Objectives To observe the effect of the Trimetazidine on endothelial function of patient with chronic heart failure, in order to provide a theretical basis for clinical medicine.
Methods 68 patients with chronic heart failure were divided into two groups randomly (34 per group). The control group received conventional medicine such as diuretics, beta blockers, ACEI and digitalis in treatment of heart failure. while the Trimetazidine group on the control group basis gives Trimetazidine. Both of them were treated for four weeks. Flow-mediated vasodilation of the brachial artery (FMD), the level of serum nitric oxide (NO), and endothelin-1 (ET-1) of two groups were observed before and after treatment.
Results (1) The general informations of two groups have no statistical difference (P > 0.05). (2) The effect of Trimetazidine for FMD(%): The FMD of the two groups were improved in post-treatment (control group: 9.17 ± 2.93 vs 10.06 ± 3.18, P<0.05; Trimetazidine group: 9.25 ± 3.06 vs 11.78 ± 3.25, P<0.01) but the Trimetazidine group was obviously superior to the control group, 10.06 ± 3.18 vs 11.78 ± 3.25, P<0.05. (3)The effect of Trimetazidine for he level of serum NO(μmol/L): The level of serum NO of the two groups increased after treatment (control group: 49.7 ± 5.89 vs 83.1 ± 5.16,P < 0.05; Trimetazidine group: 50.2 ± 6.12 vs 116.2 ± 6.53, P < 0.01), and more siginificantly increased in the Trimetazidine group, 83.1 ± 5.16 vs 116.2 ± 6.53, P < 0.01. (4) The effect of Trimetazidine for he level of serum ET-1(ng/L): The level of serum ET-1 of the two groups decreased significantly after treatment (control group: 56.79 ± 8.18 vs 50.2 ± 6.12, P < 0.01; Trimetazidine group: 57.93 ± 8.76 vs 41.09 ± 6.01, P < 0.01), and more siginificantly decreased in the Trimetazidine group, 50.2 ± 6.12 vs 41.09 ± 6.01, P < 0.01. (5) Side effects: BP, HR, liver and renal function, routine analysis of blood, urine and stool of two groups were compared before and after treatment which have no statistical difference (P > 0.05).
Conclusions Trimetazidine based on conventional therapy can improve vascular endothelial function of patioents with chronic heart failure obviously. There are no side effects.