Imran Waheed, Zeeshan Hassan, Moazzam Ali Naqvi, Masood Ali Akbar, Ahmad Noeman, Muhammad Abu Bakar Mirza.
Effect of Trimetazidine on Functional Capacity in Diabetic patients with Left Ventricular Systolic Dysfunction.
J Cardiovascular Dis Jan ;15(4):99-103.

Varying approaches have been adopted in past to study the effect of different pharmacological interventions on functional capacity of the heart in patients with left ventricular systolic dysfunction. The role of Trimetazidine has also been evaluated in patients with angina and heart failure but there is paucity of research on the impact of Trimetazidine on functional capacity of patients with left ventricular systolic dysfunction and metabolic syndrome in previous literature. The purpose of the study was to assess the efficacy of Trimetazidine therapy on functional capacity of patients with left ventricular systolic dysfunction. MATERIAL AND METHODS:This was observational open labeled study conducted in Department of Cardiology, Government Khawaja Muhammad Safdar Medical College, Sialkot from 1st June 2018 to 31st August 2018. A total number of 200 diabetic patients with left ventricular systolic dysfunction were included in the study while patients with valvular and congenital heart disease were excluded from the study. Informed consent was taken. Left ventricular systolic dysfunction was diagnosed and graded on Echocardiography and LVEF was calculated. At the beginning, the basal Duke Activity Status Index (DASI) score (Total Score is 58.2 with METS of 9.8), VO2 and METs was calculated in all the study cases. All patients were given sustained release Trimetazidine 70 mg in divided doses on daily basis for two months at the end of which DASI score, VO2 and Mets were again calculated as final parameters along with reassessment of LV systolic dysfunction. All the collected data was subjected to statistical analysis and results were analyzed at the end of the study. RESULTS: 120 (60%) patients had moderate LV systolic dysfunction out of which 40 patients showed improved LV function at the end of drug therapy with 70 mg of Trimetazidine while cases with LVEF ranging between 25-30% or severe LV systolic dysfunction revealed similar improvement. An improvement in NYHA Class was observed pre-trimetazidine and posttrimetazidine therapy. NYHA Class improvement was seen from 73 (36.5%) to 41 (20.5%) in Class III while Class IV revealed much more improvement from 127 (63.5%) to 73(36.5%). DASI score improved from basal level of 26.30 to a final score of 41.76 with an overall improvement in METS from 5.94 to 7.8 at completion of the study CONCLUSION: In our study population drug therapy with sustained release Trimetazidine 70 mg in divided doses daily has shown significant improvement in functional capacity of the patients in terms of VO2 , METS and DASI score. It may be concluded that this drug may improve symptomatic outcomes in patients with moderate to severe LV systolic dysfunction.

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