Effect of Trimetazidine on Functional Capacity in Patient with Ischaemic Cardiomyopathy (TOFCAPI)

Objective: This study aimed to evaluate the efficacy of trimetazidine on exercise capacity via a six-minute walk test in patients with ischaemic cardiomyopathy and also evaluate the effect of trimetazidine on left ventricular function via echocardiography in the same population. Methods: This prospective observational study, conducted at the National Institute of Cardiovascular Diseases in Dhaka, Bangladesh, enrolled 200 patients with ischaemic cardiomyopathy and a depressed left ventricular ejection fraction (LVEF Results: In this study (n = 200) of ischaemic cardiomyopathy patients, the mean age was 58 years, with 76% of the patients being male. All study subjects received GDMT (Guideline-Directed Medical Therapy) for angina and heart failure. Those who received the modified released form of trimetazidine developed lesions during the 1st and 2nd follow-ups, during which the LVEF, LVIDd, and six-minute walk distance significantly improved (p Conclusion: The findings of the present study demonstrated that the addition of modified-release trimetazidine to GDMT can improve exercise capacity and left ventricular function in patients with ischaemic cardiomyopathy.

Benefits of Radiotherapy with Indigenous Tools Aiding Deep Inspiration Breath Holding Technique Compared to Free Breathing Technique among Breast Cancer Patients in Bangladesh

Background: Post-operative breast radiotherapy is used to reduce recurrence. The aim of this study was to investigate the outcomes of Deep Inspiration Breath-Hold (DIBH) technique with indigenous breath holding indicator scale in 3DCRT for breast cancer radiotherapy over Free Breathing (FB) technique. Methods: An observational study conducted at the Department of Radiation Oncology at National Institute of Cancer Research and Hospital, Dhaka and Square Hospital Limited, Dhaka, Bangladesh from June 2015 to May 2016. A total of 60 confirmed breast cancer patients who underwent adjuvant radiotherapy were included. An indigenous reproducible plastic tool (Perspex) was used as breath holding indicator scale with DIBH technique in 3DCRT. Paired sample t-test was used to compare with FB technique. Results: The mean age of patients was 47.32 (SD ± 8.33) years. In FB technique, Mean Heart Dose (MHD) was 413.27 cGy while in DIBH technique, it was 254.91 cGy (P < 0.001). The mean heart V20 and V30 were 5.5%, 4.37% in FB and 3.13%, 2.36% in DIBH respectively. In FB technique LADMD, LAD 0.2 cm3, ILMD and ILV20 were 1698.17 cGy, 2852.53 cGy, 1155.31 cGy and 28.62% while in DIBH technique, it was reduced to 1164.01 cGy, 2132.24 cGy, 1007.98 cGy and 23.39% respectively. Similarly, the lung-CLMD and breast-CLMD were reduced from 38.37 cGy and 55.18 cGy to 24.64 cGy and 33.82 cGy respectively (P < 0.001). The mean difference for breast-CLMD was 21.36 cGy. Conclusion: The use of indigenous breath holding indicator scale with DIBH had better outcomes on breast cancer radiotherapy.