Brottier L, Barat J L, Combe C, Boussens B, Bonnet J, Bricaud H
Service de Cardiologie, Hôpital Cardiologique du Haut-Lévéque, Pessac.
Ann Cardiol Angeiol (Paris). 1989 Mar;38(3):179-82.
The effect of a cellular anti-ischemic, trimetazidine (TMZ) in ischemic cardiomyopathies, was evaluated in a double-blind versus-placebo (P) trial, over a period of six months. 20 patients, mean age: 59.5 years, with advanced ischemic cardiomyopathy, demonstrated by left catheterization and coronary angiography, with a past history of myocardial infarction, received either 60 mg per day of TMZ (nine patients) or the placebo (eleven patients) in addition to a basic treatment of digitalis, diuretics and nitrated medications. A complete, clinical, biological and paraclinical evaluation, including chest X-ray, ultrasonography, isotopic ventriculography and 24 h-ECG, was performed upon inclusion in the study; and after three and six months of treatment. Two patients from the placebo group were not reevaluated at six months. The clinical condition, according to the NYHA classification, improved in all patients from the TMZ group, deteriorated in eight on nine patients from the placebo group (p less than 0.001). The isotopic stroke volume is preserved with TMZ, deteriorated with P. The cardiac volume decreases with TMZ, increasing with P. TMZ is beneficial clinically and functionally in advanced ischemic cardiomyopathies.
在一项双盲对照安慰剂试验中，对细胞抗缺血药物曲美他嗪（TMZ）在缺血性心肌病中的作用进行了为期6个月的评估。20例平均年龄59.5岁的晚期缺血性心肌病患者，经左心导管检查和冠状动脉造影证实，有心肌梗死病史，除接受洋地黄、利尿剂和硝酸盐类药物的基础治疗外，9例患者每天服用60毫克TMZ，11例患者服用安慰剂。在纳入研究时以及治疗3个月和6个月后，进行了全面的临床、生物学和辅助临床评估，包括胸部X光、超声心动图、同位素心室造影和24小时心电图检查。安慰剂组有2例患者在6个月时未重新评估。根据纽约心脏协会（NYHA）分级，TMZ组所有患者的临床状况均有改善，安慰剂组9例患者中有8例病情恶化（p<0.001）。TMZ可使同位素每搏输出量保持稳定，而安慰剂则使其恶化。TMZ可使心脏容积减小，而安慰剂则使其增加。TMZ对晚期缺血性心肌病在临床和功能方面有益。
