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Trimetazidine improves endothelial dysfunction in chronic heart failure: an antioxidant effect
Romualdo Belardinelli1, Maridia Solenghi, Loretta Volpe
1Cardiac Rehabilitation and Prevention Section, Lancisi Heart Institute, Via Conca 71, 60020 Torrette di Ancona, Italy. r.belardinelli@ao-umbertoprimo.marche.it
European Heart Journal
|April 26, 2007
Summary
Trimetazidine (TMZ) improves endothelium-dependent relaxation in chronic heart failure patients. This improvement is linked to TMZ's antioxidant effects, reducing oxidative stress markers.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Chronic heart failure (CHF) is associated with impaired endothelium-dependent relaxation (EDR) and increased oxidative stress.
- Oxidative stress, indicated by markers like malondialdehyde (MDA) and lipid hydroperoxides (LOOHs), contributes to endothelial dysfunction in CHF.
Purpose of the Study:
- To investigate the effect of trimetazidine (TMZ) on EDR in patients with CHF.
- To determine if TMZ's potential improvement in EDR is associated with its antioxidant properties.
Main Methods:
- A randomized controlled trial involving 51 patients with CHF secondary to ischaemic cardiomyopathy.
- Patients received either oral TMZ (20 mg tid) or placebo for 4 weeks.
- Endothelium-dependent vasodilation of the radial artery was assessed using acetylcholine infusion. Plasma MDA and LOOHs levels were measured.
Main Results:
- Trimetazidine significantly improved radial artery diameter in response to acetylcholine compared to placebo.
- Patients treated with TMZ showed a significant reduction in plasma MDA and LOOHs levels.
- Improvements in endothelium-dependent vasodilation correlated with reduced oxidative stress markers and increased peak oxygen uptake.
Conclusions:
- Trimetazidine enhances endothelium-dependent relaxation in patients with ischaemic cardiomyopathy.
- The antioxidant properties of trimetazidine likely contribute to its beneficial effects on endothelial function in CHF.
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