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.

Effectiveness of Atorvastatin Combined with Trimetazidine in the Treatment of Coronary Heart Disease in the Elderly and Their Effect on Cardiac Function

Objective:To analyze the effect of atorvastatin combined with trimetazidine in the treatment of elderly coronary artery disease and the effect on patients’cardiac function.Methods:60 cases of elderly coronary artery disease patients were divided into 2 groups by randomization method,and all of them received conventional symptomatic treatment,while atorvastatin was added to the control group and trimetazidine was combined with atorvastatin in the observation group,and the clinical indexes were compared.Results:After treatment,the angina attack,cardiac function indexes,and inflammatory factor levels of the observation group were better than those of the control group(P<0.05),and the differences in adverse reactions between the two groups were not significant(P>0.05).Conclusion:Combined treatment of coronary heart disease in the elderly with atorvastatin and trimetazidine can positively reduce angina symptoms,improve cardiac function,and reduce inflammatory reactions,and the effect is definite.

Meta-analysis of statin combined with trimetazidine on the regulation of inflammatory factors in coronary atherosclerotic heart disease and improvement of ventricular remodeling

Objective:To systematically evaluate the effects of statins combined with trimetazidine on the regulation of inflammatory factors and the improvement of ventricular remodeling in coronary atherosclerotic heart disease based on the inflammasomes/immune damage response theory.Methods:Using computer to search for EMbase,The Cochrane Library,Web of Science,MEDLINE,PubMed,WanFang Data,CNKI,China Biomedical Document Service System(CBM),VIP database(VIP),9 databases in total.The search time limit is from the inception of the databases to June 7,2021.All reference documents included in the study were manually searched.According to the Cochrane systematic review method,the information on atorvastatin combined with trimetazidine and conventional treatment(antiplatelet,control blood pressure,diuresis,coronary artery dilation and other expectant treatments)contrast the use of trimetazidine or stains combined with expectant treatment of coronary atherosclerotic heart disease patients in Chinese and English randomized controlled trials(RCT),and conduct the extraction and quality evaluation of the included literature data,using RevMan5.4 software for Meta analysis.Outcome indicators include inflammatory factors:C-reactive protein(CRP),IL-6(interleukin 6),tumor necrosis factor(TNF-α),and ventricular remodeling related outcome indicators:left ventricular end diastolic diameter(LVEDD),left Ventricular end systolic diameter(LVESD).Results:12 randomized controlled trials were included,a total of 1120 patients with coronary heart disease.Meta-analysis results:(1)inflammatory factors:the statin combined with trimetazidine group can significantly reduce the CRP,IL-6,TNF-α’s expression degree in the blood of patients with coronary heart disease compared with the control group(only statins or trimetazidine).CRP[n=770,SMD=-2.70,95%CI(-2.55,-1.40),P<-0.00001],TNF-α[n=678,SMD=-2.25,95%CI(-3.39,-1.12),P<-0.0001],IL-6[n=770,SMD=-2.10,95%CI(-3.10,-1.10),P<0.00001].(2)Ventricular remodeling:Compared with the control group(using statins or trimetazidine alone),the statin combined with trimetazidine group can significantly reduce the left ventricular end-systolic diameter of patients with coronary heart disease before treatment[n=626,SMD=-1.55,95%CI(-2.10,-0.99),P<-0.00001]and leftVentricular end diastolic diameter[n=626,SMD=-1.18,95%CI(-1.56,-0.80),P<-0.00001].Conclusion:Compared with the control group,statins combined with trimetazidine can significantly reduce the level of inflammatory factors based on the inflammasomes/immune injury response theory,and improve the ventricular remodeling in patients with coronary heart disease.

Protective Effects of Trimetazidine on Bone Marrow Mesenchymal Stem Cells Viability in an ex vivo Model of Hypoxia and in vivo Model of Locally Myocardial Ischemia

Bone marrow mesenchymal stem cells (MSCs) have shown potential for cardiac repair following myocardial injury,but this approach is limited by their poor viability after transplantation.The present study was to investigate whether trimetazidine (TMZ) could improve survival of MSCs in an ex vitro model of hypoxia,as well as survival,differentiation,and subsequent activities of transplanted MSCs in rat hearts with acute myocardial infarction (AMI).MSCs at passage 3 were examined for their viability and apoptosis under a transmission electron microscope,and by using flow cytometry following culture in serumfree medium and exposure to hypoxia (5% CO2,95% N2) for 12 h with or without TMZ.Thirty Wistar rats were divided into 3 groups (n=10 each group),including groupⅠ(AMI control),groupⅡ (MSCs transplantation alone),and group Ⅲ (TMZ+MSCs).Rat MSCs (4×107) were injected into peri-infarct myocardium (MSCs group and TMZ+MSCs group) 30 min after coronary artery ligation.The rats in TMZ+MSCs group were additionally fed on TMZ (2.08 mg?kg-1?day-1) from day 3 before AMI to day 28 after AMI.Cardiac structure and function were assessed by echocardiography at 28th day after transplantation.Blood samples were collected before the start of TMZ therapy (baseline),and 24 and 48 h after AMI,and inflammatory cytokines (CRP,TNF-α) were measured.Then the sur-vival and differentiation of transplanted cells in vivo were detected by immunofluorescent staining.The cellular apoptosis in the peri-infarct region was detected by using TUNEL assay.Furthermore,apoptosis-related proteins (Bcl-2,Bax) within the post-infarcted myocardium were detected by using Western blotting.In hypoxic culture,the TMZ-treated MSCs displayed a two-fold decrease in apoptosis under serumfree medium and hypoxia environment.In vivo,cardiac infarct size was significantly reduced,and cardiac function significantly improved in MSCs and TMZ+MSCs groups as compared with those in the AMI control group.Combined treatment of TMZ with MSCs implantation demonstrated further decreased MSCs apoptosis,further increased MSCs viability,further decreased infarct size,and further improved cardiac function as compared with MSCs alone.The baseline levels of inflammatory cyto-kines (CRP,TNF-α) had no significant difference among the groups.In contrast,all parameters at 24 h were lower in TMZ+MSCs group than those in MSCs group.Furthermore,Western blotting indicated that the expression of antiapoptotic protein Bcl-2 was upregulated,while the proapoptotic protein Bax was down-regulated in the TMZ+MSCs group,compared with that in the MSCs group.It is suggested that implantation of MSCs combined with TMZ treatment is superior to MSCs monotherapy for MSCs viability and cardiac function recovery.

Treatment of unstable angina with trimetazidine

Objective To evaluate the clinical therapeutic effects oftrimetazidine on the treatment of unstable angina （UA） as well as its effects on endothelin- 1 level and complications of patients. Methods One hundred and twenty patients with UA were randomized into the trimetazidine group （n =60） and the control group （n =60）, the trimetazidine group was subjected to treatment with 60 mg trimetazidine everyday for six months plus conventional treatment, and the clinical symptoms, changes in electrocardiogram, changes in the number of plasma circulating endothelial cells （CEC） and endothelin- 1 level of the two groups were observed after treatment for four weeks; and the incidence rates of cardiac arrhythmias, cardiac failure, hospitalization due to angina, myocardial infarction and sudden death were also observed after treatment for six months. Results 1） The total effective rate of integrative clinical therapeutic effects in the trimetazidine group and the control group after treatment for four weeks were 86.7% and 68.3%,respectively （P〈0.05）, and the excellence rates were 36.7% and 15% （P〈0.01）respectively; the total effective rates for the therapeutic effects in electrocardiogram were 66.7% and 46.7%,respectively （P〈0.05）, and the excellence rates were 30.0% and 11.7%, respectively （P〈0.01）. 2） The number of plasma CEC and endothelin-1 level of the two groups after treatment for four weeks significantly decreased （P〈0.05）, but the decreases in the trimetazidine group were even significant （P〈0.01 ）. 3） The incidence rates for cardiac arrhythmia in the trimetazidine group and the control group after treatment for six months were 10% and 20% （P〈0.05）, respectively, and the incidence rates for cardiac failure were 8.3% and 18.3%, respectively （P〈0.05）, and the incidence rates for hospitalization due to angina were 10% and 15%, and the incident rates for myocardial infarction were 3.3% and 13.3% respectively （P〈0.05）. Conclusion Trimetazidine can significantly improve the symptoms of UA and myocardial ischemia, reduce the damages to blood vessel endothelium and complications, and improve the prognosis.

Effect of Trimetazidine on Diabetic Patients with Coronary Heart Diseases: A Meta-Analysis of Randomized, Controlled Trials

Objective To explore the therapeutic effects of trimetazidine(TMZ)on diabetic patients with coronary heart diseases.Methods We conducted a comprehensive electronic search of PubMed,EMBASE,and Cochrane databases between the inception dates of databases and May 2019(last search conducted on 30 May 2019)to identify randomized controlled trials.The evaluation method recommended by Cochrane Collaboration for bias risk assessment was employed for quality assessment.Random or fixed models were used to investigate pooled mean differences in left ventricular function,serum glucose metabolism,serum lipid profile,myocardial ischemia episodes and exercise tolerance with effect size indicated by the 95%confidence interval(CI).Results Additional TMZ treatment contributed to considerable improvement of left ventricular ejection fraction(WMD=4.39,95%CI:3.83,4.95,P<0.00001),left ventricular end diastolic diameter(WMD=-3.17,95%CI:-4.90,-1.44,P=0.0003)and left ventricular end systolic diameter(WMD=-4.69,95%CI:-8.66,-0.72,P=0.02).TMZ administration also significantly decreased fasting blood glucose(SMD=-0.43,95%CI:-0.70,-0.17,P=0.001),glycosylated hemoglobin level(WMD=-0.59,95%CI:-0.95,-0.24,P=0.001),serum level of total cholesterol(WMD=-20.36,95%CI:-39.80,-0.92,P=0.04),low-density lipoprotein cholesterol(WMD=-20.12,95%CI:-32.95,-7.30,P=0.002)and incidence of myocardial ischemia episodes(SMD=-0.84,95%CI:-1.50,-0.18,P=0.01).However,there were no significant differences in serum triglyceride level,high-density lipoprotein cholesterol,exercise tolerance between the TMZ group and the control group.Conclusion TMZ treatment in diabetic patients with coronary heart disease is effective to improve cardiac function,serum glucose and lipid metabolism and clinical symptoms.

Role of Trimetazidine in Coronary Artery Bypass Graft Surgery

Trimetazidine is a drug that has been used to reduce the damage of reperfusion injury, which is a mechanism of oxidative aggression that occurs in coronary syndromes, angioplasty procedures, as well as in cardiovascular surgeries. Seeking to improve myocardial protection during procedures that involve reperfusion, attention was recently turned to research on cytoprotective drugs which act on segments of cellular metabolism, used in isolation or combined to reduce or prevent damage to the cardiac cell. The aim of this review is to objectively evaluate the effects of the drug trimetazidine (TMZ) on ischemia-reperfusion injury in coronary artery bypass graft surgery by reviewing all known studies from recent years.

Effect of Qishen Yiqi dripping pills combined with trimetazidine on the treatment of chronic heart failure: A meta-analysis

Objective:To systematically evaluate the safety and effectiveness of Qishen Yiqi dripping pills combined with trimetazidine in the treatment of chronic heart failure.Methods:A total of four English and Chinese electronic databases were searched:CNKI,VIP,CBM,PUBMED.Cochrane bias risk tools were used to assess the methodological quality of qualified studies.Meta-analysis was conducted by Review Manager 5.3.A total of 9 articles were included,with a total sample size of 855 cases,443 cases in the observation group and 412 cases in the treatment group.Results:Qishen Yiqi dripping pills combined with trimetazidine in the treatment of chronic heart failure has a total effective rate(RR=1.22,95%CI[1.15-1.30];p<0.00001),LVEF(MD=6.03,95%CI[5.39,6.67],P<0.00001),BNP(MD=-101.87,95%CI[-109.90,-93.83],P<0.00001),E/A(MD=-4.32,95%CI[-5.70,-2.93],P<0.00001),SYP(MD=-10.32,95%CI[-13.32,-7.32],P<0.00001),LVESD(MD=-5.50,95%CI[-6.03,-4.96],P<0.00001),6-MWT(MD=110.13,95%CI[96.89,123.36],P<0.00001)Adverse reactions occurred less frequently and did not affect treatment.Conclusion:This study shows that QYDP combined with TMZ can improve various indicators of CHF patients.However,due to the small sample size and the generally low quality of research,a more rigorous and reasonably designed RCT is needed to confirm these findings.

Effect of bisoprolol in combined with trimetazidine on the cardiac function rehabilitation in patients with chronic heart failure

Objective:To explore the effect of bisoprolol in combined with trimetazidine on the cardiac function rehabilitation in patients with chronic heart failure (CHF).Methods: A total of 84 patients with CHF who were admitted in our hospital from November, 2015 to October, 2016 were included in the study and randomized into the observation group and the control group. The patients in the two groups were given oxygen inhalation, lipid regulation, diuresis, ARB, and other routine treatments. Digitalis preparations were given for those who had poor cardiac function, and bisoprolol were orally administrated in the same time. On the above basis, the patients in the observation group were given trimetazidine dihydrochloride tablets, continuously for 3 months. The morning fasting peripheral venous blood before and after treatment in the two groups was collected. CRP, IL-6, TNF-α, BNP, NE, AngⅡ, ANP, ALD, and ET were detected. The cardiac color Doppler ultrasound diagnostic apparatus was used to detect LVPWT, PWS, PWD, IVSS, and IVMI.Results: CRP, IL-6, TNF-α, and BNP levels after treatment in the observation group were significantly lower than those in the control group. NE, AngⅡ, ANP, ALD, and ET levels after treatment in the observation group were significantly lower than those in the control group. LVPWT, PWS, PWD, IVSS, and IVMI levels after treatment in the observation group were significantly lower than those in the control group.Conclusions: Bisoprolol in combined with trimetazidine can significantly reduce the inflammatory reaction in patients with CHF, and effectively regulate the neuroendocrine stability in order to reverse or reduce VR and improve the left ventricular function.

Effect of Trimetazidine Dihydrochloride Tablets adjuvant therapy on inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function in patients with coronary heart disease complicated with heart failure

Objective: To investigate the effects of Trimetazidine Dihydrochloride Tablets on inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function in patients with coronary heart disease complicated with heart failure. Methods: A total of 98 patients with coronary heart disease and heart failure who met the criteria of the study were selected as the subjects, based on the random data table they were divided into the control group (n=49) and observation group (n=49), the patients in the control group were treated with Metoprolol Tartrate Sustained-release Tablets treatment, and the patients in the observation group were treated with Metoprolol Tartrate Sustained-release Tablets combined with Trimetazidine Dihydrochloride Tablets, the levels of inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function indexes were compared between the two groups before and after treatment. Results: The difference of the CRP, TNF-α, MDA, SOD, NO, ET-1, LVEF, LVEDD and LVESD levels in the two groups before treatment were not statistically significant;Compared with the levels of the two groups before treatment, the two groups of CRP, TNF-α, MDA, ET-1, LVEDD and LVESD levels after treatment were significantly decreased, and the level of the observation group after treatment was significantly lower than those levels in the control group, the difference was statistically significant;The levels of SOD, NO and LVEF of the two groups after treatment were significantly higher than those in the same group before treatment, and the observation group levels [(88.09±7.51) U/ml, (72.58±14.64) mol/L, (48.34±5.09)% ] were significantly higher than the control group [(79.44±7.27) U/ml, (61.89±11.06) mol/L, (44.19±4.58)%], the difference was statistically significant. Conclusion: Trimetazidine Dihydrochloride Tablets in the treatment of coronary heart disease with heart failure can effectively inhibit the release of inflammatory factors, improve oxidative stress state, vascular endothelial function and myocardial function, has an important clinical value.

Effect of trimetazidine combined with bisoprolol on the cardiac function, ventricular remodeling and neuroendocrine factors in patients with chronic heart failure

Objective:To study the effect of trimetazidine combined with bisoprolol on the cardiac function, ventricular remodeling and neuroendocrine factors in patients with chronic heart failure.Methods: A total of 52 patients with chronic heart failure who were treated in our hospital between January 2012 and November 2015 were collected and divided into the control group (n=26) who received bisoprolol therapy and the observation group (n=26) who received trimetazidine combined with bisoprolol therapy according to the double-blind randomized control method, and both groups were treated for 3 months. Before treatment and after 3 months of treatment, cardiac color Doppler diasonograph was used to determine the levels of cardiac function parameters and ventricular remodeling parameters, and RIA method was used to determine the levels if peripheral blood neuroendocrine factors.Results: Before treatment, the differences in cardiac function, ventricular remodeling and neuroendocrine factor levels were not statistically significant between two groups of patients. After 3 months of treatment, cardiac function parameters LVEDd and LVESD levels of observation group were lower than those of control group while LVEF level was higher than that of control group, and ventricular remodeling parameters LVPWT, IVSS, PWD, PWS and LVMI levels were lower than those of control group;peripheral blood neuroendocrine factors NE, ALD, AngⅡ, ANP and ET contents of observation group were lower than those of control group.Conclusion:Trimetazidine combined with bisoprolol can optimize the cardiac function, suppress the ventricular remodeling process and regulate the neuroendocrine factor secretion in patients with chronic heart failure, and it contributes to the patients' overall optimization.

Effect of trimetazidine in combined with Huangqi injection in resisting inflammation and oxygen radicals in patients with acute viral myocarditis

Objective: To explore the effect of trimetazidine in combined with Huangqi injection in resisting inflammation and oxygen radicals in patients with acute viral myocarditis (AVMC). Methods: A total of 70 patients with AVMC who were admitted in our hosptial from October, 2015 to September, 2017 were included in the study and randomized into the observation group and the control group with 35 cases in each group. The patients in the control group were orally administrated with trimetazidine. On the above basis, the patients in the observation group were given intravenous injection of Huangqi injection. The patients in the two groups were treated for 4 weeks. The morning fasting peripheral venous blood before and after treatment was collected. The serum TFN-α, IL-6, CRP, MDA, SOD, NO, cTnI, CK, CK-MB, and LDH. Results: CRP, TFN-α, and IL-6 after treatment in the observation group were significantly lower than those in the control group. MDA and NO after treatment in the observation group were significantly lower than those in the control group, while SOD was significantly higher than that in the control group. cTnI, CK, CK-MB, and LDH after treatment in the observation group were significantly lower than those in the control group. Conclusions:Trimetazidine in combined with Huangqi injection in the treatment of AVMC can effectively play the anti-inflammation and anti-OFR effects in order to reduce the myocardial damage, thus, the therapeutic effect is enhanced.

Effects of preoperative trimetazidine application on myocardial injury indexes and oxidative stress indexes in patients with AMI after PCI

Objective:To investigate the effects of preoperative trimetazidine application on myocardial injury indexes and oxidative stress indexes in patients with AMI after PCI.Methods:A total of 70 patients with AMI who received emergency PCI in this hospital between January 2015 and January 2018 were divided into the control group (n=35) (received no trimetazidine) and the trimetazidine group (n=35) (received trimetazidine) according to the application of trimetazidine before PCI or not. The differences in the contents of myocardial injury markers, inflammatory factors and oxidative stress indexes were compared between the two groups immediately after admission and after surgery.Results: Immediately after admission, the differences in serum levels of myocardial injury markers, inflammatory factors and oxidative stress indexes were not statistically significant between the two groups of patients. Twenty-four hours after surgery, serum myocardial injury markers CK-MB, cTnⅠ, Myo and h-FABP levels of trimetazidine group were lower than those of control group;inflammatory factors hs-CRP, Neopterin and IL-1β levels were lower than those of control group;oxidative stress index SOD level was higher than that of control group whereas MDA and LHP levels were was lower than those of control group.Conclusion: Trimetazidine treatment before PCI can effectively optimize the postoperative cardiac function and reduce the oxidative stress response in patients with AMI.

Clinical Efficacy of Metoprolol Succinic Acid Sustained Release Tablets Combined with Trimetazidine in the Treatment of Gastrointestinal Tumors with Angina Pectoris

Objective:To investigate the clinical efficacy of metoprolol succinate sustained-release tablets combined with trimetazidine in the treatment of gastrointestinal tumors with angina pectoris.Methods:We enrolled the 58 patients with digestive tract tumor merger angina in November 2017-October 2019 and analysis the hospital clinical data by retrospective method.We included patients with routine treatment in control group(n=31 cases)and the subjects treated with increased dose of succinic acid metoprololzyban joint with trimetazidineinobservation group(n=27 cases)according to the different treatment group.Results:The effective rate of angina pectoris treatment in the observation group was higher than that in the control group.Furthermore,the incidence of adverse reactions was lower than that in the control group and the difference was statistically significant(P<0.05).Conclusion:Metoprolol succinic acid sustained release tablets combined with trimetazidine in the treatment of gastrointestinal tumors with angina pectoris can improve the efficacy of angina pectoris.The drug use is safe and worthy of clinical use.

Experimental study that trimetazidine inhibits Fas/FasL pathway to relieve the myocardial ischemia reperfusion injury in rats

Objective: To study the protective effect and molecular mechanism of trimetazidine on myocardial ischemia reperfusion injury in rats. Methods: Adult male SD rats were chosen as the experimental animals and randomly divided into control group, ischemia reperfusion group and trimetazidine group, and myocardial ischemia reperfusion models were established and then given intraperitoneal injection of trimetazidine hydrochloride for intervention. The expression levels of Fas/FasL pathway molecules as well as the contents of inflammatory and oxidative stress molecules in the myocardium, and the contents of myocardial enzymes in the blood circulation were measured 120 min after reperfusion. Results: Fas, FasL, Caspase-8 and Caspase-3 mRNA expression as well as NK-κB, TNF-α, ICAM-1, IL-17, IL-23, NOX2, NOX4, AOPP and MDA contents in myocardium, and LDH, CK and CK-MB contents in blood circulation of ischemia reperfusion group were significantly higher than those of control group, and Fas, FasL, Caspase-8 and Caspase-3 mRNA expression as well as NK-κB, TNF-α, ICAM-1, IL-17, IL-23, NOX2, NOX4, AOPP and MDA contents in myocardium, and LDH, CK and CK-MB contents in blood circulation of trimetazidine group were significantly lower than those of ischemia reperfusion group;LDH, CK and CK-MB contents in blood circulation as well as NK-κB, TNF-α, ICAM-1, IL-17, IL-23, NOX2, NOX4, AOPP and MDA contents in myocardium of trimetazidine group were positively correlated with Fas and FasL mRNA expression. Conclusion: Trimetazidine can inhibit Fas/FasL pathway to reduce the myocardial damage caused by inflammatory response and oxidative stress response during myocardial ischemia reperfusion in rats.

Analysis about the effect of trimetazidine combined with atorvastation calcium on myocardin i level, cardiac and renal function in patients with ischemic cardiomyopathy

Objective:Analyze the effect of trimetazidine combined with atorvastation calcium on Myocardin I level, cardiac and renal function in patients with Ischemic cardiomyopathy. Methods:A total of 82 patients who were admitted in our hospital from January 2013 to May 2016 were selected and divided them randomly into the research group and the control group. All subjects were treated with conventional therapy after admission. On this basis, the control group was given atorvastation calcium, meanwhile the research group was given trimetazidine combined with atorvastation calcium. Then analyzed the cTnI level, evaluated their cardiac and renal function (cardiac function indexes: LVEF, LVESD, LVEDD, renal function indexes: Scr, BUN and mALB) after three months treatment.Results: After treatment, the level of cTnI, LVESD and LVEDD in this two groups were decreased dramatically, the level of cTnI, LVESD and LVEDD in the research group were (0.51±0.24) ng/mL, (38.35±3.94) mm and (51.43±4.56) mm respectively, compared with the control group, these levels were significantly decreased;the level of LVEF was (51.10±4.07)% in research group, increased more obviously than the control group, and the difference was statistical significant. The Scr, BUN and mALB in two groups were decreased after treatment, the research group was significantly reduced, in addition, these levels in research group were (80.14±10.21) μmol/L, (5.89±1.06) mmol/L and (51.35±20.94) mg/24 h respectively, lower than the control group.Conclusion: The therapy of trimetazidine combined with atorvastation calcium in patients with Ischemic cardiomyopathy, was worthy of clinical application, seeing that can ameliorate effectively myocardial injury , the cardiac and renal function.

Effect of trimetazidine on exercise capacity of the patients with old myocardial infarction during recovery period

Objective To investigate the effect of trimeta zidine(TMZ )on ex ercise capacity of the patients with old myocardial infarction during recovery p eriod.Method28patients were administered hitra les,blockers and antipemic ag ents.30patients were administered TMZ 20mg tid.After 12weeks ,we compar ed ni trite expenditures,time to onset of angina after exercise,the time to 1 mm ST segment depression after exercise and rate pressure product.Result Nitrit e expenditures per week were s ignificantly reduced than before tr eatment and c omprehensive group(P <0.001).The rate pressure product of TMZ did n’ t change significantly(P >0.05).Conclusion TMZ may increase exercise capac ity of patients with old myocardial infa rction.

Protective effect of trimetazidine on myocardial ischemia reperfusion injury in ovariectomized rats and the effect on Fas and FasL gene expression

ABSTRACT Objective:To study the protective effect of trimetazidine on myocardial ischemia reperfusion injury in ovariectomized rats and the effect on Fas and FasL gene expression.Methods:Female Wistar rats were selected and divided into ovariectomized model group (OVX group), ovariectomized + ischemia reperfusion model group (OVX+I/R group) and ovariectomized + ischemia reperfusion + trimetazidine intervention group (OVX+I/R+TMZ group) (n=8), and the content of serum myocardial enzymes and structural proteins, hemodynamic indexes and the expression levels of apoptotic molecules and autophagy genes in myocardial tissue were determined.Results:Serum creatine kinase (CK) and isoenzyme (CK-MB), lactate dehydrogenase (LDH),α-hydroxybutyrate dehydrogenase (α-HBDH) content, troponin I (cTnI) and troponin T (cTnT) content as well as LVEDP level of OVX+I/R group were significantly higher than those of OVX group (P<0.05) while LVSP,+dp/dtmax and-dp/dtmax levels were significantly lower than those of OVX group (P<0.05), and serum CK, CK-MB, LDH,α-HBDH, cTnI and cTnT content as well as LVEDP level of OVX+I/R+TMZ group were significantly lower than those of OVX+I/R group (P<0.05) while LVSP,+dp/dtmax and-dp/dtmax levels were significantly higher than those of OVX+I/R group (P<0.05). Fas, FasL, Beclin-1 and P62 expression levels as well as LC3II/LC3I ratio in myocardial tissue of OVX+I/R group were significantly higher than those of OVX group (P<0.05), and Fas, FasL, Beclin-1 and P62 expression levels as well as LC3II/LC3I ratio in myocardial tissue of OVX+I/R+TMZ group were significantly lower than those of OVX+I/R group (P<0.05). Conclusions:Trimetazidine has protective effect on myocardial ischemia reperfusion injury in ovariectomized rats, and inhibiting cell apoptosis and cell autophagy mediated by Fas/FasL is the molecular mechanism for trimetazidine to play the protective role.

Effect of atorvastatin combined with trimetazidine on oxidative stress, hemorheology, and NT-proBNP, hs-CRP in patients with coronary heart disease

Objective:To explore the effect of Atorvastatin Combined with trimetazidine on oxidative stress, hemorheology and NT-proBNP and hs-CRP in patients with coronary heart disease. Method:A total of 84 patients with coronary heart disease were admitted in our hospital from February 2015 to February 2017 were randomly divided into the observation group and the control group, each group with 42 cases. The two groups received routine treatment of coronary heart disease, while the control group was treated with atorvastatin and the observation group was treated with Atorvastatin Combined with trimetazidine. Both groups were treated continuously for one month. The levels of oxidative stress indexes (SOD), malondialdehyde, (MDA), blood rheology indexes (ESR, whole blood hyposhear viscosity, whole blood hypershear viscosity, plasma viscosity, Fibrinogen (Fib) and serum N-terminal pro-brain natriuretic peptide (NT-proBNP), hypersensitive C reaction protein (hs-CRP) index in two groups were compared analytically.Results: Before treatment, there was no significant difference between the observation group and the control group in terms of oxidative stress, blood rheology and NT-proBNP and hs-CRP index. Compared with before treatment, the level of SOD in observation group and the control group was significantly increased and MDA significantly decreased. While the level of SOD in observation group was significantly higher than the control group, and MDA level was significantly lower than the control group after treatment. Compared with before treatment, the levels of hemorheology indexes included ESR, whole blood viscosity, plasma viscosity and Fib in observation group and control group were significantly decreased. After treatment, the levels of ESR, whole blood viscosity, plasma viscosity and Fib in the observation group were significantly lower than the control group. Compared with before treatment, the levels of NT-proBNP and hs-CRP in the observation group and control group were significantly decreased. After treatment, the levels of NT-proBNP and hs-CRP in the observation group were significantly lower than the control group,there was significantly statistical difference.Conclusion:Atorvastatin combined with trimetazidine can significantly reduce oxidative stress, restore normal blood rheology, and improve levels of NT-proBNP and hs-CRP in patients with coronary heart disease. This treatment is worthy of clinical promotion.