Effect of Trimetazidine on Left Ventricular Function in Heart Failure Secondary to Ischemic Heart Disease

Abstract

Background: Ischemic heart disease is the leading cause of heart failure. This study was conducted to see the effect of Trimetazidine on left ventricular function in heart failure secondary to ischemic heart disease.

Material & Methods: This study was conducted at Pharmacology Department, Gomal Medical College, D.I.Khan from 1st February 2007 to 1st February 2009. Sixty-three patients with heart failure secondary to ischemic heart disease were randomized into two groups; 31 in Trimetazidine group, and 32 in conventional therapy group. All patients underwent assessment for New York Heart Association functional class. Echocardiography was performed to measure the Left ventricular function at start and at 3 months. The primary outcome was improvement in LV function. While the secondary end point was improvement in NYHA functional class.

Results: Out of 63 patients, 46(73.02%) were males and 17(26.98%) females. The mean age in Trimetazidine group was 62.2±12.9 and conventional group 64.4±6.6 years. Treatment with Trimetazidine resulted in significant reduction in left ventricular end diastolic dimensions from 71.7±4.1mm to 68.1±6.8mm as compared to conventional group with an increase from 73.3±3.6mm to 74.8±6.1mm, p<0.001. Left ventricular end systolic dimensions reduced significantly in Trimetazidine group from 58.97±5.8mm to 54.3±7.89mm as compared to conventional group from 61±5.8mm to 62.3±8.9mm, p<0.001. There was significant improvement in ejection fraction in Trimetazidine group from 32.4±7.2% to 36.7±9.1% as compared to conventional group from 30.7±9.2% to 30.9±10.5%, p=0.022. NYHA functional class reduced significantly in Trimetazidine group from 2.74±0.44 to 2±0.52 and in conventional group from 2.66±0.48 to 2.81±0.54, p<0.001.

Conclusion: Trimetazidine improves left ventricular function with resultant improvement in NYHA functional class in patients with heart failure secondary to ischemic heart disease.