MANAGEMENT OF ANGINA ATTACKS IN HEART FAILURE DUE TO NONCORONARY HEART DISEASE: TRIMETAZIDINE USAGE

Aim. To study trimetazidine (TZ) impact on the frequency of hospitalizations, structural and functional myocardium parameters, exercise tolerance (ET) in congestive heart failure patients (CHF) of nonischemic etiology (after myocarditis or DCMP), having complaints on chest pains.

Material and methods. Totally 35 patients included (27 males) with CHF II-III FC, under observation in screening groups at SRD HF NWFMRC n. a. Almazov V. A. of the Healthcare Ministry. Mean age was 48±2,5 y., mean BMI — 26±2,5 kg/m2. Patients were randomized to two groups: main group (MG) of 20 persons — receiving TZ (Preductal МВ, “Les Laboratories Servier”, France) 70 mg per day for 12 months additionally to basic therapy of CHF; controls (CG) of 15 persons — those receiving only basic CHF therapy.

Results. All patients completed the study. There were no cases of TZ discontinuation. In both groups LV EF increased from 35±4,8 to 38,2±4,3, with р<0,05 in MG, and no significantly — in CG (from 34±5,5 to 36,1±5,1, р>0,05). By the end of TZ therapy the results by MLHFQ improved in both groups and reached 49±2,7 and 55,6±2,8 points, in MG and CG, resp., р<0,05. Baseline CPT were
comparable in both groups: VО2peak were 12,9±0,9 ml/min/kg (gap 10,1-15,0 ml/min/kg) and 13,0±1,2 (10,0-15,2 ml/min/kg), resp., (pVО2peak>0,05). In 12 months values of VО2peak increased and became significantly better than in MG than in CG: 16,4±1,3 ml/min/kg (11,8-18,3 ml/min/kg) and 14,5±1,1 ml/min/kg (11,2-16,7 ml/min/kg), resp., (pVО2peak<0,01). In MG there were strong positive correlations between duration of CHF and improvement of oxygen volume consumed at the peak of exercise (r=0,6, p<0,05); and between CHF duration and LV EF increase (r=0,74, p<0,05).

Conclusion. Hence the results of the study demonstrate that prescription of TZ to the patients with HF-LEF of non-ischemic ethiology with dose 70 mg per day additionally to basic therapy helps to decrease angina syndrome severity, to improve life quality and increase oxygen consumption during exercise.

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