Journal Article

Trimetazidine improves endothelial dysfunction in chronic heart failure: an antioxidant effect

Romualdo Belardinelli, Maridia Solenghi, Loretta Volpe and Augusto Purcaro

in European Heart Journal

Published on behalf of European Society of Cardiology

Volume 28, issue 9, pages 1102-1108
Published in print May 2007 | ISSN: 0195-668x
Published online April 2007 | e-ISSN: 1522-9645 | DOI:
Trimetazidine improves endothelial dysfunction in chronic heart failure: an antioxidant effect

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To determine whether trimetazidine (TMZ) improves the endothelium-dependent relaxation (EDR) in chronic heart failure (CHF) and whether this effect is associated with its antioxidant properties.

Methods and results

We studied 51 patients (mean age 51.4 ± 6 years) with CHF secondary to ischaemic cardiomyopathy (ejection fraction 32.5 ± 4.5%). Plasma malondialdehyde (MDA) and lipid hydroperoxides (LOOHs) were measured from an antecubital vein on study entry and after a 4 week treatment with oral TMZ (20 mg tid) (group T, n = 23) or placebo (group C, n = 22) given randomly. Endothelium-dependent vasodilation of the radial artery (RA) was determined by intra-arterial infusion of acetylcholine (7.5, 15 and 30 µg/min). Patients receiving TMZ had an increased radial artery diameter (RAD) in response to each dose of acetylcholine infusion and a greater peak oxygen uptake (P < 0.01 vs. placebo). Plasma MDA and LOOHs levels were reduced at 4 weeks only in patients receiving TMZ (P < 0.001 for both vs. placebo). The improvement in ED-vasodilation was correlated with changes in peak VO2 (r = 0.68; P = 0.0001), MDA (r = −0.61; P = 0.0002) and LOOHs (r = −0.59; P = 0.005).


TMZ improves the ED-relaxation in patients with ischaemic cardiomyopathy. The antioxidant properties of TMZ may play a role.

Keywords: Trimetazidine; Chronic heart failure; Endothelial dysfunction; Oxidative stress

Journal Article.  4111 words.  Illustrated.

Subjects: Cardiovascular Medicine

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