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Influence of therapy with trimetazidine on the state of the main vessels and microcirculation in patients with CHF and DM type 2. The results of the original study

https://doi.org/10.21518/2079-701X-2018-5-65-69

Abstract

Endothelial dysfunction plays a major role in the pathogenesis of target organ damage in patients with chronic heart failure (CHF) and type 2 diabetes mellitus (DM). The aim of the study was to evaluate the effect of trimetazidine on the parameters of the elasticity of the large arteries and microcirculation (MC) in patients with CHF and type 2 diabetes. 60 diabetic patients with CHF at the age of 45–70 years were included. All patients received baseline therapy of CHF and DM. Trimetazidine at a dose of 70 mg / day was prescribed for all patients of 1 group (n = 30) in addition to traditional treatment. The elastic properties of large arteries were evaluated by analyzing the velocity of the pulse wave propagation (SRV), and the MC parameters were studied. Results. Treatment with using of trimetazidine in addition to traditional treatment for 16 weeks significantly improved endothelial function, clinical state of patientsфтв the state of the parameters of the microcirculation.

About the Authors

M. E. Statsenko
Волгоградский государственный медицинский университет Минздрава России
Russian Federation
MD, Prof.


S. V. Fabritskaya
Волгоградский государственный медицинский университет Минздрава России
Russian Federation
PhD in medicine


U. A. Ryndina
Волгоградский государственный медицинский университет Минздрава России
Russian Federation


References

1. 2016 ESC guidelines for the diagnosis and treatm ent of acute and chronic heart failure. Rossiyskiy Kardiologicheskiy Zhurnal, 2017, 1 (141): 7-81. DOI: 10.15829 / 1560-4071-2017-1-7-81.

2. National OSSN, RKO and RNMOT guidelines for the diagnosis and treatment of CHF (fourth revision). Zhurnal Serdechnaya Nedostatochnost’, 2013, 7 (81): 379-472.

3. Dedov II, Shestakova MV, Vikulova OK. Epidemiology of diabetes mellitus in the Russian Federa tion: clinical and statistical analysis according to the Federal Diabetes Mellitus Register. Sakharnyy Diabet, 2017, 20 (1): 13-41. DOI: 10.14341 / DM8664.

4. Dedov II, Shestakova MV, Galstyan GR. The prevalence of type 2 diabetes in the adult population of Russia (NATION study). Sakharnyy Diabet, 2016, 19 (2): 104-112.

5. Dedov II, Shestakova MV, Mayorova AYu. Standards of specialized medical c are in diabetes mellitus (8th issue). Sakharnyy Diabet, 2017, 20 (1S): 1-112. DOI: 10.14341 / DM20171S8.

6. MacDonald MR, Petrie MC, Hawkins NM et al. Diabetes, left ventricular systolic dysfunction, and chronic heart failure. Eur Heart J, 2008, 29: 1224–1240.

7. Thomas MC. Type 2 Diabetes and Heart Failure: Challenges and Solutions. Curr Cardiol Rev, 2016, 12(3): 249-55.

8. Shah AD, Langenberg C, Rapsomaniki E et al. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in 1•9 mil lion people. Lancet Diabetes Endocrinol, 2015, 3: 105–113.

9. Vasyuk YuA, Ivanova SV, Shkoln ik EL, et al. Russian experts reached an agreed opinion on assessing arterial stiffness in clinical practice. Kardiovaskulyarnaya Terapiya i Profilaktika, 2016, 15: 4-19.

10. Orlova YA, Ageev FT. Arterial stiffness as an integral indicator of cardiovascular risk: physiology, assessment methods and drug correction. Serdtse, 2006, 2: 65-69.

11. Kosheleva NA, Rebrov AP. Risk factors for the development of cardiovascular complications in patients with chronic heart failure: focus on arterial stiffness. Serdec hnaya Nedostatochnost, 2011, 3 (65): 136-141.

12. Masenko VP, Orlova YA, Ageev FT, Yarovaya EB, Kuzmina AE. Effect of arterial stiffness on the development of cardiovascular complications in coronary heart disease. Kardiologiya, 2009, 12: 11-17.

13. Rutten JH, Mattace-Raso FU, Verwoert GC, Lindemans J, Hofman A, Witteman JC, van den Meiracker AH. Arterial stiffness as determinant of increased amino terminal pro-B-type natriuretic peptide levels in individuals with and without cardiovascular disease-the Rotterdam Study. J Hypertens, 2010, 28(10): 2061–2067.

14. Van Bort el LM, Laurent S, Boutouyrie P et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid-femoral pulse wave velocity. J Hypertens, 2012, 30: 445-8.

15. Hinkel R, Hoewe A, Renner S, Ng J, Lee S, Klett K et al. Diabetes Mellitus-Induced Micro-vascular Destabilization in the Myocardium.J Am Coll Cardiol, 2017, 69(2): 131-143.DOI: 10.1016/j.jacc.2016.10.058.

16. Sörensen BM, Houben AJ, Berendschot TT, Schou-ten JS, Kroon AA, van der Kallen CJ et al. Prediabetes and Type 2 Diabetes Are Associated With Generalized Microvascular Dysfunction: The Maastricht Study. Circulation, 2016, 134(18): 1339-1352.

17. Lindenmeyer MT, Kretzler M, Boucherot A et al. Interstitial vascular rarefaction and reduced VEGFA expression in human diabetic nephropathy. J Am Soc Nephrol, 2007, 18: 1765-76.

18. Harrison DG. Cellular and molecular mechanisms of endothelial cell dysfunction. J Clin Invest, 1997, 19: 23-27.

19. Cameron AC, Lang NN, Touyz RM. Drug Treatment of Hypertension: Focus on Vascular Health. Drugs, 2016 Oct, 76(16): 1529-1550.

20. Drapkina O, Palatkina L, Zyatenkova E. Pleiotropic effects of statins. Effect on the blood vessel stiffness . Vrach, 2012, 9: 5-8.

21. Statsenko ME, Turkina SV, Fabritskaya SV, Shilina NN. Efficacy of short-term meldoni-um therapy in patients with chronic heart failure of ischemic etiology and type 2 diabetes mellitus. Kardiologiya, 2017, 57 (4): 58-63.

22. Statsenko ME, Starkova GV, Govorukha OA, Burlay SV, Sporova OE, Belenkova SV. Therapeutic potential of mildronate in the complex treatment of chronic heart failure in patients in the early post-infarction period. R ossiyskiy Kardiologicheskiy Zhurnal, 2005, 6 (56): 62-66

23. Rehberger-Likozar A, Šebeštjen M. Influence of trimetazidine and ranolazine on endothelial function in patients with ischemic heart disease. Coron Artery Dis, 2015, 26(8): 651-6. DOI: 10.1097/MCA.0000000000000272.

24. Li R, Tang X, Jing Q, Wang Q, Yang M, Han X et al. The effect of trimetazidine treatment in patients with type 2 diabetes undergoing percutaneous coronary intervention for acute myocardial infarction. Am J Emerg Med, 2017, S0735-6757(17): 30405-9. DOI: 10.1016/j.ajem.2017.05.024.

25. Grajek S, Michalak M, Frenneaux M, Anker SD. The effect of trimetazidine added to pharmacological treatment on all-cause mortality in patients with systolic heart failure. Cardiology, 2015, 131: 22–29.

26. Fi Z, Kovács G, Szentes V. Role of trimetazidine in the treatment of diabetic microangiopathy in ischaemic heart disease. Orv Hetil, 2015, 156(19): 765-8. DOI: 10.1556/650.2015.30160.

27. Szwed H, Sadowski Z, Pachocki R. et al. Combination treatment in stable effort angina using trimetazidine and metoprolol: results of a randomized,double-blind, multicentre study (TRIMPOL II) 187 TRIMetazidine in POLand. Eur. Heart J, 2001, 22: 2267-2274.

28. Tsioufis K. Trimetazidine and cardioprotection: facts and perspectives. Angiology, 2015, 66(3): 204-210.

29. Yoon JW, Cho BJ, Park HS et al. Differential effects of trimetazidine on vascular smooth muscle cell and endothelial cell in response to carotid artery balloon injury in diabetic rats. Int J Cardiol, 2013, 167: 126–133.

30. Stępień M, Wlazeł RN, ParadowskiM et al. Serum concentrations of adiponectin, leptin, resistin, ghrelin and insulin and their association with obe sity indices in obese normo- and hypertensive patients – pilot study. Arch Med Sci, 2012, 8: 431–436.

31. Khlebodarova FE. Vascular endothelial dysfunction and cytoprotectors correction in patients with stable angina and arterial hypertension. Rossiyskiy Kardiologicheskiy Zhurnal , 2009, 6 (80): 34-38.

32. Chrusciel P. Defini ng the Role of Trimetazidine in the Treatment of Cardiovascular Disorders: Some Insights on Its Role in Heart Failure and Peri pheral Artery Disease. Drugs, 2014, 74: 9: 971–980.

33. Vitale C, Marazzi G, Pel liccia F et al. Trimetazidine improves exercise performance in patients with peripheral arterial disease. Diabetes Technol Ther, 2011, 13(11): 1155-1160.

34. Ilyukhi n OV, Ilyukhina MV, Kalganova EL, Ivanenko VV, Lopatin YuM. The role of pulse wave propagation rate in the evaluation of endothelial dysfunction in patients with chronic heart failure of ischemic etiology. Serdechnaya Nedostatochnost, 2005, 1: 16-8

35. Amaral N, OkonkoDO. Metabolic abnormalities of the heart in type II diabetes. Diab Vasc Dis Res, 2015, 12(4): 239-48. DOI: 10.1177/1479164115580936.

36. Belardinelli R., Solenghi M., Volpe L. et al. Trimetazidine improves endothelial dysfunction in chronic heart failure: an antioxidant effect. Eur Heart J, 2007, 28: 1102-1 108.

37. Prasad K, Gupta JB, Kalra J, et al. Oxygen free radicals in volume overload heart failure. Mol Cell Biochem, 1992, 111: 55-59.


Review

For citations:


Statsenko ME, Fabritskaya SV, Ryndina UA. Influence of therapy with trimetazidine on the state of the main vessels and microcirculation in patients with CHF and DM type 2. The results of the original study. Meditsinskiy sovet = Medical Council. 2018;(5):65-69. (In Russ.) https://doi.org/10.21518/2079-701X-2018-5-65-69

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ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)