Effects of Trimetazidine on Rat Heart Muscle during Hypoxia and Reperfusion
Main Article Content
Abstract
Abstract
Objective: Trimetazidine (TMZ) is a cardioprotective drug with anti-ischemic and anti-hypoxic metabolic actions. This study aims to investigate the impact of TMZ on the contractile and recovery properties of isolated papillary heart muscle under normoxic and hypoxic conditions.
Methods: Left ventricular papillary muscles were harvested from 40 Wistar rats. After a 10-minute equilibration period in a normoxic bath, contractile and relaxation responses were recorded in normoxic and hypoxic baths with varying concentrations of TMZ (0 M, 5 x 10–6 M, and 5 x 10-5 M). The specimens were then re-perfused with oxygenated Krebs-Henseleit solution (95% O2 and 5% CO2) and equilibrated for 10 minutes in a normoxic bath. Recovery contractile and relaxation responses were measured.
Results: Both doses of TMZ had a negative inotropic effect on muscle (p < 0.001), resulting in a limited decline in biomechanical performance in the hypoxic bath (p < 0.001). However, both doses of TMZ also increased the recovery biomechanical performance compared to the control group (p < 0.001).
Conclusions: Under normoxic conditions, TMZ pretreatment alone did not show any cardioprotective effect. However, adding TMZ at a concentration of 5 x 10-6 M, a therapeutic level in humans, reduced ischemic contracture and improved postischemic recovery of contraction forces in both pretreated and control groups. Despite trimetazidine's negative inotropic effect under normoxic conditions, near-therapeutic doses of the drug have significant protective effects on isolated papillary heart muscle contractility, leading to improved contractile function under hypoxic conditions.
Downloads
Article Details
Copyright (c) 2024 Emre M, et al.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Kantor PF, Lucien A, Kozak R, Lopaschuk GD. The Antianginal drug trimetazidine shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3- ketoacyl coenzyme a thiolase. Cir Res. 2000; 86: 580-588. Available from: https://doi.org/10.1161/01.res.86.5.580
Marzilli M. Cardioprotective effects of trimetazidine: a review. Curr Med Res and Opinion. 2003; 19(7):661-672. Available from: https://doi.org/10.1185/030079903125002261
Guarneieri C, Finelly C, Zini M, Muscari C. Effects of trimetazidine on the calcium transport and oxidative phosphorylation of isolated rat heart mitochondria. Basic Res Cardiol. 1997; 92: 90-95. Available from: https://doi.org/10.1007/bf00805569
Rossi A, Lavanchy N, Martin J. Anti-ischemic effects of trimetazidine: 31P-NMR spectroscopy study in the isolated rat heart. Cardiovasc Drugs and Ther. 1990; 4 (Suppl 4): 812-813. Available from: https://doi.org/10.1007/bf00051281
Hugtenburg JG, Jap TJ, Mathy MJ, van Heiningen PN, Bohnenn VA, Heijnis JB, et al. Cardioprotective effect of trimetazidine and nifedipine in guinea–pig hearts subjected to ischemia. Arch Int Pharmachodyn. 1989; 300: 186-208. Available from: https://pubmed.ncbi.nlm.nih.gov/2559668/
Fantini E, Athias P, Demaison L, Grynberg A. Protective effects of trimetazidine on hypoxic cardiac myocytes from rats. Fund Clin Pharmacol. 1997; 11: 427-439. Available from: https://doi.org/10.1111/j.1472-8206.1997.tb00205.x
Emre M, Karayaylalı İ, San M. Effects of trimetazidine and selenium on high-frequency fatigue in isolated rat diaphragm muscle. Adv in Ther. 2003; 20(5):261-269. Available from: https://doi.org/10.1007/bf02849855
Hearse DJ, Opie LH, Boucher FR. Trimetazidine and myocardial ischemic contracture in isolated rat heart. Am J Cardiol. 1995; 76: 38B-40B. Available from: https://pubmed.ncbi.nlm.nih.gov/7645526/
Humphrey SM, Gavin JB, Herdson PB. The relationship of ischemic contracture to vascular reperfusion in the isolated rat heart. J Mol Cell Cardiol.1980; 12: 1397-1406. Available from: https://doi.org/10.1016/0022-2828(80)90124-8
Boucher FR, Hearse DJ, Opie LH. Effects of trimetazidine on ischemic contracture in isolated perfused rat hearts. J Cardiovasc Pharmacol. 1994;24(1):45-49. Available from: https://doi.org/10.1097/00005344-199407000-00008
Belardinelli R, Purcaro A. Effect of trimetazidine on the contractile response of chronically dysfunctional myocardium to low-dose dobutamine in ischaemic cardiomyopathy. Eur Heart J. 2001; 22: 2164-2170. Available from: https://doi.org/10.1053/euhj.2001.2653
Shu H, Peng Y, Hang W, Zhou N and Wang DW. Trimetazidine in Heart Failure. Front. Pharmacol. 2021; 11:569132,1-10. Available from: https://doi.org/10.3389/fphar.2020.569132
Spinale FG, Mukherjee R, Fulbright BM, Hu J, Crawford FA, Zile MR. Contractile properties of isolated porcine ventricular myocytes. Cardiovasc Res. 1993; 27: 304-311. Available from: https://doi.org/10.1093/cvr/27.2.304
Kiyosue T, Nakamura S, Arita M. Effects of trimetazidine on action potentials and membrane currents of guinea-pig ventricular myocytes. Journal of Molecular and Cellular Cardiology, 1986; 18(2), 1301 – 1311. Available from: https://doi.org/10.1016/s0022-2828(86)80433-3
Minasian SM, Galagudza MM, Dmitriev YV, Kurapeev DI, Vlasov TD. Myocardial protection against global ischemia with Krebs-Henseleit buffer-based cardioplegic solution. J Cardiothorac Surg. 2013;8:60. Available from: https://doi.org/10.1186/1749-8090-8-60
Van Lunteren E, Torres A, Moyer M. Effects of hypoxia on diaphragm relaxation rate during fatigue. J Appl Physiol. 1997; 82: 1472-1478. Available from: https://doi.org/10.1152/jappl.1997.82.5.1472
Opie LH, Boucher FR. Trimetazidine and myocardial ischemic contracture in isolated rat heart. Am J Cardiol. 1995; 76: 38B-40B. Available from: https://pubmed.ncbi.nlm.nih.gov/7645526/
Allibardi S, Chierchia SL, Margonato V, Merati G, Neri G, Dell'Antonio G, Samaja M. Effects of trimetazidine on metabolic and functional recovery of post-ischemic rat hearts. Cardiovasc Drugs Ther. 1998; 12: 543-549. Available from: https://doi.org/10.1023/a:1007731219206
Veitch K, Maisin L, Hue L. Trimetazidine effects on the damage to mitochondrial functions caused by ischemia and reperfusion. Am J Cardiol. 1995; 76: 25B-30B. Available from: https://pubmed.ncbi.nlm.nih.gov/7645524/
Renaud JF. Internal pH, Na+, and Ca++ regulation by trimetazidine during cardiac cell necrosis. Cardiovasc Drug Ther. 1988; 1: 677-685. Available from: https://doi.org/10.1007/bf02125756
Rahman F, Toshima Y, Kohno H, Kinoshita K, Tokunaga K. The protective effects of trimetazidine on normothermic ischemic myocardium in rats. Jpn J Surg. 1989; 19: 346-350. Available from: https://doi.org/10.1007/bf02471411
Hisatome I, Ishiko R, Tanaka Y. Trimetazidine inhibits Na+, K+-ATPase activity, and overdrive hyperpolarization in guinea pig ventricular muscles. Eur J Pharmacol. 1991; 195: 381-388. Available from: https://doi.org/10.1016/0014-2999(91)90479-a
Morin D, Elimadi A, Sepana R. Evidence for the existence of [3H]-trimetazidine binding sites involved in the regulation of the mitochondrial permeability transition pore. Br J Pharmacol. 1998; 123: 1385-94. Available from: https://doi.org/10.1038/sj.bjp.0701755
Albengres E, Tillement JP, Louet HL, Morin D. Trimetazidine: Experimental and clinical update review. Cardiovasc Drug Rev. 1998; 16: 359-390. Available from: https://doi.org/10.1111/j.1527-3466.1998.tb00364.x
van Overschelde JLJ, Janier MF, Bergmann SR. The relative importance of myocardial energy metabolism compared with ischemic injury in isolated perfused rabbit hearts. Circ Res. 1994; 74: 817-828. Available from: https://doi.org/10.1161/01.res.74.5.817