曲美他嗪缩短缺血性心力衰竭患者的 QTc 间期。
Trimetazidine shortens QTc interval in patients with ischemic heart failure.
机构信息
Advanced Heart Failure and Transplantation Center, Division of Cardiology, Ljubljana University Medical Center, Ljubljana, Slovenia.
出版信息
J Cardiovasc Pharmacol Ther. 2010 Mar;15(1):31-6. doi: 10.1177/1074248409354601. Epub 2009 Dec 4.
BACKGROUND
Trimetazidine improves functional class and left ventricular function in patients with heart failure; however, its potential impact on QTc interval remains undefined. We analyzed the effects of trimetazidine on QTc interval in patients with ischemic heart failure.
METHODS
A prospective trial included 42 patients with ischemic heart failure (New York Heart Association [NYHA] 2 or 3) and reduced left ventricular ejection fraction (<55%), who were randomly allocated to conventional therapy plus trimetazidine in a modulated release formulation (35 mg twice daily; 22 patients) or conventional therapy alone (20 patients; controls). We measured QTc interval at baseline and after 1 month.
RESULTS
At baseline, QTc interval duration was similar in both groups (443 +/- 41 milliseconds in trimetazidine group vs 446 +/- 27 milliseconds in controls, P = .62). After 1 month, QTc interval decreased in the trimetazidine group (404 +/- 36 milliseconds, P = .0002) but not in controls (452 +/- 25 milliseconds, P = .74). QTc interval shortening with trimetazidine was more pronounced in patients with prolonged (>440 milliseconds) baseline QTc interval (-45 +/- 38 milliseconds) than in patients with normal QTc interval (-19 +/- 19 milliseconds P = .04). Significant QTc interval shortening (>20 milliseconds) was present in 14 of 22 patients (64%) in trimetazidine group compared to 3 of 20 (15%) patients in control group (P = .002).
CONCLUSIONS
Trimetazidine therapy is associated with QTc interval shortening in patients with ischemic heart failure.
背景
曲美他嗪可改善心力衰竭患者的功能分级和左心室功能；然而，其对 QTc 间期的潜在影响尚不清楚。我们分析了曲美他嗪对缺血性心力衰竭患者 QTc 间期的影响。
方法
前瞻性试验纳入了 42 例缺血性心力衰竭（纽约心脏协会 [NYHA] 心功能 2 级或 3 级）和左心室射血分数降低（<55%）的患者，随机分为常规治疗加曲美他嗪控释剂型（35mg，每日 2 次；22 例）或常规治疗（20 例；对照组）。我们在基线和 1 个月时测量 QTc 间期。
结果
基线时，两组的 QTc 间期持续时间相似（曲美他嗪组为 443±41 毫秒，对照组为 446±27 毫秒，P=0.62）。1 个月后，曲美他嗪组 QTc 间期缩短（404±36 毫秒，P=0.0002），但对照组无变化（452±25 毫秒，P=0.74）。与正常 QTc 间期患者（-19±19 毫秒，P=0.04）相比，基线 QTc 间期延长（>440 毫秒）患者的 QTc 间期缩短更为明显（-45±38 毫秒）。与对照组相比，曲美他嗪组 14 例（64%）患者的 QTc 间期显著缩短（>20 毫秒），而对照组仅 3 例（15%）（P=0.002）。
结论
曲美他嗪治疗与缺血性心力衰竭患者的 QTc 间期缩短有关。
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