If it is possible to prevent metabolic remodelling possibilities of trimetazidine use


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Trimetazidine is related to those medicaments, which mechanism of action is aimed at myocardium metabllism improvement. The main mechanism of action of the medicine is connected with its possibility to suppress long-chain mitochondrial 3ketoacyl-coenzyme A-tiolaze, due to which fatty acids' pinch and oxydation are suppressed with sumultaneuos activation of glucose metabolism. Trimetazidine farmacological characteristics are considered, results of its clinical trials are discussed. Obtaind data prove, that the medicine can be used for curation of patients with different diseases, firstly cardiovascular diseases, in particular for stable stenocardia treatment, and also in case of stenocardia and diabetes melitus combination. The ability of trimetazidine to normalyze metabolic processes is fixed. That, possibly, slows the heart remodelling down.

Full Text

Restricted Access

About the authors

Viktor V. Cheltzov

Peoples' frendship university of Russia

Email: vcheltsov@mail.ru
MD, professor, professor of the Department of general and clinical pharmacology

References

  1. Информационный бюллетень ВОЗ, 2017;1. [Informational bulletin of WHO. 2017;1]
  2. Pepine C.J., Abrams J., Marks R.G., Morris J.J., Schedt S.S., Handberg E. Characteristics of a contemporary population with angina pectoris. TIDES Investigators. Am. J. Cardiol. 1994;74:226-31.
  3. Fox K.M., Mulcahy D., Findlay I., Ford I., Dargie H.J. The Total Ischemic Burden European Trial (TIBET). Effects of atenolol, nifedipine SR and their combination on the exercise test and total ischemic burden in 608 patients with stable angina. The TIBET Study Group. Eur. Heart J., 1996;17:96-103.
  4. Ussher J.R., Keung W., Fillmore N., Koves T.R., Mori J., Zhang L., Lopaschuk D.G., Illkayeva O.R., Wagg C.S., Jaswal J.S., Muoio D.M., Lopaschuk G.D. Treatment with the 3-ketoacyl-CoA thiolase inhibitor trimetazidine does not exacerbate whole-body insulin resistance in obese mice. J. Pharmacol. Exp. Ther. 2014;349:487-96.
  5. Stanley W.C., Lopaschuk G.D., Hall J.L., McCormack J.G. Regulation of myocardial carbohydrate metabolism under normal and ischaemic conditions: Potential for pharmacological interventions. Cardiovasc. Res. 1997;33(2)243-57.
  6. Gertz E.W., Wisneski J.A., Stanley W.C., Neese R.A. Myocardial substrate utilization during exercise in humans. Dual carbon-labeled carbohydrate isotope experiments. J. Clin. Invest. 1988;82:2017-025.
  7. Nagoshi T. et al. цит. по Dezsi C.A. Trimetasidine in practice: review of the clinical and experimental evidence. Am. J. Therapeutics. 2016;23:e871-9.
  8. Hutter J.D., Piper H.M., Spieckerman P.G. Effect of fatty acid oxidation on efficiency of energy production in rat heart. Am. J. Physiol. 1985;249(4):723-8.
  9. Pauly D.F., Pepine C.J. Ischemic Heart Disease: metabolic approaches to management. Clin. Cardiol. 2004;27;439-41.
  10. Randle P.J., Garland P.B., Hales C.N., Newsholme E.A. The glucose fatty-acid cycle. Its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus. Lancet. 1963;281(7285):785-9.
  11. Stanley W.C. цит. по Lee L., Horowitz J., Frenneaux M. Metabolic manipulation in ischemic heart disease, a novel approach to treatment. Eur. Heart J. 2004;25;634-41.
  12. Taegtmeyer H., Roberts A.F., Raine A.E. Energy metabolism in reperfused heart muscle: metabolic correlation to return of function. Am. J. Coll. Cardiol. 1985;6(4):864-80.
  13. Depre C., Vanoverschelde J.L., Taegtmeyer H. Glucose for the heart. Circulation.1999;99(4):578-88.
  14. Lopaschuk G.D., Wambolt R.B., Barr R.L. An imbalance between glycolysis and glucose oxidation is a possible explanation for the detrimental effects of high levels of fatty acids during aerobic reperfusion of ischemic hearts. J. Pharmacol. Exp. Ther. 199;264(1):135-44.
  15. Heusch G. Hibernating myocardium. Physiol. Rev. 1998;78(4):1055-85.
  16. Sellier P., Audouin B., Payen B., Corona P., Duong T.C., Ourbak P. Acute effects of trimetazidine evaluated by exercise testing. Eur. J. Pharmacol. 1987;33: 205-7.
  17. Fantini E., Demaison L., Sentex E., Grenberg A., Athias P. Some biochemical aspects of the protective effect of trimetazidine on rat cardiomyocytes during hypoxia and reoxygenation. J. Mol. Cell. Cardiol. 1994;26:949-58.
  18. Kantor P.F., Lucien A., Kozak R., Lopaschuk G.D. The antianginal drug trimetazidine shift cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase. Circ. Res. 2000;86:580-8.
  19. skesen I., Saribulbul O., Cerrahoglu M., Var A., Nazli Y., Sirin H. Trimetazidine Reduces Oxidative Stress in Cardiac Surgery. Circ J., 2006;70:1 169-73.
  20. Liu Х., Gai Y., Liu F., Gao W., Zhang Y., Xu M., Li Zh. Trimetazidine inhibits pressure overload-induced cardiac fibrosis through NADPH oxidase-ROS-CTGF pathway. Cardiovasc. Res. 2010;8:150-8.
  21. Ruiz-Meana M., Garcia-Dorado D., Julia M., Gonzalez M.A., Inserte J., Soler-Soler J. Pre-treatment with trimetazidine increases sarcolemmal mechanical resistance in reoxygenated myocytes. Cardiovasc. Res. 1996;32:587-92.
  22. Kowalski J. et al. Цит. по: Chrusciel P., Rysz J., Banach M. Defining the role of trimetazidine in the treatment of cardiovascular disorders: some insight on its role in heart failure and peripheral arterial disease. Drugs. 2014;74:971-90.
  23. Ozbay L., Unal D.O., Erol D. Food effect on bioavailability of modified- release trimetazidine tablets. J. Clin. Pharmacol. 2012;52:1535-9.
  24. Harpey C., Clauser P., Labrid C. Trimetazidine, a cellular anti-ischemic agent. Cardiovasc. Drug Rev. 1989;6:292-312.
  25. Simon N., Brunet P., Roumenov D., Dussol B., Barre J., Duche J-C., Albengres E., D'Athis P., Chauvet-Monges A.M., Berland Y., Tillement J.P. Trimetazidine does not modify blood levels and immunosuppressant effects of cyclosporine A in renal allograft recipients. Br. J. Clin. Pharmacol. 1997;44:591-4.
  26. Edeki T.I., Johnston A., Campbell B., Ings R.M.J., Brownsill R., Genissel P., Turner P. An examination of the possible pharmacokinetic interaction of trimetazidine with theophylline, digoxin and antipyrine. Br. J. Сlin. Pharmacol. 1988;26:657.
  27. Passeron J. Effectiveness of trimetazidine in stable effort angina due to chronic coronary insufficiency. A double-blind versus placebo study. Presse Med. 1986;15:1777-8.
  28. Pornin M., Harpey C., Allal P.J., Selier P., Ourback P. Effects of trimetazidine on systemic hemodynamics in patients with coronary artery disease. J. Mol. Cell. Cardiol. 1990;22(suppl. 22):150.
  29. Kober G., Buck T., Sievert H., Vallbracht C. Myocardial protection during percutaneous transluminal coronary angioplasty: effects of trimetazidine. Eur. Heart J. 1992;13:1109-15.
  30. Belardinelli R., Solenghi M., Volpe L., Purcaro A. Trimetazidine improves endothelial dysfunction in chronic heart failure: an antioxidant effect. Eur. Hеаrt J. 2007;28:1 102-8.
  31. Dalla Volta S., Maraglino G., Della Valentina B., Viena P., Desideri A. Comparison of tremetazidine with nifedipine in effort angina: a double blind, cross-over study. Cardiovasc. Drugs Ther. 1990;4(suppl. 4):853-60.
  32. Detry J.M., Sellier P., Pennaforte S., Cokkinos D., Dargie H., Mathes P. Trimetazidine: a new concept in the treatment of angina. Comparison with propranolol in patients with stable angina. Br. J. Clin. Pharmacol.1994;37:279-88.
  33. Michaelides A.P., Vissoulis G.P., Bonoris P.E., Psaros T.K., Papadopoulos P.D., Toutouzas P.K. Beneficial effects of trimetazidine in men with stable angina under betablocker treatment. Curr. Ther. Res. 1989;46:565-76.
  34. Szwed H., Sadowski Z., Elikowski W., Koronkiewicz A., Mamcarz A., Orszulak W., Skibinska E., Szymczak K., Swiatek J., Winter M. Combination treatment in stable effort angina using trimetazidine and metoprolol. Results of randomized, double-blind, multicentre study (TRIMPOL). Eur. Heart J. 2001;22:2267-74.
  35. Федорова Т.А., Ильина Ю.В., Рыбакова М.К., Максимова И.А. Триметазидин в лечении хронической сердечной недостаточности у больных с ишемической болезнью сердца. Consilium medicum. 2013;5:32-7. [Fyodorova T.A., Iljyna Ju.V., Rybakova M.K. Maksimova I.A. Trimetazidine in treatment of chronic cardiac insufficiency in ishemic heart disease patients. Consilium medicum. 2013;5:32-7.]
  36. Di Napoli P., Taccardi A.A., Barsotti A. Long term cardioprotective action of trimetazidine and potential effect on the inflammatory process in patients with ischaemic dilated cardiomyopathy. Heart. 2005;91:161-5.
  37. Gao D., Ning N., Niu X., Hao G., Meng Z. Trimetazidine: a meta-analysis оf randomized controlled trials in heart failure. Heart. 2011;97:278-86.
  38. Davila-Roman V.G., Vedala G., Herrero P., de las Fuentes L., Rogers J.G., Kelly D.P., Gropler R.J. Altered myocardial fatty acid and glucose metabolism in idiopathic dilated cardiomyopathy. Am. J. Coll. Cardiol. 2002;40:271-7.
  39. Tuunanen H., Engblom E., Naum A., Nagren K., Scheinin M., Hesse B., Airaksinen J., Nuutila P., Iozzo P., Ukkonen H., Opie L.H., Knuuti J. Trimetazidine, a metabolic modulator, has cardiac and extracardiac benefits in idiopathic dilated cardiomyopathy. Circulation. 2008;1 18:1250-8.
  40. Wallhaus T.R., Taylor M., DeGrado T.R., Russel D.C., Stanko P., Nickles R.J., Stone C.K. Myocardial free fatty acid and glucose use after carvedilol treatment in patients with congestive heart failure. Circulation. 2001;103:2441-6.
  41. Pech A., Labaeye P., Wayoff M., Lancomme Y., Bebear J.P., Morgon A.A. 2-month, multicentre, double-blind, placebocontrolled study of trimetazidine in tinnitus. Drugs Today. 1990;26(suppl. 8):77-95.
  42. Haguenauer J.P. Trimetazidine in degenerative hypoacousis: effects on hearing and integration. Drugs Today. 1990;26(suppl. 8):59-65.
  43. Kluyskens P., Lambert P., Dhooge D. Trimetazidine versus betahistine in vestibular vertigo. Double-blind study. Drugs Today. 1990;26(suppl. 8):13-22.
  44. Onbasili A.O., Yeniceriglu Y., Agaoglu P., Karul A., Tekten T., Akar H., Disicigil G. Trimetazidine in the prevention of contrast-induced nephropathy after coronary procedures. Heart. 2007;93:698-702.
  45. Bonello L., Sbragia P., Amabile N., Com O., Pierre S.V., Levy S., Paganelli F. Protective effect of an acute oral loading dose of trimetazidine оп myocardial injury following percutaneous coronary intervention. Heart. 2007;93:703-7.
  46. Effect of 48-h intravenous trimetazidine on short- and long-term outcomes of patients with acute myocardial infarction, with and without thrombolytic therapy. A double-blind, placebo-controlled, randomized trial The EMIP-FR GROUP. Eur. Heart J. 2000;21:1537-46.
  47. Marti Masso J.F., Marti I., Carrera N., Poza J.J., de Lopes Minain A. Trimetazidine induced parkinsonism, gait disorders and tremor. Therapie. 2005;60:419-22.
  48. Диагностика и лечение стабильной стенокардии. Национальные рекомендации. М., 2011. [Diagnostics and treatment of stable stenocardia. National recommendations. M., 2011.]
  49. ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur. Heart J. 2013;34:2949-3003.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2017 Bionika Media

This website uses cookies

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

About Cookies