1.
Antianginal effects of trimetazidine and left ventricular function improvement in patients with stable angina pectoris.
Shlyakhto, EV, Almazov, VV, Nifontov, EM, Vakhrameyeva, IV, Rudomanov, OG, Zakharov, DV, Kazarin, VV, Vakhrameyeva, NV
American journal of cardiovascular drugs : drugs, devices, and other interventions. 2002;(2):119-24
Abstract
OBJECTIVE To evaluate the effects of add-on treatment with trimetazidine, single dose and long-term, on clinical and objective parameters of ischemia in patients with stable angina pectoris receiving standard antianginal therapy. DESIGN One-month single-blind, placebo-controlled study. PATIENTS 40 patients with stable angina pectoris. INTERVENTIONS Patients received 1-month treatment with either trimetazidine 20 mg (n = 20) or placebo (n = 20) 3 times daily in addition to standard antianginal therapy. MAIN OUTCOME MEASURES All patients underwent bicycle stress tests at baseline and at 1 month to assess exercise tolerance. Patients receiving trimetazidine also underwent a stress test 2 hours after administration of a 60 mg single dose. Influence of trimetazidine on stress-induced left ventricular function was assessed in 11 patients, with dobutamine stress echocardiography performed at baseline and at 1 month. Clinical efficacy was evaluated in terms of mean weekly number of anginal episodes and weekly nitroglycerin (glyceryl trinitrate) tablet consumption during the study. RESULTS Trimetazidine significantly improved most stress test parameters, after a single dose and after 1 month of treatment; the rate-pressure product remained unchanged. Dobutamine tests showed significant (p < 0.05) increases from baseline values in time to onset of anginal pain and threshold dobutamine dose (13.5 +/- 0.7 versus 10.2 +/- 0.8 min, and 43.6 +/- 2.8 versus 35.4 +/- 3.4 microg/kg/min, respectively). The severity of anginal pain and mean weekly number of anginal episodes was reduced significantly (p < 0.05) from baseline values after 1 months' treatment with trimetazidine (1.3 +/- 0.6 versus 2.3 +/- 0.3, and 6.6 +/- 1.4 versus 10.1 +/- 1.3, respectively). After 1 month, weekly consumption of nitroglycerin tablets was decreased by 3.1 from baseline values in the trimetazidine group but increased by 0.3 in the placebo-treated group. No patient withdrew due to treatment-related adverse effects. CONCLUSION This study confirms the antianginal and anti-ischemic efficacy of single dose and long-term treatment with trimetazidine. Treatment with trimetazidine was well tolerated.
2.
Low calcium dialysate increases cardiac relaxation in CAPD patients.
Tuncer, M, Ermiş, C, Süleymanlar, G, Yakupoglu, G, Ersoy, FF
Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. 2002;(6):714-8
Abstract
OBJECTIVE To establish whether changes in serum calcium affect left ventricular (LV) function in continuous ambulatory peritoneal dialysis (CAPD) patients. METHODS This study was conducted on 28 clinically stable CAPD patients (11 females, 17 males). Left ventricular relaxation and systolic function were echocardiographically examined in all patients during standard dialysate (containing 1.75 mmol/L calcium) treatment. All patients were then changed to low calcium dialysate (1.25 mmol/L calcium) for 1 month and all patients were re-examined echocardiographically. Decrement in isovolumic relaxation time (IVRT) and deceleration time (DT), and increment in the ratio of peak early to peak late diastolic velocities (E/Amax) were admitted as indexes showing improvement in LV relaxation. 17 age- and sex-matched controls were also echocardiographically examined. RESULTS Deceleration time, interventricular septal thickness at systole (IVSTS) and diastole (IVSTD), and posterior wall thickness at systole (PWS) and diastole (PWD) were higher in CAPD patients using standard dialysate than in normal controls. With the use of low calcium dialysate, DTs were similar but IVSTS, IVSTD, PWS, and PWD values remained higher. In normal controls, E/Amax values were higher than those in CAPD patients using standard dialysate (p < 0.001) and low calcium dialysate (p = 0.009). Serum intact parathyroid hormone level, weight, clinical volume status, and blood pressure were similar throughout the study period. Serum ionized calcium levels were decreased significantly during low calcium dialysate treatment. The changes in IVRT, DT, and E/Amax suggest improvement in LV relaxation during low calcium dialysate treatment. CONCLUSION Left ventricular relaxation is increased with the use of low calcium dialysate compared with standard dialysate treatment. The idea of possible beneficial effects of increment in LV relaxation on cardiovascular morbidity and mortality deserves further studies.
3.
Intensive isotonic training modifies basal and exercise Doppler indexes of systolic function: a comparative study of athletes and sedentary men.
Fisman, EZ, Motro, M, Adler, Y, Lasry, E, Leibovitch, L, Tenenbaum, A
The American journal of cardiology. 2001;(5):594-8