Beneficial effects of trimetazidine (VastarelMR) in patients with chronic heart failure

The possibility of modifying cardiac metabolism by switching the fuel used by the myocardium could become increasingly important, especially in clinical conditions characterized by reduced energy availability, such as heart failure. Trimetazidine (VastarelMR), an inhibitor of free fatty acid (FFA) oxidation, holds the characteristics to play a fundamental role in the therapeutic strategy of patients with heart failure. More specifically, shifting the energy substrate preference away from FFA metabolism and toward glucose metabolism has been shown to be an effective adjunctive treatment in terms of myocardial metabolism and left ventricular function improvement. These effects seem operative in heart failure syndromes regardless of their etiopathogenetic cause and are not confined to those of ischemic origin. In this paper, the recent literature on the beneficial therapeutic effects of trimetazidine on left ventricular dysfunction and heart failure is reviewed and discussed.