Abstract:
Background: The heart affection at is associated with energy deficiency due to oxygen dearth which alters a lot of cardiac functions, most important
of them being ion pump working, myocardial contractility and relaxation. Attempting of energy synthesis improvement is an important tenet of cardiac
metabolic therapy leading to clinical and functional benefits. Nowadays trimetazidine (TMZ) is admittedly recognized as a reliable remedy providing
energetic gain, thereby, inhibition of mitochondrial long chain 3-ketoacyl Co-enzyme A thiolase involved in free fatty acids oxidation, shifting energy
synthesis toward glucose oxidation which needs lesser oxygen consumption by up to 25%.
Material and methods: This article is aimed at the revealing of TMZ effects on patients with stable angina pectoris, ischemia-reperfusion syndrome
and chronic heart failure inclusively based on evidences of A level (data of randomized trials and meta-analyses). Added to standard anti-ischemic
therapy, TMZ (60 or 70 mg/day) has led to a significant increase of time and volume of physical effort, period of ST decline and angina appearing, as well
as reducing of angina episodes per day and anti-anginal remedies’ dosage.
Results: The chronic heart failure therapy supplementation by TMZ induced a more conspicuous decrease of NYHA class, preserved ventricular
end-systolic and end-diastolic volumes, Tei index value, B-type natriuretic peptide blood level, while ejection fraction raised higher even in patients
with diabetes mellitus.
Conclusions: It is important to emphasize the TMZ capacity to blunt the oxidative stress activity, nonspecific inflammation response and cell apoptosis
during myocardial ischemia-reperfusion, to improve the function of affected and hibernating myocardium, to prevent or attenuate the cardiovascular
sequels after coronary revascularization by artery bypass surgery or angioplasty with stent implantation.
Description:
Department of Interventional Cardiology, Institute of Cardiology, Chisinau, the Republic of Moldova
