Yu.N. FEDULAEV¹, O.N. ANDREEVA¹, V.V. LOMAYCHIKOV¹, A.V. BABAYEV², А.G. BILICH², A.G. RODICHKINA²

¹Russian National Research Medical University named after N.I. Pirogov, 1 Ostrovityanov Str., Moscow, Russian Federation, 117997

²City Clinical Hospital № 13, 1/1 Velozavodskaya Str., Moscow, Russian Federation, 115280

Fedulaev Yu.N. ― D. Med. Sc., Professor, Head of the Department of Faculty Therapy

Andreeva O.N. ― Cand. Med. Sc., Associate Professor

Lomaychikov V.V. ― Assistant Lecturer of the Department, therapist

Babayev A.V. ― Assistant Lecturer

Bilich A.G. ― Cand. Med. Sc., Associate Professor

Rodichkina A.G. ― doctor of functional diagnostics

The use of trimetazidine in patients with coronary heart disease has proven its effectiveness not only by influencing the indicators of pain and painless myocardial ischemia, but also by increasing the exercise tolerance, as well as increasing the global contractility of the left ventricle and reducing arrhythmic manifestations. However, the effectiveness of cytoprotective therapy in patients with relative coronary insufficiency remains underestimated.

The aim of the study was to evaluate the effect of Trimetazidine (Daredorm MV 70 mg) on the volume and speed of the left ventricle filling, the number of ventricular extrasystoles in patients with relative coronary insufficiency on the background of left ventricular hypertrophy.

Materials and methods. 66 patients with hypertensive disease were examined, who, according to echocardiography, had moderate left ventricular hypertrophy and fully preserved systolic function, while the diastolic dysfunction of the left ventricle in the form of impaired relaxation and pseudonormalization was revealed in terms of transmittal blood flow. Holter monitoring of the electrocardiogram with evaluation of proarrhythmic markers (cardiac rhythm turbulence and T wave microalternations) was performed. The basic therapy of hypertension was supplemented with a 3-month application of trimetazidine 70 mg once a day (Depenorm MB 70 mg of CJSC «Canonpharma Production»). The control group consisted of 59 hypertensive patients with comparable parameters of myocardial hypertrophy and left ventricular systolic function, as well as similar characteristics of transmittral blood flow. The patients took an antihypertensive therapy in accordance with the National Recommendations for diagnosis and treatment of patients with arterial hypertension.

Results. A strong correlation was found between the characteristics of transmittal blood flow, quantitative characteristics of ventricular extrasystole and proarrhythmic markers in the form of turbulence of the heart rhythm and microalternations of the T wave. Doppler indices in patients with traditional therapy did not change significantly.

Conclusions. The inclusion of trimetazidine (Deprenorm MG 70 mg once daily) in the treatment of hypertension led to a significant improvement in the majority of amplitude and temporal characteristics of transmittral blood flow in patients with impaired relaxation.

Key words: hypertension, myocardial hypertrophy of the left ventricle, the relative coronary insufficiency, diastolic dysfunction of the left ventricle, heart rate turbulence, microalternation of T wave, trimetazidine, Deprenorm MV 70 mg.