Beneficial Electrophysiological Effects of Trimetazidine in Patients With Postischemic Chronic Heart Failure

Abstract

The aim of the study was to assess whether trimetazidine (TMZ) could affect dispersion of atrial depolarization and ventricular repolarization. Corrected QT interval (QTc), QTc dispersion (QTc-d), Tpeak-Tend, and Tpeak-Tend dispersion (Tpeak-Tend-d) were measured in 30 patients with chronic heart failure (CHF) before and 6 months after randomization to conventional therapy plus TMZ (17 patients) or conventional therapy alone (13 patients). After 6 months, QTc was significantly reduced in both groups, whereas QT-peak was increased only in control group. Tpeak-Tend-d decreased (from 63.53 +/- 24.73 to 42.35 +/- 21.07 milliseconds, P = .006) only in TMZ group. When subgrouped according to CHF etiology, only ischemic patients on TMZ showed Tpeak-Tend-d reduction (65.00 +/- 27.14 vs 36.67 +/- 11.55 milliseconds, P = .001 in ischemic patients; 60.00 +/- 20.00 vs 56.00 +/- 33.86 milliseconds, P = NS, in nonischemic). These electrophysiological properties indicate an undiscovered mechanism of action of TMZ, which could be useful in conditions at risk of major arrhythmias.

Comparison of Ranolazine and Trimetazidine on Glycemic Status in Diabetic Patients with Coronary Artery Disease – A Randomized Controlled Trial

“…This was different from a previous study with trimetazidine (35 mg BD) in which statistically significant shortening of QTc interval by >20 ms was observed in 64% (14 of 22) of patients with heart failure [22]. Similarly another study done in 30 patients with chronic heart failure showed significant reduction in QTc interval after 6 months of treatment with trimetazidine [23]. However, the mechanism of QTc shortening with trimetazidine is not clear and this has been observed only in patients with heart failure.…”

Is Treatment with Trimetazidine Beneficial in Patients with Chronic Heart Failure?

“…The baseline characteristics of enrolled studies are shown in Tables 2 and 3. Among the included studies, 17 trials described LVEF [10]–[24], [26], [27], 8 NYHA classification [15], [17], [19]–[21], [24]–[26], 6 exercise duration [12], [16]–[18], [22], [27], 3 all-cause mortality [16], [17], [19], 4 hospitalization [13], [15], [17], [23], 3 BNP [17], [20], [28] and 3 CRP [19], [22], [28]. TMZ dosage ranged from 40 to 70 mg/day and follow-up periods from 1 to 24 months.…”

Defining the Role of Trimetazidine in the Treatment of Cardiovascular Disorders: Some Insights on Its Role in Heart Failure and Peripheral Artery Disease

“…At baseline, the groups did not differ significantly in terms of the QTc intervals ( p  = 0.62); however, after 1 month of treatment, a statistically significant QTc interval reduction was observed only in the trimetazidine group (404 ± 36 ms; p  = 0.0002) [50]. Cera et al [51] studied the effects of trimetazidine on the change in QTc duration in CHF patients. The study included 13 patients receiving conventional treatment and 17 patients additionally receiving trimetazidine.…”