Pornin M, Harpey C, Allal J, Sellier P, Ourbak P
Service de Cardiologie, Hôpital Broussais, Paris, France.
Clin Trials Metaanal. 1994 Apr;29(1):49-56.
Trimetazidine has been shown to improve anginal symptoms and exercise tolerance in patients with coronary artery disease (CAD). To determine the hemodynamic effects of trimetazidine, systemic hemodynamics were studied in 15 patients suffering from CAD (12 male, 3 female, mean age +/- SEM = 58.6 +/- 1.8 years). Cardiac index was determined by thermodilution method. Left ventricular and aortic pressures were measured using micromanometers (Miller Instruments). After basal measurements, patients were randomly given either placebo (n = 5) or one of two therapeutic doses of trimetazidine 1 mg.kg-1 (n = 5) or trimetazidine 1.5 mg.kg-1 (n = 5) in a double-blind procedure. Data were recorded 5, 10 and 20 min after intravenous drug bolus. Throughout the procedure, the evolution of systemic hemodynamic parameters was not statistically different between the three groups, in particular heart rate, cardiac index, systolic, diastolic and mean aortic pressures, end-diastolic ventricular pressure, mean capillary wedge pressure, pulmonary artery pressures or systemic vascular resistances. We conclude that, unlike other antianginal drugs (particularly beta-blockers, nitrates and calcium-channel inhibitors), trimetazidine does not modify systemic hemodynamics in patients with CAD. These results are consistent with a direct effect of trimetazidine on the ischemic myocardial cell previously reported.
已证实曲美他嗪可改善冠状动脉疾病（CAD）患者的心绞痛症状和运动耐量。为确定曲美他嗪的血流动力学效应，对15例CAD患者（男12例，女3例，平均年龄±标准误=58.6±1.8岁）进行了全身血流动力学研究。采用热稀释法测定心排血量。使用微测压计（米勒仪器公司）测量左心室和主动脉压力。在基础测量后，患者以双盲程序随机给予安慰剂（n=5）或曲美他嗪的两种治疗剂量之一，即1mg·kg-1（n=5）或1.5mg·kg-1（n=5）。在静脉推注药物后5、10和20分钟记录数据。在整个过程中，三组之间全身血流动力学参数的变化无统计学差异，尤其是心率、心排血量、主动脉收缩压、舒张压和平均压、舒张末期心室压力、平均毛细血管楔压、肺动脉压力或全身血管阻力。我们得出结论，与其他抗心绞痛药物（特别是β受体阻滞剂、硝酸盐和钙通道抑制剂）不同，曲美他嗪不会改变CAD患者的全身血流动力学。这些结果与先前报道的曲美他嗪对缺血心肌细胞的直接作用一致。
