Aim To investigate whether or not additional treatment of ischemic heart disease with trimetazidine could improve effort tolerance and overall quality of life of patients with ischemic heart disease. Methods The study included 200 patients with ischemic heart disease. The sample was divided into 2 randomly selected groups: experimental and control group. The diagnostic procedures included: trade-mill test according to Bruce protocol, heart ultrasound for assessment of ejection fraction, test for the assessment of quality of life and subjective problems (Short Form SF 36). Patients were tested for time of discharge from hospital, after 6 and 12 months, including re-evaluation of the overall condition of the previous period. Results Patients have been tested for the tolerance of effort with the measurement Metabolic Equivalent of TASK (METs), which is the equivalent of physical labor. Patients treated with trimetazidine since the time of hospital discharge achieved an average of 3.68, after 6 months 5.68, and after 12 months 7.79 METs. The control group achieved 3.68, 3.59 and 3.87 METs, respectively. Using Mann-Whitney test no difference at discharge time (p=0.880), but after six and twelve months there was some difference (p<0.001). Results of ejection fraction measured by echocardiography were similar. No difference between the two groups with regard to time of discharge (p=0.821, but p<0.001 after six and twelve months, respectively). Conclusion Patients treated with conventional therapy including trimetazidine have better tolerance to effort and better ejection fraction on heart ultrasound examination in comparison with those treated without trimetazidine, so trimetazidin improve the metabolic balance of heart muscle.
Panchal B, Panchal G, Trivedi R, Ghataliya S. A study of regional wall motion abnormalities in patients of ischemic heart. IJSR -International Journal of Scientific Research. 2017;44–78.
2.
Task F, Members, Montalescot G, Sechtem U, Achenbach S, Andreotti F, et al. Eur Heart J. 2013;2949–3003.
3.
Vlodaver Z, Vilson R, Garry D. Coronary Heart Disease: Clinical, Pathological, Imaging, and Molecular Profiles. 2012;
4.
Roffi M, Patrono C, Collet J, Mueller C, Valgimigli M, Andreotti F, et al. 015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016;267–315.
5.
Burnett H, Earley A, Voors A, Senni M, Mcmurray J, Deschaseaux C, et al. Thirty years of evidence on the efficacy of drug treatments for chronic heart failure with reduced ejection fraction: a network meta-analysis. Circ Heart Fail. 2017;(1).
6.
Belardinelli R, Solenghi M, Volpe L, Purcaro A. Trimetazidine improves endothelial dysfunction in chronic heart failure: an antioxidant effect. Eur Heart J. 2007;1102–8.
7.
Kota S, Kota S, Jammula S, Panda S, Modi K. Effect of diabetes on alteration of metabolism in cardiac myocytes: therapeutic implications. Diabetes Technol Ther. 2011;1155–60.
8.
Ng K, Steinhubl S, Defilippi C, Dey S, Stewart W. Early detection of heart failure using electronic health records practical implications for time before diagnosis, data diversity, data quantity, and data density. Circ Cardiovasc Qual Outcomes. 2016;649–58.
9.
Kantor P, Kozak L, Lopaschuk R, G. The antianginal drug trimetazidine shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase. Circ Res. 2000;580–8.
10.
Mccord J. Oxygen derived free radicals in post-ischaemic tissue injury. N Engl J Med. 1985;159–63.
11.
Jolly M. Exercise testing-ACC/AHA Guidelines for Exercise Testing. 2013;768–90.
12.
Guazzi M 1, Adams V, Conraads V, Halle M, Mezzani A, Vanhees L, et al. EACPR/AHA Joint Scientific Statement: Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Eur Heart J. 2012;2917.
13.
Lang R, Badano L, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiog. 2015;281–320.
14.
Komajda M, Lam C. Heart failure with preserved ejection fraction: a clinical dilemma. European heart journal. 2014;1022–32.
15.
Alagiakrishnan K, Banach M, Jones L, Datta S, Ahmed A, Aronow W. Update on diastolic heart failure or heart failure with preserved ejection fraction in the older adults. Ann Med. 2013;37–50.
16.
Ware J, Sherbourne C. The MOS 36-item Short-Form health survey (SF-36). Med Care. 1992;473–83.
17.
Salobir G, Keber B, Kurija I, Vreg S, F. Quality of life after myocardial infarction. Cardiovasc Dis. 1998;465–73.
18.
Szwed H, Sadowski Z, Elikowski W, Koronkiewicz A, Mamcarz A, Orszulak W, et al. Combination treatment in stable effort angina using trimetazidine and metoprolol. Results of a randomized, double-blind, multicentre study (TRIMPOL II). Eur Heart J. 2001;2267–74.
19.
Passeron J. Effectiveness of trimetazidine in stable effort angina due to chronic coronary insufficiency. A double-blind versus placebo study. Presse Med. 1986;1775–8.
20.
Akhras F, Jackson G. Efficacy of nifedipine and isosorbide mononitrate in combination with atenolol in stable angina. Lancet. 1991;1036–9.
21.
Manchanda S, Krishnaswami S. Combination treatment with trimetazidine and diltiazem in stable angina pectoris. Heart. 1997;353–7.
22.
Kantor P, Kozak L, Lopaschuk R, G. The antianginal drug trimetazidine shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase. Circ Res. 2000;580–8.
23.
Komajda M, Lam C. Heart failure with preserved ejection fraction: a clinical dilemma. European heart journal. 2014;1022–32.
24.
Zhang L, Lu Y, Jiang H, Zhang L, Sun A, Zou Y, et al. Additional use of trimetazidine in patients with chronic heart failure: meta-analysis. J Am Coll Cardiol. 2012;913–22.
25.
Karimi M, Brazier J, Health. health-related quality of life, and quality of life: what is the difference? Pharmacoeconomics. 2016;645–9.
26.
Tsioufis K, Andrikopoulos G, Manolis A. Trimetazidine and cardioprotection: facts and perspectives. Angiology. 2015;204–10.
27.
Maurer M, King D, El-K Houry Rumbarger L-Packer M, Burkhoff D. Left heart failure with a normal ejection fraction: identification of different pathophysiologic mechanisms. J Card Fail. 2005;177–87.
28.
Fukuta H, Little W. Diagnosis of diastolic heart failure. Curr Cardiol Rep. 2007;224–8.
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