Cardiology Letters 2014, 23(4):275-281

Ischaemic heart disease - can it be treated by influencing cardiac metabolism?

Murín J

I. interná klinika LFUK a UN Bratislava, Nemocnica Staré mesto, Bratislava, Slovenská republika

The heart is in need of a sufficient amount of energy in the form of adenosine triphosphate (ATP) for performance of its myocytes. The production of ATP needs the supply of energetic substrates, mostly of free fatty acids and glucose, but also of oxygen to the myocytes (their mitochondria). Here ATP is produced by oxydative phosphorylation and is transported to the contractile apparatus. In diabetes, in left ventricular hypertrophy and in elderly people there is a myocardial dysfunction in production of ATP and this dysfunction is greatest in cases of myocardial ischaemia. There are pharmacological possibilities to shift ATP production in the myocytes from a less efficient form to a more efficient (shifting the fuel from free fatty acids to glucose). Among these pharmacological possibilities treatment with trimetazidine has a great place, which is supported by the results (efficiency and safety) of many clinical studies. This treatment can influence positively ischaemic symptoms/signs and can improve prognosis. Ref. 52, Online full text (Free, PDF) www. cardiology.sk

Keywords: ischaemic heart disease; energetic metabolism of myocytes; ATP production trimetazidine

Published: April 1, 2014  Show citation