[Effect of acetyl-CoA C-acyltransferase inhibitor trimetazidine on parameters of global and local systolic and diastolic functions of left ventricular myocardium in patients with combined postinfarction ischemic syndrome]

Rostov-Don State Medical University, Russia.

AIM: To assess effect of trimetazidine on global and regional systolic and diastolic left ventricular function in patients with combined postinfarction ischemic syndrome. MATERIAL: Patients (n=32) with healed myocardial infarction and signs of global systolic (ejection fraction 38,5+/-2,7%) and diastolic (EIA=0,88+/-0,03) left ventricular dysfunction confirmed by Doppler echocardiography. METHODS: Regional systolic and diastolic function was assessed by dobutamine stress echocardiography with Doppler tissue imaging before and after 3 months during which the patients received 60 mg/day of trimetazidine. RESULTS: The segments with hibernating myocardium were found in every patient. These segments along with segments with scars displayed greatest degree of local systolic and diastolic dysfunction and because of their prevalence made significant contribution to the setting of global diastolic dysfunction. Improvement of global diastolic function at rest after trimetazidine was associated with decrease of total number of ischemic segments (from 80 to 67%) especially of those with hibernation (from 61 to 46%). CONCLUSION: The hibernating myocardium was most sensitive to metabolic intervention and its presence after myocardial infarction predicted improvement after drug treatment of not only systolic but also diastolic left ventricle dysfunction. Restoration of function of hibernating myocardium turned out to be possible not only after myocardial revascularization but also after medical therapy.

PMID: 14593366 [PubMed - indexed for MEDLINE]