The Acute Administration of Trimetazidine Modified Myocardial Perfusion and Left Ventricular Function in 31 Patients with Ischaemic Ventricular Dysfunction

Feola, Mauro; Biggi, Alberto; Francini, Antonella; Leonardi, Giovanni; Ribichini, Flavio; Ferrero, Valeria; Uslenghi, E

doi:10.1023/b:caim.0000041937.63446.f8

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…In some other studies, the addition of Trimetazidine to myocardial Tc-99 m sestamibi or tetrofosmin SPECT improved myocardial perfusion and LV function [45–47]. …”

Section: Recent Trends In Viability Assessmentmentioning

confidence: 99%

Myocardial Viability: What We Knew and What Is New

Shabana

El‐Menyar

2012

Cardiology Research and Practice

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Some patients with chronic ischemic left ventricular dysfunction have shown significant improvements of contractility with favorable long-term prognosis after revascularization. Several imaging techniques are available for the assessment of viable myocardium, based on the detection of preserved perfusion, preserved glucose metabolism, intact cell membrane and mitochondria, and presence of contractile reserve. Nuclear cardiology techniques, dobutamine echocardiography and positron emission tomography are used to assess myocardial viability. In recent years, new advances have improved methods of detecting myocardial viability. This paper summarizes the pathophysiology, methods, and impact of detection of myocardial viability, concentrating on recent advances in such methods. We reviewed the literature using search engines MIDLINE, SCOUPS, and EMBASE from 1988 to February 2012. We used key words: myocardial viability, hibernation, stunning, and ischemic cardiomyopathy. Recent studies showed that the presence of viable myocardium was associated with a greater likelihood of survival in patients with coronary artery disease and LV dysfunction, but the assessment of myocardial viability did not identify patients with survival benefit from revascularization, as compared with medical therapy alone. This topic is still debatable and needs more evidence.

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“…In some other studies, the addition of Trimetazidine to myocardial Tc-99 m sestamibi or tetrofosmin SPECT improved myocardial perfusion and LV function [45–47]. …”

Section: Recent Trends In Viability Assessmentmentioning

confidence: 99%

Myocardial Viability: What We Knew and What Is New

Shabana

El‐Menyar

2012

Cardiology Research and Practice

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“…They found that wall motion dysfunction improved and EF increased. Feola et al [45] studied the effect of 3-day TMZ treatment in patients with ischemic HF. Compared with placebo, TMZ improved EF and reduced LV end-systolic volume.…”

Section: Acute Metabolic Modulationmentioning

confidence: 99%

Myocardial fatty acid metabolism and cardiac performance in heart failure

Tuunanen¹,

Ukkonen²,

Knuuti

2008

Curr Cardiol Rep

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It is well established that cardiac metabolism is abnormal in heart failure (HF). Experimental studies suggest that in severe HF, cardiac metabolism reverts to a more fetal-like substrate use characterized by enhanced glucose and downregulated free fatty acid (FFA) metabolism. Correspondingly, in humans, when FFA levels are similar, myocardial glucose metabolism is increased, and FFA metabolism is decreased. However, depression of left ventricular function and insulin resistance induces a shift back to greater FFA uptake and oxidation by increasing circulating FFA availability. Myocardial insulin resistance may further impair myocardial glucose uptake and lead to an energy depletion state. Experimental and preliminary clinical studies suggest that metabolic modulators enhancing myocardial glucose oxidation may improve cardiac function in patients with chronic HF. However, it has been found that acute FFA deprivation is harmful to the cardiac performance. Optimizing myocardial energy metabolism may serve as an additional approach for managing HF, but further studies are warranted.

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“…Feola et al studied the changes in myocardial perfusion and global left ventricular function induced by short-term treatment with trimetazidine in patients with ischaemic ventricular dysfunction [118]. They demonstrated a significant improvement in myocardial perfusion during treatment as compared with the images obtained under placebo, and this improvement was accompanied by a significant reduction in left ventricular end-systolic volume and a significant increase in the ejection fraction; however, in the subgroup of patients with the most severe left ventricular dysfunction, the perfusion recovery was not associated with a significant functional improvement [118]. Thus, the functional effect of treatment could be analysed taking into account also the interaction between drug action and perfusion pattern.…”

Section: Gated Spect For the Evaluation Of Left Ventricular Volumes Amentioning

confidence: 99%

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Sciagrà

2007

Eur J Nucl Med Mol Imaging

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Background Gating of single-photon emission computed tomography (SPECT) has significantly improved the reliability and diagnostic accuracy of myocardial perfusion imaging. The functional parameters derived from this technique, mainly left ventricular volumes and ejection fraction, have been demonstrated to be accurate and reproducible. They are able to increase the detection of severe and extensive coronary artery disease and show a significant incremental prognostic power over perfusion abnormalities. Therefore, the importance given to gated SPECT functional data has progressively grown. Discussion This circumstance has further expanded the indications for myocardial perfusion imaging and strengthened its position among the different imaging modalities. Moreover, several studies show that the evaluation of ventricular function may have a leading part in justifying the execution of perfusion scintigraphy in various clinical conditions. Aim Aim of this review is to describe this evolution of gated SPECT functional assessment from a supporting rank with respect to perfusion, to a main actor position in the field of cardiac imaging.

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The Acute Administration of Trimetazidine Modified Myocardial Perfusion and Left Ventricular Function in 31 Patients with Ischaemic Ventricular Dysfunction

Abstract: In comparison with placebo, the addition of TMZ to myocardial Tc-99m tetrofosmin SPECT improved myocardial perfusion and LVEF, reducing LVESV. These effects were lost in patients with more severe ventricular dysfunction.

Cited by 5 publications

References 16 publications

Myocardial Viability: What We Knew and What Is New

Myocardial Viability: What We Knew and What Is New

Myocardial fatty acid metabolism and cardiac performance in heart failure

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

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