Shi Wenjing, Cui Juan, Chen Chunyan
Department of Cardiovascular, The Third Affiliated Hospital of Zhejiang Chinese Medical University, No. 219 Moganshan Road, Hangzhou, 310005, Zhejiang, China.
Gen Thorac Cardiovasc Surg. 2025 Jun 17. doi: 10.1007/s11748-025-02171-w.
Ischemic cardiomyopathy (ICM) is a late manifestation of coronary artery disease, marked by significant deterioration of cardiac pump function and abnormal ventricular remodeling. Current therapies have limitations, driving the search for novel approaches, especially targeting myocardial metabolism, as a key research focus.
This study aims to systematically evaluate the effects of Trimetazidine (TMZ) on improving cardiac function and delaying ventricular remodeling in patients with ICM.
Relevant literature was retrieved from five databases: PubMed, Embase, Web of Science, Cochrane Central, and CNKI, covering all studies published to date. A meta-analysis was conducted to assess the impact of trimetazidine on LVEF, E/A ratio, wall motion index, LVEDD, and LVESD, using standardized mean differences (SMD) as the effect measure and calculating the 95% CI.
A total of 9 studies involving 1037 patients were included. The meta-analysis results showed that the LVEF in the trimetazidine treatment group was significantly higher than that in the control group (SMD = 0.64, 95% CI: [0.30, 0.97], p < 0.0001). The E/A ratio and wall motion index also showed improvement (SMD = 0.20, 95% CI: [0.03, 0.36]; SMD = - 0.54, 95% CI: [- 0.78, - 0.29]). However, the effects of trimetazidine on LVEDD and LVESD were not significant (SMD = - 0.36, 95% CI [- 1.09, 0.36]; SMD = - 0.03, 95% CI [- 1.12, 1.07]).
TMZ can effectively improve cardiac function in patients with ischemic cardiomyopathy, but its impact on ventricular remodeling is limited. Future research should further explore its application in the treatment of ICM.
缺血性心肌病（ICM）是冠状动脉疾病的晚期表现，其特征为心脏泵功能显著恶化和心室重塑异常。当前的治疗方法存在局限性，这促使人们寻找新的方法，特别是将心肌代谢作为关键研究重点。
本研究旨在系统评估曲美他嗪（TMZ）对改善缺血性心肌病患者心功能和延缓心室重塑的效果。
从五个数据库检索相关文献：PubMed、Embase、Web of Science、Cochrane Central和CNKI，涵盖截至目前发表的所有研究。进行荟萃分析以评估曲美他嗪对左心室射血分数（LVEF）、E/A比值、室壁运动指数、左心室舒张末期内径（LVEDD）和左心室收缩末期内径（LVESD）的影响，采用标准化均数差（SMD）作为效应量并计算95%置信区间（CI）。
共纳入9项研究，涉及1037例患者。荟萃分析结果显示，曲美他嗪治疗组的LVEF显著高于对照组（SMD = 0.64，95% CI：[0.30, 0.97]，p < 0.0001）。E/A比值和室壁运动指数也有所改善（SMD = 0.20，95% CI：[0.03, 0.36]；SMD = -0.54，95% CI：[-0.78, -0.29]）。然而，曲美他嗪对LVEDD和LVESD的影响不显著（SMD = -0.36，95% CI [-1.09, 0.36]；SMD = -0.03，95% CI [-1.12, 1.07]）。
TMZ可有效改善缺血性心肌病患者的心功能，但其对心室重塑的影响有限。未来研究应进一步探索其在缺血性心肌病治疗中的应用。
