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Effect of partial inhibition of fatty acid oxidation by trimetazidine on whole body energy metabolism in patients with chronic heart failure
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Effect of partial inhibition of fatty acid oxidation by trimetazidine on whole body energy metabolism in patients with chronic heart failure
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Effect of partial inhibition of fatty acid oxidation by trimetazidine on whole body energy metabolism in patients with chronic heart failure
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Journal Article
Effect of partial inhibition of fatty acid oxidation by trimetazidine on whole body energy metabolism in patients with chronic heart failure
2011
Overview
ObjectiveTrimetazidine 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.DesignSingle blind randomised study.SettingUniversity Hospital.Patients44 patients with systolic heart failure receiving full medical treatment.InterventionsIndirect calorimetry and two-dimensional echocardiography at baseline and after 3 months.Main outcome measuresWhole body resting energy expenditure (REE), percentage of predicted REE, LV ejection fraction (EF), NYHA class, quality of life.ResultsTrimetazidine increased EF compared with conventional therapy alone (from 35±8% to 42±11% vs from 35±7% 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<0.0001). REE (from 1677±264 to 1580±263 kcal/day) and percentage of predicted REE (based on the Harris–Benedict equation: from 114±10% to 108±9%) decreased in the trimetazidine group, but not in the control group (REE from 1679±304 to 1690±337 kcal/day and percentage of predicted REE from 113±12% to 115±14%). The variation was different between groups (p=0.03 and 0.023, respectively).ConclusionsIn patients with systolic heart failure, improvement in functional class and LV function induced by middle-term trimetazidine therapy is paralleled by a reduction in whole body REE. The beneficial cardiac effects of trimetazidine may be also mediated by a peripheral metabolic effect.
Publisher
BMJ Publishing Group Ltd and British Cardiovascular Society,BMJ Publishing Group,BMJ Publishing Group LTD
Subject
/ Biological and medical sciences
/ Diabetes
/ Energy Metabolism - drug effects
/ Female
/ Glucose
/ Heart
/ Heart Failure - drug therapy
/ Heart failure, cardiogenic pulmonary edema, cardiac enlargement
/ Humans
/ Lipids
/ Male
/ Oxidation-Reduction - drug effects
/ Studies
/ Systolic-dysfunction heart failure
/ Trimetazidine - administration & dosage
/ Trimetazidine - pharmacology
/ Trimetazidine - therapeutic use
/ Vasodilator Agents - administration & dosage
