Cardioprotective effects of trimetazidine on patients with dilated cardiomyopathy and left bundle branch block  

作　　者：张汉 梁远红 林纯莹 费洪文 刘烈 陈东骊 陈泗林 

机构地区：[1]Guangdong Dianbai people’s Hospital, Department of Internal Medicine [2]Guangdong General Hospital, Guangdong Academy of Medical Sciences, Department of Cardiology, Guangdong Provincial Cardiovascular Institute

出　　处：《South China Journal of Cardiology》2014年第2期130-135,共6页岭南心血管病杂志（英文版）

基　　金：supported by Science and Technology Key Foundation of Guangdong Province(No.2010B031600166);the Science and Technology Foundation of Guangdong Province(No.2011B061300072);the Natural Science Foundation of Guangdong Province(No.7001020)

摘　　要：Background The effects of trimetazidine on patients with dilated cardiomyopathy（DCM） and left bundle branch block（LBBB） are not clear. Methods Sixty consecutive patients with DCM, LBBB and heart dysfunction（35% ≤ LVEF ≤ 45%） were randomly allocated to heart failure therapy plus trimetazidine group（20 mg three times a day; 30 patients） or heart failure therapy alone group（30 patients）. During follow-up of 6months, QRS morphology, plasma NT-proBNP, 6-minute walk test（6MWT） and echocardiographic indexes were measured. Results At the 6th month, a significant functional improvement was noted in patients receiving trimetazidine added to heart failure treatment. In patients from the trimetazidine group, an increase of left ventricular ejection fraction（LVEF） was noted（from 38 ± 5.5% to 47 ± 7.1%, P = 0.020）. The increase of LVEF in the trimetazidine group was associated with a more significant reduction of the left ventricular endsystolic diameter（LVESD） compared with the control group at 6-month follow-up. The NT-pro BNP levels decreased significantly in the trimetazidine group（3.11 ± 0.47 at baseline and 2.77 ± 0.45 at 6-month followup, P 〈 0.01） and the 6MWT increased significantly in the trimetazidine group（325 ± 44 m at baseline and419 ± 56 m at 6-month follow-up, P 〈 0.01）. The differences in NT-pro BNP levels（2.77 ± 0.45 vs 2.96 ±0.46, P = 0.036） and 6MWT（419 ± 56 m vs 366 ± 54 m, P = 0.032） between the two groups were significant at 6-month follow-up. Conclusions Trimetazidine can improve LV function caused by DCM and LBBB. The positive effects of trimetazidine on LV function are especially evident in patients with optimization of drug therapy for heart failure, which strongly suggests an additive effect of these therapy modalities.Background The effects of trimetazidine on patients with dilated cardiomyopathy（DCM） and left bundle branch block（LBBB） are not clear. Methods Sixty consecutive patients with DCM, LBBB and heart dysfunction（35% ≤ LVEF ≤ 45%） were randomly allocated to heart failure therapy plus trimetazidine group（20 mg three times a day; 30 patients） or heart failure therapy alone group（30 patients）. During follow-up of 6months, QRS morphology, plasma NT-proBNP, 6-minute walk test（6MWT） and echocardiographic indexes were measured. Results At the 6th month, a significant functional improvement was noted in patients receiving trimetazidine added to heart failure treatment. In patients from the trimetazidine group, an increase of left ventricular ejection fraction（LVEF） was noted（from 38 ± 5.5% to 47 ± 7.1%, P = 0.020）. The increase of LVEF in the trimetazidine group was associated with a more significant reduction of the left ventricular endsystolic diameter（LVESD） compared with the control group at 6-month follow-up. The NT-pro BNP levels decreased significantly in the trimetazidine group（3.11 ± 0.47 at baseline and 2.77 ± 0.45 at 6-month followup, P 〈 0.01） and the 6MWT increased significantly in the trimetazidine group（325 ± 44 m at baseline and419 ± 56 m at 6-month follow-up, P 〈 0.01）. The differences in NT-pro BNP levels（2.77 ± 0.45 vs 2.96 ±0.46, P = 0.036） and 6MWT（419 ± 56 m vs 366 ± 54 m, P = 0.032） between the two groups were significant at 6-month follow-up. Conclusions Trimetazidine can improve LV function caused by DCM and LBBB. The positive effects of trimetazidine on LV function are especially evident in patients with optimization of drug therapy for heart failure, which strongly suggests an additive effect of these therapy modalities.

关 键 词：TRIMETAZIDINE left bundle branch block dilated cardiomyopathy heart function 

分 类 号：R542.2[医药卫生—心血管疾病]