TRIMETAZIDINE THERAPY INFLUENCE ON HEART RATE VARIABILITY IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE

Abstract

Aim. To study the influence of metabolic cytoprotector trimetazidine on the heart rate variability (HRV) in patients with stable ischemic heart disease (CHD).Material and methods. Into the simple, prospective, non-randomized trial totally 50 patients included with stable CHD, continuously showed positive stress test on treadmill. HRV was investigated on the short episodes of recording (the device and software of MEDASS, Russia) before and after 4-month therapy by trimetazidine 35 mg BID in supine position and during the 10-minute active ortostatic test. The temporal and frequency parameters of HRV were assessed.Results. HRV in CHD patients is decreased and the prominence of the decrease depends upon gender, age, diabetes mellitus and ejection fraction. After the shift from supine to upright position with normal reaction of heartrate there was decrease of RR-interval moda and normalized value in the area of high-frequency component, the vegetative balance index increased, as the centralization index, that shows on the decrease of parasympathetic influence. While being treated by trimetazidine the HRV parameters were increased in the temporal area – variational amplitude between maximal and minimal values, also there was decrease (improvement) of vegetative balance index and index of regulatory systems tension.Conclusion. Trimetazidine in patients with stable CHD increases the decreased at baseline HRV and normalizes the reaction on ortostatic test. Its effects can be explained by the decrease of ischemia, oxidative stress and improvement of nitric oxide bioavailability.

Keywords

• stable angina heart rate variability
• ortostatic test
• trimetazidine