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Trimetazidine improves left ventricular function in diabetic patients with coronary artery disease: a double-blind placebo-controlled study.

Rosano GM, Vitale C, Sposato B, Mercuro G, Fini M - Cardiovasc Diabetol (2003)

Bottom Line: After six month baseline left ventricular end-diastolic diameters increased from 62.4 +/- 1.7 to 63 +/- 2.1 mm in the placebo group, while decreased from 63.2 +/- 2.1 to 58 +/- 1.6 mm (p < 0.01 compared to baseline) in the trimetazidine group.A significant improvement in wall motion score index and in the E/A wave ratio was detected in patients treated with trimetazidine, but not in those receiving placebo. in diabetic patients with ischemic heart disease trimetazidine added to standard medical therapy has beneficial effect on left ventricular volumes and on left ventricular ejection fraction compared to placebo.This effect may be related to the effect of trimetazidine upon cardiac glucose utilization.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Sciences, San Raffaele-TOSINVEST SANITA, Rome, Italy. giuseppe.rosano@fastwebnet.it

ABSTRACT

Background: Patients with diabetic cardiomyopathy have an impaired myocardial glucose handling and distal distribution of coronary atherosclerosis. Trimetazidine, an anti-ischemic metabolic agent, improves myocardial glucose utilization though inhibition of fatty acid oxidation. Aim of the present study was to evaluate whether the metabolic effect of trimetazidine on left ventricular function in patients with diabetic cardiomyopathy.

Methods: 32 patients (24 males and 8 females, mean (SE) age = 67 +/- 6 years) with type 2 diabetes and ischemic cardiomyopathy were randomized to receive either trimetazidine (20 mg, t.d.s.) or placebo (t.d.s.) for six months in a randomized parallel study. Patients performed an echocardiogram at baseline and after 6 months.

Results: Demographic data were comparable between the two groups. After six month baseline left ventricular end-diastolic diameters increased from 62.4 +/- 1.7 to 63 +/- 2.1 mm in the placebo group, while decreased from 63.2 +/- 2.1 to 58 +/- 1.6 mm (p < 0.01 compared to baseline) in the trimetazidine group. Compared to baseline, left ventricular ejection fraction increased by 5.4 +/- 0.5% (p < 0.05) in the trimetazidine group while remained unchanged in the placebo group -2.4 +/- 1.1% (NS), p < 0.01 between groups. A significant improvement in wall motion score index and in the E/A wave ratio was detected in patients treated with trimetazidine, but not in those receiving placebo.

Conclusion: in diabetic patients with ischemic heart disease trimetazidine added to standard medical therapy has beneficial effect on left ventricular volumes and on left ventricular ejection fraction compared to placebo. This effect may be related to the effect of trimetazidine upon cardiac glucose utilization.

No MeSH data available.


Related in: MedlinePlus

Effect of six month therapy with trimetazidine or placebo on wall motion score index (WMSI). A significant improvement in WMSI was detected in patients receiving trimetazidine while no change was noted in patients allocated to standard care and placebo
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Figure 3: Effect of six month therapy with trimetazidine or placebo on wall motion score index (WMSI). A significant improvement in WMSI was detected in patients receiving trimetazidine while no change was noted in patients allocated to standard care and placebo

Mentions: After six months, compared to patients treated with placebo, diabetic patients treated with trimetazidine showed a significant reduction of left ventricular diastolic and systolic diameters (63.2 ± 2.1 to 58 ± 1.6 mm -8% vs 62.4 ± 1.7 to 63 ± 2.1 mm 1, 6%, p < 0.05; 41.1 ± 1.5 to 34 ± 1 mm vs 39.5 ± 1.3 to 41 ± 0.9 mm, p < 0.05 respectively, table 2, figure 1), while no significant changes compared to pre-treatment values were detected in the placebo group. A significant decrease in left ventricular end-diastolic volume index (-3.7 ± 1.9 ml/m2, p < 0.04 compared to baseline and placebo) and end-systolic volume index (-2.2 ± 1.1 ml/m2, p < 0.04 compared to placebo and baseline) was noted in patients treated with trimetazidine, while an increase in left ventricular end-diastolic volume index (1.9 ± 1.1 ml/m2) and end systolic volume (0.48 ± 0.4 ml/m2) was found in the placebo group. Patients treated with trimetazidine showed an improvement in left ventricular ejection fraction (5.4 ± 0.5%), while a decrease (-2.4 ± 1.1%) was noted in patients treated with placebo (Figure 2). The wall motion score index significantly decreased in patients treated with trimetazidine (from 1.37 ± 0.2 to 1.26 ± 0.16, p < 0.01) while it remained unchanged in patients treated with placebo (from 1.38 ± 0.3 to 1.42 ± 0.21, Figure 3). Left ventricular diastolic function evaluated trough E/A on mitral flow significantly improved in patients treated with trimetazidine (from 0.68 ± 0.1 to 0.89 ± 0.3, while it remained unchanged in patients treated with placebo (Figure 4).


Trimetazidine improves left ventricular function in diabetic patients with coronary artery disease: a double-blind placebo-controlled study.

Rosano GM, Vitale C, Sposato B, Mercuro G, Fini M - Cardiovasc Diabetol (2003)

Effect of six month therapy with trimetazidine or placebo on wall motion score index (WMSI). A significant improvement in WMSI was detected in patients receiving trimetazidine while no change was noted in patients allocated to standard care and placebo
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC305354&req=5

Figure 3: Effect of six month therapy with trimetazidine or placebo on wall motion score index (WMSI). A significant improvement in WMSI was detected in patients receiving trimetazidine while no change was noted in patients allocated to standard care and placebo
Mentions: After six months, compared to patients treated with placebo, diabetic patients treated with trimetazidine showed a significant reduction of left ventricular diastolic and systolic diameters (63.2 ± 2.1 to 58 ± 1.6 mm -8% vs 62.4 ± 1.7 to 63 ± 2.1 mm 1, 6%, p < 0.05; 41.1 ± 1.5 to 34 ± 1 mm vs 39.5 ± 1.3 to 41 ± 0.9 mm, p < 0.05 respectively, table 2, figure 1), while no significant changes compared to pre-treatment values were detected in the placebo group. A significant decrease in left ventricular end-diastolic volume index (-3.7 ± 1.9 ml/m2, p < 0.04 compared to baseline and placebo) and end-systolic volume index (-2.2 ± 1.1 ml/m2, p < 0.04 compared to placebo and baseline) was noted in patients treated with trimetazidine, while an increase in left ventricular end-diastolic volume index (1.9 ± 1.1 ml/m2) and end systolic volume (0.48 ± 0.4 ml/m2) was found in the placebo group. Patients treated with trimetazidine showed an improvement in left ventricular ejection fraction (5.4 ± 0.5%), while a decrease (-2.4 ± 1.1%) was noted in patients treated with placebo (Figure 2). The wall motion score index significantly decreased in patients treated with trimetazidine (from 1.37 ± 0.2 to 1.26 ± 0.16, p < 0.01) while it remained unchanged in patients treated with placebo (from 1.38 ± 0.3 to 1.42 ± 0.21, Figure 3). Left ventricular diastolic function evaluated trough E/A on mitral flow significantly improved in patients treated with trimetazidine (from 0.68 ± 0.1 to 0.89 ± 0.3, while it remained unchanged in patients treated with placebo (Figure 4).

Bottom Line: After six month baseline left ventricular end-diastolic diameters increased from 62.4 +/- 1.7 to 63 +/- 2.1 mm in the placebo group, while decreased from 63.2 +/- 2.1 to 58 +/- 1.6 mm (p < 0.01 compared to baseline) in the trimetazidine group.A significant improvement in wall motion score index and in the E/A wave ratio was detected in patients treated with trimetazidine, but not in those receiving placebo. in diabetic patients with ischemic heart disease trimetazidine added to standard medical therapy has beneficial effect on left ventricular volumes and on left ventricular ejection fraction compared to placebo.This effect may be related to the effect of trimetazidine upon cardiac glucose utilization.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Medical Sciences, San Raffaele-TOSINVEST SANITA, Rome, Italy. giuseppe.rosano@fastwebnet.it

ABSTRACT

Background: Patients with diabetic cardiomyopathy have an impaired myocardial glucose handling and distal distribution of coronary atherosclerosis. Trimetazidine, an anti-ischemic metabolic agent, improves myocardial glucose utilization though inhibition of fatty acid oxidation. Aim of the present study was to evaluate whether the metabolic effect of trimetazidine on left ventricular function in patients with diabetic cardiomyopathy.

Methods: 32 patients (24 males and 8 females, mean (SE) age = 67 +/- 6 years) with type 2 diabetes and ischemic cardiomyopathy were randomized to receive either trimetazidine (20 mg, t.d.s.) or placebo (t.d.s.) for six months in a randomized parallel study. Patients performed an echocardiogram at baseline and after 6 months.

Results: Demographic data were comparable between the two groups. After six month baseline left ventricular end-diastolic diameters increased from 62.4 +/- 1.7 to 63 +/- 2.1 mm in the placebo group, while decreased from 63.2 +/- 2.1 to 58 +/- 1.6 mm (p < 0.01 compared to baseline) in the trimetazidine group. Compared to baseline, left ventricular ejection fraction increased by 5.4 +/- 0.5% (p < 0.05) in the trimetazidine group while remained unchanged in the placebo group -2.4 +/- 1.1% (NS), p < 0.01 between groups. A significant improvement in wall motion score index and in the E/A wave ratio was detected in patients treated with trimetazidine, but not in those receiving placebo.

Conclusion: in diabetic patients with ischemic heart disease trimetazidine added to standard medical therapy has beneficial effect on left ventricular volumes and on left ventricular ejection fraction compared to placebo. This effect may be related to the effect of trimetazidine upon cardiac glucose utilization.

No MeSH data available.


Related in: MedlinePlus