyopathy often related to diffuse coronary artery disease. Trimetazidine protects ischaemic myocardium by improving the myocardial energy utilisation during myocardial ischaemia. Aim of the present study was to evaluate the effects of trimetazidine on left ventricular (LV) function in elderly patients with ischaemic heart disease and reduced LV function. Forty seven elderly patients (40 males and 7 females, mean age 78 ± 3 years) were randomised to receive, in addition to standard therapy, either trimetazidine or placebo and were evaluated by echocardiography at baseline and after 6 months. Trimetazidine and placebo had no effect on either blood pressure or heart rate (SBP 2 ± 5 vs 4 ± 6 mmHg, DBP -1 ± 6 vs 3 ± 4 mmHg, HR -3 ± 7 vs 5 ± 9 bpm, trimetazidine and placebo compared to baseline, respectively). At the end of the study patients randomised to trimetazidine showed a significant greater left ventricular function and smaller left ventricular diastolic and systolic diameters and volume indices compared to patients receiving placebo (LVEF: 34.4 ± 2.3{\%} vs 27 ± 2.8{\%}, p <0.0001; LVEDD: 58.6 ± 1.9 mm vs 64 ± 1.7 mm, p <0.0001; LVESD: 44.5 ± 1.1 vs 50 ± 0.8 mm, p <0.0001). A significant smaller wall motion score index was detected in trimetazidine-treated patients compared to those allocated to placebo (1.24 ± 0.12 vs 1.45 ± 0.19, p <0.01), the percentage change in LVEF compared to baseline was also significantly greater in trimetazidine-treated patients. Diastolic function significantly improved in the trimetazidine group while it remained unchanged in the placebo group. At follow-up evaluation, patients receiving trimetazidine showed a greater improvement in angina and NYHA class than patients allocated to placebo. Quality of life significantly improved in all patients treated with trimetazidine while remained unchanged in those allocated to placebo. In elderly patients with ischaemic cardiomyopathy trimetazidine in addition to standard medical therapy has a beneficial effect on LV systolic and diastolic function, and improves quality of life.",
keywords = "Ischaemic heart disease, Left ventricular function, Trimetazidine",
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T1 - Trimetazidine improves left ventricular function and quality of life in elderly patients with coronary artery disease

AU - Vitale, Cristiana

AU - Wajngaten, Mauricio

AU - Sposato, Barbara

AU - Gebara, Otavio

AU - Rossini, Paola

AU - Fini, Massimo

AU - Volterrani, Maurizio

AU - Rosano, Giuseppe M C

PY - 2004/10

Y1 - 2004/10

N2 - Elderly patients have an increased incidence of ischaemic dilated cardiomyopathy often related to diffuse coronary artery disease. Trimetazidine protects ischaemic myocardium by improving the myocardial energy utilisation during myocardial ischaemia. Aim of the present study was to evaluate the effects of trimetazidine on left ventricular (LV) function in elderly patients with ischaemic heart disease and reduced LV function. Forty seven elderly patients (40 males and 7 females, mean age 78 ± 3 years) were randomised to receive, in addition to standard therapy, either trimetazidine or placebo and were evaluated by echocardiography at baseline and after 6 months. Trimetazidine and placebo had no effect on either blood pressure or heart rate (SBP 2 ± 5 vs 4 ± 6 mmHg, DBP -1 ± 6 vs 3 ± 4 mmHg, HR -3 ± 7 vs 5 ± 9 bpm, trimetazidine and placebo compared to baseline, respectively). At the end of the study patients randomised to trimetazidine showed a significant greater left ventricular function and smaller left ventricular diastolic and systolic diameters and volume indices compared to patients receiving placebo (LVEF: 34.4 ± 2.3% vs 27 ± 2.8%, p <0.0001; LVEDD: 58.6 ± 1.9 mm vs 64 ± 1.7 mm, p <0.0001; LVESD: 44.5 ± 1.1 vs 50 ± 0.8 mm, p <0.0001). A significant smaller wall motion score index was detected in trimetazidine-treated patients compared to those allocated to placebo (1.24 ± 0.12 vs 1.45 ± 0.19, p <0.01), the percentage change in LVEF compared to baseline was also significantly greater in trimetazidine-treated patients. Diastolic function significantly improved in the trimetazidine group while it remained unchanged in the placebo group. At follow-up evaluation, patients receiving trimetazidine showed a greater improvement in angina and NYHA class than patients allocated to placebo. Quality of life significantly improved in all patients treated with trimetazidine while remained unchanged in those allocated to placebo. In elderly patients with ischaemic cardiomyopathy trimetazidine in addition to standard medical therapy has a beneficial effect on LV systolic and diastolic function, and improves quality of life.

AB - Elderly patients have an increased incidence of ischaemic dilated cardiomyopathy often related to diffuse coronary artery disease. Trimetazidine protects ischaemic myocardium by improving the myocardial energy utilisation during myocardial ischaemia. Aim of the present study was to evaluate the effects of trimetazidine on left ventricular (LV) function in elderly patients with ischaemic heart disease and reduced LV function. Forty seven elderly patients (40 males and 7 females, mean age 78 ± 3 years) were randomised to receive, in addition to standard therapy, either trimetazidine or placebo and were evaluated by echocardiography at baseline and after 6 months. Trimetazidine and placebo had no effect on either blood pressure or heart rate (SBP 2 ± 5 vs 4 ± 6 mmHg, DBP -1 ± 6 vs 3 ± 4 mmHg, HR -3 ± 7 vs 5 ± 9 bpm, trimetazidine and placebo compared to baseline, respectively). At the end of the study patients randomised to trimetazidine showed a significant greater left ventricular function and smaller left ventricular diastolic and systolic diameters and volume indices compared to patients receiving placebo (LVEF: 34.4 ± 2.3% vs 27 ± 2.8%, p <0.0001; LVEDD: 58.6 ± 1.9 mm vs 64 ± 1.7 mm, p <0.0001; LVESD: 44.5 ± 1.1 vs 50 ± 0.8 mm, p <0.0001). A significant smaller wall motion score index was detected in trimetazidine-treated patients compared to those allocated to placebo (1.24 ± 0.12 vs 1.45 ± 0.19, p <0.01), the percentage change in LVEF compared to baseline was also significantly greater in trimetazidine-treated patients. Diastolic function significantly improved in the trimetazidine group while it remained unchanged in the placebo group. At follow-up evaluation, patients receiving trimetazidine showed a greater improvement in angina and NYHA class than patients allocated to placebo. Quality of life significantly improved in all patients treated with trimetazidine while remained unchanged in those allocated to placebo. In elderly patients with ischaemic cardiomyopathy trimetazidine in addition to standard medical therapy has a beneficial effect on LV systolic and diastolic function, and improves quality of life.

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