Impact of trimethasidine therapy on the patterns of arrhythmias and on the parameters of cardiac rhythm variability in patients with chronic heart failure


Cite item

Full Text

Abstract

Aim. To study the effects of trimethasidine on the specific features of arrhythmias, on the parameters of cardiac rhythm variability (CRV) and ischemic changes in the ST segment in patients with functional classes II-III chronic heart failure (CHF).
Material and Methods. Twenty male patients with less than 45% left ventricular ejection fraction were examined. After stabilizing their status and working through basic therapy for a week, the patients were randomly divided in ftvo subgroups equally and followed up in the outpatient setting for 6 months. During two 3-month periods, they alternately received either the standard basic therapy or the standard therapy in combination with trimethasidine in a dose of 20 mg thrice a day. Hotter monitoring was performed before and 3 and 6 month after the therapy.
Results. In patients with CHF on trimethasidine, there was a significant reduction in the number of paroxysms of ventricular tachycardia and high-grade ventricular extrasystoles, and a significant improvement of cardiac rhythm variability. Concurrently, a significant decrease in the frequency of episodes of ST-segment depression was recorded at ECG.
Conclusion. Trimethasidine treatment in CHF patients induced a reduction in the incidence of cardiac rhythm disturbances, which may be associated with its antiischemic effect on the myocardium and, possibly, with the positive effect of cytoprotective therapy on autonomic tone.

References

  1. Сыркин А. Л., Долецкий А. А. Триметазидин в лечении ишемической болезни сердца. Клин, фармакол. и тер. 2001; 1: 1-4.
  2. Елисеев О. М. Триметазидин (предуктал). Новый подход в борьбе с ишемией миокарда. Тер. арх. 1996; 68 (8): 57-63.
  3. Kanton P. F., Lucien A., Kozac Л., Lopaschuk G. D. The antianginal drug trimetazidine shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3 - ketoacyl coenzyme A thiolase. Circ. Res. 2000; 86: 580-588.
  4. Fantini E., Demaison L., Sentex E. et al. Some biochemical aspects of the protective effects of trimetazidine on rat cardomyocytes during hypoxia and reoxygenation. J. Mol. Cell. Cardiol. 1994; 26: 949-958.
  5. Панкин В. 3., Тихазе А. К., Беленков Ю. Н. Свободнорадикальные процессы при заболеваниях сердечно-сосудистой системы. Кардиология 2000; 7: 58-71.
  6. Ferrari R. Metabolic disturbances during myocardial ischemia and reperfusion. Am. J. Cardiol. 1995; 60: 1346-1352.
  7. Панкин В. 3., Тихазе А. К., Жарова Е. А,, Беленков Ю. Н. Исследование антиоксидантных свойств цитопротекторного препарата триметазидина. Кардиология 2001; 3: 21-28.
  8. Бойцов С. А., Подлесов А. М. Нарушения ритма сердца при хронической сердечной недостаточности. Сердеч. недостаточность 2001; 5: 224-227.
  9. Голицын С. П. Лечение желудочковых аритмий с позиций первичной и вторичной профилактики внезапной смерти. Там же. 201-208.
  10. Задионченко В. С., Мартынова Л. И., Тимофеева Н. Ю., Анисина Т. Т. Вариабельность сердечного ритма в оценке прогрессирования сердечной недостаточности и эффективности терапии ингибиторами ангиотензинпревращающего фермента. Там же. 214-317.
  11. Bigger J. Т., Fleiss J. L., Rolnitzky L. M. et al. Frequency domain measures of heart rate variability to assess risk late after myocardial infarction. J. Am. Coll. Cardiol. 1993; 21: 729-736.
  12. Heart rate variability. Standards of measurements, physiological interpretation, and clinical use. Eur. Heart J. 1996; 17: 354-381.
  13. Heart rate variability. Standards of measurements, physiological interpretation, and clinical use. Circulation 1996; 93 (5): 1043-1065.
  14. Bigger J. Т., Fleiss J. L., Steinman R. С. et al. Frequency domain measures of heart rate variability and mortality rate after myocardial infarction. Ibid. 1992; 85: 164-171.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2003 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

© 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies