PMID- 16510466
OWN - NLM
STAT- MEDLINE
DCOM- 20060731
LR  - 20131121
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 27
IP  - 8
DP  - 2006 Apr
TI  - Effects of metabolic modulation by trimetazidine on left ventricular function and 
      phosphocreatine/adenosine triphosphate ratio in patients with heart failure.
PG  - 942-8
AB  - AIMS: The addition of trimetazidine to standard treatment has been shown to 
      improve left ventricular (LV) function in patients with heart failure. The aim of 
      this study is to non-invasively assess, by means of in vivo 31P-magnetic 
      resonance spectroscopy (31P-MRS), the effects of trimetazidine on LV cardiac 
      phosphocreatine and adenosine triphosphate (PCr/ATP) ratio in patients with heart 
      failure. METHODS AND RESULTS: Twelve heart failure patients were randomized in a 
      double-blind, cross-over study to placebo or trimetazidine (20 mg t.i.d.) for two 
      periods of 90 days. At the end of each period, all patients underwent exercise 
      testing, 2D echocardiography, and MRS. New York Heart Association (NYHA) class, 
      ejection fraction (EF), maximal rate-pressure product, and metabolic equivalent 
      system (METS) were evaluated. Relative concentrations of PCr and ATP were 
      determined by cardiac 31P-MRS. On trimetazidine, NYHA class decreased from 
      3.04+/-0.26 to 2.45+/-0.52 (P = 0.005), whereas EF (34+/-10 vs. 39+/-10%, P = 
      0.03) and METS (from 7.44+/-1.84 to 8.78+/-2.72, P = 0.03) increased. The mean 
      cardiac PCr/ATP ratio was 1.35+/-0.33 with placebo, but was increased by 33% to 
      1.80+/-0.50 (P = 0.03) with trimetazidine. CONCLUSION: Trimetazidine improves 
      functional class and LV function in patients with heart failure. These effects 
      are associated to the observed trimetazidine-induced increase in the PCr/ATP 
      ratio, indicating preservation of the myocardial high-energy phosphate levels.
FAU - Fragasso, Gabriele
AU  - Fragasso G
AD  - Department of Clinical Cardiology, Heart Failure Clinic, Istituto 
      Scientifico/Universita' San Raffaele, Via Olgettina 60, 20132 Milano, Italy. 
      gabriele.fragasso@hsr.it
FAU - Perseghin, Gianluca
AU  - Perseghin G
FAU - De Cobelli, Francesco
AU  - De Cobelli F
FAU - Esposito, Antonio
AU  - Esposito A
FAU - Palloshi, Altin
AU  - Palloshi A
FAU - Lattuada, Guido
AU  - Lattuada G
FAU - Scifo, Paola
AU  - Scifo P
FAU - Calori, Giliola
AU  - Calori G
FAU - Del Maschio, Alessandro
AU  - Del Maschio A
FAU - Margonato, Alberto
AU  - Margonato A
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20060301
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Vasodilator Agents)
RN  - 020IUV4N33 (Phosphocreatine)
RN  - 8L70Q75FXE (Adenosine Triphosphate)
RN  - N9A0A0R9S8 (Trimetazidine)
SB  - IM
MH  - Adenosine Triphosphate/metabolism
MH  - Aged
MH  - Cross-Over Studies
MH  - Double-Blind Method
MH  - Echocardiography
MH  - Female
MH  - Heart Failure/*drug therapy/metabolism/physiopathology
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Magnetic Resonance Angiography/methods
MH  - Male
MH  - Phosphocreatine/metabolism
MH  - Prospective Studies
MH  - Trimetazidine/*therapeutic use
MH  - Vasodilator Agents/*therapeutic use
MH  - Ventricular Dysfunction, Left/*drug therapy/metabolism/physiopathology
EDAT- 2006/03/03 09:00
MHDA- 2006/08/01 09:00
CRDT- 2006/03/03 09:00
PHST- 2006/03/03 09:00 [pubmed]
PHST- 2006/08/01 09:00 [medline]
PHST- 2006/03/03 09:00 [entrez]
AID - ehi816 [pii]
AID - 10.1093/eurheartj/ehi816 [doi]
PST - ppublish
SO  - Eur Heart J. 2006 Apr;27(8):942-8. doi: 10.1093/eurheartj/ehi816. Epub 2006 Mar 
      1.