Introduction : Adjunctive Trimetazidine (TMZ) is known to improve symptoms of heart failure (HF), but its mechanistic effects on cardioprotection are not fully understood. This study evaluated whether adjunctive TMZ therapy improves left ventricular ejection fraction (LVEF) and alters plasma biomarkers in patients with heart failure with reduced ejection fraction (HFrEF) compared to standard HF therapy (STD).
Methods : In this single-center observational study, 60 HFrEF patients were divided into two groups: TMZ + STD (n = 30) and STD alone (n = 30). LVEF was assessed by echocardiography, and biomarkers including visfatin, asymmetric dimethylarginine (ADMA), nicotinamide adenine dinucleotide (NAD+), reduced and oxidized glutathione (GSH and GSSG), and sirtuin1 (sirt1) mRNA were measured. Correlations between LVEF and biomarkers were analyzed.
RESULTS : LVEF was significantly higher in the TMZ + STD group compared to STD alone. Plasma levels of visfatin, ADMA, and GSSG decreased, while NAD+, GSH, and sirt1 mRNA levels increased in the TMZ + STD group. Negative correlations were observed between LVEF and visfatin, ADMA, and GSSG, while positive correlations were found with NAD+, GSH, and sirt1 mRNA.
CONCLUSION : Adjunctive TMZ therapy enhances cardiac function by improving LVEF and modulating biomarkers associated with oxidative stress, inflammation, and myocardial remodeling. These findings suggest TMZ’s potential to optimize biomarker profiles and provide cardioprotection in HFrEF patients.