Trimetazidine Improves Myocardial Perfusion and Left Ventricular Function in Ischemic Left Ventricular Dysfunction

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

doi:10.1097/01.rlu.0000109298.69905.04

Cited by 8 publications

(2 citation statements)

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“…Thus, we employed a test protocol that entails the administration of both trimetazidine and nitroglycerin before radiotracer injection. A recent study by Feola et al showed that the addition of trimetazidine to 99m Tc-tetrofosmin scintigraphy improved the sensitivity of the perfusion scan for the detection of viable myocardial tissue, both at 2- and 6-months follow-up, compared with placebo, maintaining a satisfactory specificity ( 17 ). Furthermore, the predictive power of 99m Tc-sestamibi scintigraphy was also enhanced with the addition of nitrates, obtaining an improvement in both the sensitivity and specificity (up to 95 and 88%, respectively) ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Dobutamine-Induced Strain and Strain Rate Predict Viability Following Fibrinolytic Therapy in Patients with ST-Elevation Myocardial Infarction

Ismaïl

Nammas

2015

Front. Cardiovasc. Med.

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Background: Low-dose dobutamine stress echocardiography is increasingly used for identifying myocardial viability.Aim: We explored whether dobutamine-induced strain (S) and strain rate (SR) can identify myocardial viability following fibrinolytic therapy for ST-segment-elevation myocardial infarction (STEMI), taking 99mTc-sestamibi scintigraphy as the “gold standard” for diagnosis.Methods: We enrolled 60 consecutive patients presenting for myocardial viability assessment at least 4 weeks following STEMI. S and SR were measured by tissue Doppler imaging individually for all myocardial segments under low-dose dobutamine stress echocardiography. Patients underwent resting 99mTc-sestamibi scintigraphy using the standard imaging technique. Based on the results of 99mTc-sestamibi scintigraphy, the dobutamine-induced S and SR were compared between viable and non-viable segments. Receiver-operating characteristics curve was constructed to determine the cutoff value of the dobutamine-induced S and SR that best identifies viability.Results: The dobutamine-induced S and SR were significantly higher in viable compared with non-viable segments, a finding that was consistent for most individual myocardial segments (10 out of 16 for S and 11 out of 16 for SR). A cutoff value ranging from −8.5 to −9.6% for the S identified viability in apical and mid- segments, whereas a cutoff value ranging from −11.5 to −21.5% identified viability in basal segments. Similarly, a cutoff value ranging from −0.5 to −1.2 s−1 for the SR identified viability in apical and mid-segments, whereas a cutoff value ranging from −1.4 to −1.7/s−1 identified viability in basal segments.Conclusion: In patients undergoing viability assessment following fibrinolytic therapy for STEMI, the dobutamine-induced S and SR were higher in viable versus non-viable segments. A cutoff value of dobutamine-induced S and SR identified viability in most individual myocardial segments.

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Section: Discussionmentioning

confidence: 99%

Dobutamine-Induced Strain and Strain Rate Predict Viability Following Fibrinolytic Therapy in Patients with ST-Elevation Myocardial Infarction

Ismaïl

Nammas

2015

Front. Cardiovasc. Med.

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“…In patients with myocardial ischemia, TMZ improves myocardial perfusion, increases the left ventricular ejection fraction and reduces the residual left ventricular end-systolic volume [17]. Furthermore, when used during thrombolysis in patients with acute myocardial infarction, TMZ reduces reperfusion injury.…”

Section: Discussionmentioning

confidence: 99%