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Trimetazidine Effect on the Cardiac Autonomic Nerve System after Percutaneous Coronary Intervention in Coronary Heart
Bing Xiao1, Peng-Fan Yin2, Ye-Hui Jin1
1Department of Cardiology, The Second Hospital of Hebei Medical University, Hebei, China.
Insights
Trimetazidine (TMZ) effectively improved cardiac autonomic nervous system (CANS) function in coronary heart disease (CHD) patients post-percutaneous coronary intervention (PCI). This therapy enhanced heart rate variability (HRV) and sympathovagal balance, indicating better autonomic regulation.
Area of Science:
- Cardiology
- Autonomic Neuroscience
- Pharmacology
Background:
- Coronary heart disease (CHD) poses significant cardiovascular risks.
- Percutaneous coronary intervention (PCI) is a common revascularization strategy.
- Cardiac autonomic nervous system (CANS) dysfunction is prevalent in CHD patients post-PCI.
Purpose of the Study:
- To evaluate the impact of trimetazidine (TMZ) combined with conventional therapy on CANS in CHD patients after PCI.
- To assess changes in heart rate (HR) and heart rate variability (HRV) parameters.
Main Methods:
- A descriptive study involving 50 CHD patients post-PCI treated with TMZ plus conventional therapy (cases) and 50 controls on conventional therapy alone.
- Evaluation of CANS function using HR and HRV parameters, including sympathetic (SDNN, LF), parasympathetic (RMSSD, pNN50, SDSD, HF), and sympathovagal balance (LF/HF ratio).
Main Results:
- Conventional therapy alone improved HRV parameters but did not affect HR in controls.
- Trimetazidine (TMZ) combined with conventional therapy significantly improved all HRV parameters within 4 weeks.
- The TMZ-treated group exhibited enhanced parasympathetic activity, reduced sympathetic activity, and a lower LF/HF ratio compared to controls (p<0.05).
Conclusions:
- Trimetazidine (TMZ) effectively improves CANS function in coronary heart disease (CHD) patients following percutaneous coronary intervention (PCI).
- TMZ application demonstrates a beneficial effect on autonomic regulation beyond conventional therapy.
Objective:
To assess the effects of trimetazidine (TMZ) added to conventional drug therapy on cardiac autonomic nervous CANS in patients with coronary heart disease (CHD) after the percutaneous coronary intervention (PCI).
Study Design:
Descriptive study.
Place And Duration Of Study:
Department of Cardiology, The Second Hospital of Hebei Medical University, Hebei, China, from May 2018 to September 2019.
Methodology:
The study included 50 patients with CHD after a successful PCI who received trimetazidine plus conventional therapy were included as cases (exposed group), and 50 matched patients were identified as controls (non-exposed group). Heart rate (HR) and heart rate variability (HRV) parameters including sympathetic activity (SDNN, LF), parasympathetic activity (RMSSD, pNN50, SDSD, HF), and sympathovagal balance (LF/HF ratio) were used to evaluate CANS function.
Results:
There were no statistical differences in the HR and HRV parameters before and after PCI (p>0.05). In the non-exposed group, conventional therapy significantly improved the HRV parameters (all p<0.05), while not affecting HR (p>0.05). In the exposed group, all HRV parameters except HR were improved after 4 weeks of treatment. After 4 weeks of treatment, the exposed group had higher parasympathetic-nerve activity, lower sympathetic-nerve activity, and LF/HF ratio compared to the non-exposed group (all p<0.05).
Conclusions:
The application of TMZ based on conventional therapy effectively improved the CANS in CHD patients who underwent PCI.
Key Words:
Coronary heart disease, Percutaneous coronary intervention, Trimetazidine, Cardiac autonomic nervous system, Heart rate variability.
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