European Journal of Cardiovascular Medicine

Background: A lot has been investigated about how trimetazidine (TMZ); a metabolic modifier works at molecular level, however very little is known about how well that translates into mechanistic benefit at LV muscular level. This study was done to evaluate the effects of trimetazidine on the LV mechanics in patients of chronic stable angina. Material & Methods: Hospital based observational study, we followed 40 patients of chronic stable angina on conventional optimal medical therapy (OMT). LV mechanical indices including 2D Global Longitudinal Strain (GLS),4D Global Circumferential Strain (GCS),4D Global Area Strain (GAS), 4D Global Radial Strain (GRS), LVEF, E/A, E/e’ were measured at baseline and compared 1 month after addition of TMZ to OMT.  Results: The mean 2D GLS at baseline was -17.36 ± 3.09%, which improved to -18.33 ± 3.13% on follow up (P=0.001). The mean 4D GCS at baseline was -6.87 ± 3.41%, and -8.52 ± 2.69% on follow up (P= 0.003). The mean 4D GAS at baseline was-12.40 ± 5.90% vs -14.02 ± 4.38% on follow up (P= 0.017). The mean 4D GRS at baseline was 16.50 ± 7.81% vs 18.00 ± 6.76% on follow up, P =0.091(NS). The mean LVEF improved from 55.67 ± 5.46 at baseline to 57.62 ± 5.15 on follow up after 1month on TMZ therapy (P=0.001). The mean E/A value at baseline was 1.14 ± 0.39, which changed to 1.04 ±0.24 on follow up (P=0.038). The mean E/e’ value at baseline was 8.91 ± 2.50, which improved to 8.14 ±2.17 on follow up (P=0.008). Conclusion: TMZ has beneficial effects on the LV Mechanistic indices when added over and above the conventional OMT in patients of chronic stable angina.