The impact of trimetazidine on left ventricular function and cardiac biomarkers among diabetic patients suffering from left ventricular diastolic dysfunction has been the focus of new research conducted at Ain Shams University, Cairo, Egypt. This study, registered with clinicaltrials.gov, sought to explore the efficacy of trimetazidine over the course of three months on patients with left ventricular diastolic dysfunction, marking it as one of the first studies to address diabetic cardiomyopathy.
Diabetic cardiomyopathy (DCM) is significant due to its prevalence and impact on heart health. Defined as cardiomyopathy occurring due to diabetes mellitus, DCM can remain underdiagnosed as it progresses through asymptomatic phases characterized by diastolic dysfunction, leading to heart failure. The incidence of left ventricular diastolic dysfunction ranges markedly among diabetic patients, placing them at higher risks for mortality and subsequent cardiac events.
To investigate trimetazidine's potential role, researchers recruited 63 patients with type 2 diabetes diagnosed with left ventricular diastolic dysfunction. The patients were randomly assigned to receive either trimetazidine or placebo over three months, followed by rigorous assessments including echocardiographic indices and measurements of biomarkers such as tumor necrosis factor alpha (TNF-α) and N-terminal pro brain natriuretic peptide (NT-proBNP).
The findings reveal promising results. Among those treated with trimetazidine, there was a marked improvement with reductions in the left atrial volume index and increases in average e’ velocity—two definitive indicators of diastolic function. The trimetazidine group saw significant improvements, with the left ventricular global longitudinal strain (LVGLS) increasing by 6.66%, whereas the placebo group exhibited declines.
Supporting these findings, the modified Medical Research Council (mMRC) dyspnea score—a scale measuring breathlessness—showed improvements among those treated with trimetazidine, decreasing to scores reflecting lesser complaints of dyspnea compared to the placebo group. Patients using trimetazidine also reported lower levels of low-density lipoprotein cholesterol compared to the placebo group....
The study underscored the drug's effectiveness without serious side effects, which highlights its potential as part of treatment regimens for patients with diabetes experiencing early signs of cardiac issues. Overall, trimetazidine’s role appears to bolster cardiac functions significantly, offering hope for quality of life improvements among patients with diabetic cardiomyopathy.
Continued research is needed to assess the long-term efficacy of trimetazidine and its effects beyond the three-month period studied here. Key questions remain about the mechanisms through which trimetazidine operates at the metabolic and cellular levels, as well as how it interfaces with inflammatory processes linked to diabetes and heart dysfunction. Future trials will be necessary to elucidate these pathways and refine treatment protocols for those facing the early stages of diabetes-related cardiac impairment.