The effects of trimetazidine on p-wave duration and dispersion in heart failure patients.

Abstract

BACKGROUND:

P-wave duration and dispersion (PWD) have been shown to be noninvasive predictors for development of atrial fibrillation. Thus, it may be possible to attenuate atrial fibrillation risk through normalization of P-wave duration and dispersion. Trimetazidine, a metabolic modulator, has been reported to improve cardiac function in heart failure (HF) patients.

METHODS:

Thirty-six HF patients being treated with angiotensin inhibitors, carvedilol, spironolactone, and furosemide were prescribed trimetazidine, 20 mg three times a day. Electrocardiographic and echocardiographic examinations were obtained before and 6 months after addition of trimetazidine in HF patients and 36 healthy control group patients having normal echocardiographic examination.

RESULTS:

Maximum P-wave duration (Pmax) (106.7 +/- 15.8 vs. 91.7 +/- 12.7 ms) and PWD (57.2 +/- 15.4 vs. 37.9 +/- 16.7 ms) were significantly longer in HF patients compared to the control group. There were significant correlations of Pmax and PWD with left atrial diameter (r = 0.508, P = < 0.001 and r = 0.315, P = 0.029), left ventricular ejection fraction (LVEF) (r = 0.401, p = 0.005 and r = 0.396, P = 0.005), deceleration time (r = 0.296, P = 0.032 and r = 0.312, P = 0.035), and isovolumetric relaxation time (r = 0.265, P = 0.038 and r = 0.322, P = 0.015). There were significant improvements in LVEF (32.7 +/- 6.5% to 37.2 +/- 5.5%, P = 0.036), left atrial diameter (41.5 +/- 6.7 to 40.3 +/- 6.1 mm, P < 0.001), and Pmax (106.7 +/- 15.8 to 102.2 +/- 11.5 ms, P = 0.006) and PWD (57.2 +/- 15.4 to 48.9 +/- 10.1 ms, P < 0.001) during follow-up.

CONCLUSIONS:

Trimetazidine added to optimal medical therapy in HF may improve Pmax and PWD in association with improved left ventricular function. Longer-term and larger studies are necessary to evaluate whether these findings may have clinical implications on prevention of atrial fibrillation.

• Authors: Yilmaz Gunes, Mustafa Tuncer, Unal Guntekin, Serkan Akdag, Hasan Ali Gumrukcuoglu
• Journal: Pacing and clinical electrophysiology : PACE (Pacing Clin Electrophysiol) Vol. 32 Issue 2 Pg. 239-44 (Feb 2009) ISSN: 1540-8159 [Electronic] United States
• PMID: 19170914 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Vasodilator Agents
• Trimetazidine

Topics

• Chemotherapy, Adjuvant (methods)
• Electrocardiography (drug effects)
• Female
• Heart Failure (diagnosis, prevention & control)
• Heart Rate (drug effects)
• Humans
• Male
• Middle Aged
• Trimetazidine (administration & dosage)
• Vasodilator Agents (administration & dosage)
• Ventricular Dysfunction, Left (diagnosis, prevention & control)