Trimetazidine MB treatment in patients with chronic heart failure

Aim. To assess the effects of the complex therapy, including trimetazidine MB, on the clinical course of chronic heart failure (CHF), cardiac hemodynamics, myocardial structure, function, and bio-electric activity in patients with coronary heart disease (CUD) complicated by CHF. Material and methods. In 82 patients (67 men, 15 women), mean age 62,2 7,3 years, with CHD and Functional Class (FC) II-III CHF, the effects of 16-week complex therapy including trimetazidine MB (70 mg/d; Group I) vs. trimetazidine-free therapy (Group II) on CHF FC dynamics, left ventricular (LV) remodelling, physical stress tolerance, and myocardial bio-electric activity were investigated. Results. After 16 weeks of the treatment, clinical improvement and CHF FC reduction were observed in 28 % and 26 % of the patients from Groups I and II, respectively. The percentage of the patients with FC III decreased to 27,2 % and 30,9 %, respectively, while for FC II, the respective percentages decreased to 67,5 % and 66,7 %. According to the Holter ECG monitoring results, the incidence of paired ventricular extrasystoles (VE) decreased by 57,6 % and 28,8 % in Groups I and II, respectively (p<0,05), the incidence of isolated VE - by 23,6 % (p>0,05) and 6,9 % (p>0,05), and the incidence of supraventricular extrasystoles (SVE) - by 26,4 % (p>0,05) and 10,8 % (p>0,05), respectively. The 24-hour number of ST depression episodes decreased by 55,5 % (p<0,05) and 23,3 % (p<0,05) in Groups I and II, while the total duration of these episodes was reduced, respectively, by 17,8 % (p<0,05) and 12,7 % (p<0,05). According to echocardiography results, LV ejection fraction increased by 13,7 % (p<0,05) and 10,4 % (p<0,05), respectively. In treadmill test, total load time increased by 16,8 % (p<0,05) in Group I and 8,2 % (p<0,05) in Group II. Conclusion. Trimetazidine MB, as a part of complex CHF therapy in CHD patients, significantly improved clinical symptoms and reduced CHF FC, which was also associated with improvement in cardiac structure, function, and bio-electric activity.