Heart failure & cardiomyopathies
Trimetazidine in Heart Failure with Preserved Ejection Fraction: A Randomized Controlled Cross-Over Trial
Primary result · Pulmonary capillary wedge pressure over multiple levels of exerciseResult — go to the resultMean change 0 mmHg 95% CI −2 to 2Authors' conclusion
Trimetazidine did not improve myocardial energy homeostasis and did not improve exercise haemodynamics in patients with HFpEF.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) confirmed by (exercise) right heart catheterizationcross-over
- Participants
- 25 patients
- Comparison
- Trimetazidine vs placebo
- Primary endpoint
- Change in pulmonary capillary wedge pressure at multiple stages of bicycling exercise (right heart catheterization)
- Follow-up
- 3 months
Methodological detailsphase II, single-centre, double-blind, placebo-controlled, cross-over
- Phase II
- Single-centre
- Double-blind
- Placebo-controlled
- Cross-over
Primary result
As reported in the abstract
Pulmonary capillary wedge pressure over multiple levels of exercise
Mean change
0 mmHg
95% CI −2 to 2
P = 0.60
Trimetazidinevs Placebo
mean change 0 mmHg (95% CI −2 to 2); P = 0.60
Secondary outcomes
| Outcome | Trimetazidine | Placebo | P value |
|---|---|---|---|
| Myocardial phosphocreatine/ATP (31P MR spectroscopy)Similar to placebo | 1.08 (interval 0.76–1.76) | 1.30 (interval 0.95–1.86) | P = 0.08 |
| 6-min walking distance (exploratory)Mean change, m | −6 (95% CI −18–7) | −5 (95% CI −22–22) | P = 0.93 |
| NT-proBNP (exploratory) | 5 (interval −156–166) ng/L | −13 (interval −172–147) ng/L | P = 0.70 |
Quality of life (KCCQ, EQ-5D-5L) (exploratory)
- No change in KCCQ
- P = 0.78
- No change in EQ-5D-5L
- P = 0.51
Diastolic function (echocardiography, CMR) and metabolic parameters (exploratory)
- No change by trimetazidine vs placebo
Original publication
Trimetazidine in Heart Failure with Preserved Ejection Fraction: A Randomized Controlled Cross-Over Trial. ESC Heart Fail. Published 2 August 2023. doi:10.
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