Russian Heart Failure Journal 2004year Effect of the 3-KAT inhibitor trimetazidine on parameters of left ventricular myocardium global and regional systolic and diastolic function in patients with combined postinfarction ischemic syndrome
Effect of the 3-KAT inhibitor trimetazidine on parameters of left ventricular myocardium global and regional systolic and diastolic function in patients with combined postinfarction ischemic syndrome
Kastanyan A.A., Nelasov N.Yu., Eroshenko O.L., Kazaryan N.B., Drobotya N.V.
Urgency. Pathophysiological state of the myocardium after myocardial infarction (MI) is uneven and the contribution of segments with different ischemic states including hybernation into the pathogenesis of left ventricular (LV) myocardium diastolic dysfunction (DD) remains understudied. Effect of the myocardial cytoprotector trimetazidine (T) on myocardial systolic function is known while its effect on the diastolic function is obscure. Aim: Evaluating the effect of the 3-KAT inhibitor trimetazidine on myocardial global and regional SF and diastolic function (DF) in patients with combined postinfarction ischemic syndrome. Materials and methods. Thirty-two patients with history of IM and presenting with global LV DD as evaluated by Doppler echocardiography (echoCG) received trimetasidine 60 mg daily for 3 months. Dobutamine stress echoCG and tissue Doppler echoCG were performed in all patients before and after the treatment. Results. Segments with scar-changed and hybernating myocardium, which significantly contribute to SF and DF disorders of LV myocardium displayed the most severe regional DD at rest. Improvement of global DF after the T treatment was due to a decrease in the total amount of ischemic segments (from 80 to 67%). Among them, segments with hybernating myocardium, the amount of which was also decreased (from 61 to 46%), were most of all important for recovery of DF. Hybernating myocardium was the most sensitive to metabolic therapy. The presence of hybernating myocardium after survived MI provides recovery of myocardial function under the T treatment and serves as a beneficial prognostic sign. Results of our study confirm that recovery of hybernating myocardial function can occur not only after revascularization but also under the influence of drug therapy, in particular trimetazidine.