Trimetazidine improves myocardial perfusion and left ventricular function in ischemic left ventricular dysfunction

Trimetazidine (TMZ) has an antiischemic effect unrelated to changes in myocardial oxygen supply-to-demand ratio. TMZ improves energy metabolism during ischemia and protects myocardial cells against ischemic damage to mitochondrial function. The preserved mitochondrial metabolism might explain the increased cardiac uptake of Tc-99m tetrofosmin or Tc-99m sestamibi on myocardial SPECT in patients with coronary artery disease. Oral administration of TMZ might improve myocardial uptake of Tc-99m tetrofosmin and left ventricular function in ischemic cardiac dysfunction. Treatment with TMZ before myocardial Tc-99m tetrofosmin SPECT could help in revealing hibernating myocardium.