Trimetazidine in Heart Failure

Abstract

Heart failure is a systemic syndrome caused by multiple pathological factors. Current treatments do not have satisfactory outcomes. Several basic studies have revealed the protective effect of trimetazidine on the heart, not only by metabolism modulation but also by relieving myocardial apoptosis, fibrosis, autophagy, and inflammation. Clinical studies have consistently indicated that trimetazidine acts as an adjunct to conventional treatments and improves the symptoms of heart failure. This review summarizes the basic pathological changes in the myocardium, with an emphasis on the alteration of cardiac metabolism in the development of heart failure. The clinical application of trimetazidine in heart failure and the mechanism of its protective effects on the myocardium are carefully discussed, as well as its main adverse effects. The intention of this review is to highlight this treatment as an effective alternative against heart failure and provide additional perspectives for future studies.

Repurposing of Trimetazidine for amyotrophic lateral sclerosis: A study in SOD1G93Amice

“…Trimetazidine is a metabolic modulator that is used to treat cardiomyopathies. It improves metabolic performance of cardiac fibres by targeting a range of molecular pathways (Shu et al, 2021).…”

“…Trimetazidine is a metabolic modulator that is used to treat cardiomyopathies. It improves metabolic performance of cardiac fibres by targeting a range of molecular pathways (Shu et al, 2021 ). By inhibiting fatty acid oxidation, trimetazidine is able to enhance glucose metabolism (Marzilli et al, 2019 ).…”

Trimetazidine as a Modifier of Chemotherapy-Induced Endothelium Homeostasis Disturbances

“…The present study aimed to investigate the AC-mode of chemotherapy-induced endothelium integrity impairment as a one of risk factor for atherosclerosis formation. As a modifi er of chemotherapy-induced CV complications, a well-known and aff ordable piperine-compound myocardial protector TMZ was chosen considering its antioxidant, cytoprotective, antihypoxic, and antianginal properties [14]. The pharmacological action of TMZ is associated with the mitochondrial 3-ketoacyl-CoA thiolase inhibition [15].…”

Function and Mechanism of Trimetazidine in Myocardial Infarction-Induced Myocardial Energy Metabolism Disorder Through the SIRT1–AMPK Pathway

“…Trimetazidine (TMZ) is a metabolic anti-ischemic agent that can shift the energy substrate metabolism and enhance glucose metabolism ( Kallistratos et al, 2019 ). Clinically, TMZ is administered as treatment for angina pectoris and heart failure ( Shu et al, 2020 ; Amoedo et al, 2021 ). Existing evidence has demonstrated the participation of TMZ in severe adverse cardiac events, myocardial metabolic remodeling, and percutaneous coronary intervention by the activation of AMPK and PPARα ( Ferrari et al, 2020 ; Li et al, 2020 ; Zhu et al, 2020 ).…”