Effect of trimetazidine in the treatment of myocardial ischemia-reperfusion injury

ZHANG Guoyong; ZHANG Po; GAO Ying; GUO Xinying; JIANG Xue; GUO Caixia

doi:10.7619/jcmp.20221532

Journal of Clinical Medicine in Practice > 2022 > 26(16): 71-75, 81. > DOI: 10.7619/jcmp.20221532

ZHANG Guoyong, ZHANG Po, GAO Ying, GUO Xinying, JIANG Xue, GUO Caixia. Effect of trimetazidine in the treatment of myocardial ischemia-reperfusion injury[J]. Journal of Clinical Medicine in Practice, 2022, 26(16): 71-75, 81. DOI: 10.7619/jcmp.20221532

Citation:

PDF (818 KB)

Effect of trimetazidine in the treatment of myocardial ischemia-reperfusion injury

1.
Department of Cardiology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing, 100730
2.
Department of Cardiology, the 989th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Luoyang, Henan, 471000

More Information

Received Date: May 12, 2022
Available Online: July 26, 2022

Graphical Abstract

Abstract

Abstract

Objective
To observe the efficacy of trimetazidine in the treatment of patients with myocardial ischemia-reperfusion injury.
Methods
A total of 90 patients with myocardial ischemia-reperfusion injury were randomly divided into control group and study group, with 45 cases in each group. The control group was treated with routine treatment, while the study group was treated with routine treatment and trimetazidine. Before and after treatment, the levels of myocardial oxygen radical injury indexes levels[glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde (MDA), total antioxidant capacity (T-AOC)], inflammatory indexes levels[nuclear factor κB (NF-κB), Toll-like receptor 2 (TLR2), hypersensitive C-reactive protein (hs-CRP)], myocardial injury indexes [anti-apoptotic protein B-cell lymphoma factor-2 (Bcl-2), protease activated receptor-2 (PAR-2), cardiac troponin I (cTnI), creatine kinase MB isoenzyme (CK-MB), autophagy gene Beclin1, ischemia modified albumin (IMA)], cardiac function indexes levels[left ventricular ejection fraction (LVEF), maximum early diastolic flow velocity of mitral valve (EV), left ventricular end diastolic diameter (LVEDd)] and clinical efficacy were compared between two groups.
Results
After treatment, the levels of MDA, NF-κB, TLR2, hs-CRP, PAR-2, Beclin1, cTnI, IMA, CK-MB and LVEDd in the study group were significantly lower than those in the control group, while the levels of GSH-Px, SOD, T-AOC, Bcl-2, LVEF and EV were significantly higher than those in the control group (P < 0.05). The total effective rate of treatment in the study group was 97.78%, which was significantly higher than 86.67% of the control group (P < 0.05).
Conclusion
Trimetazidine is safe and effective in the treatment of patients with myocardial ischemia-reperfusion injury, which can inhibit the level of oxygen radical, alleviate myocardial peroxidation injury, inhibit the levels of inflammation related factors, reduce the levels of PAR-2 and Beclin1, increase the Bcl-2 level, and improve cardiac function.

FullText(HTML)

References (26)

References

[1]	LI J, ZHAO C T, ZHU Q, et al. Sweroside protects against myocardial ischemia-reperfusion injury by inhibiting oxidative stress and pyroptosis partially via modulation of the Keap1/Nrf2 axis[J]. Front Cardiovasc Med, 2021, 8: 650368. doi: 10.3389/fcvm.2021.650368
[2]	ZHANG J, LUO C J, XIONG X Q, et al. miR-21-5p-expressing bone marrow mesenchymal stem cells alleviate myocardial ischemia/reperfusion injury by regulating the circRNA_0031672/miR-21-5p/programmed cell death protein 4 pathway[J]. J Geriatr Cardiol, 2021, 18(12): 1029-1043.
[3]	邹青, 卢少平, 张明明, 等. FIB和TNF-α联合检测对冠心病患者PCI术后心肌缺血再灌注损伤的预测价值[J]. 临床误诊误治, 2021, 34(6): 71-75. doi: 10.3969/j.issn.1002-3429.2021.06.015
[4]	胡晓星, 孙婧, 杨国红, 等. 培哚普利联合新活素减轻冠脉介入对心肌缺血再灌注的损伤研究[J]. 长春中医药大学学报, 2020, 36(5): 968-970. https://www.cnki.com.cn/Article/CJFDTOTAL-CZXX202005038.htm
[5]	ZHENG W Q, LIU C. The cystathionine γ-lyase/hydrogen sulfide pathway mediates the trimetazidine-induced protection of H9c2 cells against hypoxia/reoxygenation-induced apoptosis and oxidative stress[J]. Anatol J Cardiol, 2019, 22(3): 102-111.
[6]	能海霞. 通脉养心汤联合曲美他嗪对冠心病介入术后心肌缺血再灌注损伤患者cTnI、CK-MB、IMA、SOD、MMP-9水平的影响[J]. 环球中医药, 2018, 11(11): 1790-1793. doi: 10.3969/j.issn.1674-1749.2018.11.045
[7]	ZHU H, ZHOU H. Novel insight into the role of endoplasmic Reticulum stress in the pathogenesis of myocardial ischemia-reperfusion injury[J]. Oxid Med Cell Longev, 2021, 2021: 5529810.
[8]	ZHENG W Y, XIE Q, ZHANG Z G, et al. Inhibited HDAC3 or elevated microRNA-494-3p plays a protective role in myocardial ischemia-reperfusion injury via suppression of BRD4[J]. Mol Neurobiol, 2021, 58(9): 4268-4279. doi: 10.1007/s12035-021-02369-y
[9]	LI Q, LI Z Q, FAN Z X, et al. Involvement of non-coding RNAs in the pathogenesis of myocardial ischemia/reperfusion injury (Review)[J]. Int J Mol Med, 2021, 47(4): 42. doi: 10.3892/ijmm.2021.4875
[10]	何贵新, 冯雨菲, 秦伟彬, 等. MiRNA155-DNA甲基化介导mitoKATP调节线粒体自噬在芪参益气滴丸改善心肌缺血再灌注损伤中的分子机制理论探讨[J]. 海南医学院学报, 2022, 28(5): 394-400. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYY202205012.htm
[11]	陈乘波, 陈天宝, 许友榜. 川芎嗪通过JAK2/STAT3信号通路调节线粒体自噬减轻心肌缺血再灌注损伤的机制研究[J]. 中国免疫学杂志, 2021, 37(7): 819-823. doi: 10.3969/j.issn.1000-484X.2021.07.009
[12]	刘瑞, 刘璐, 郭鹏. 心肌缺血再灌注损伤的发病机制及其防治策略[J]. 世界最新医学信息文摘, 2019, 19(6): 73-74. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201906034.htm
[13]	陈晨. 曲美他嗪及缺血后处理对心肌缺血再灌注损伤的保护作用及潜在机制[D]. 福州: 福建医科大学, 2021.
[14]	WANG C, CHEN W W, YU M, et al. Efficacy of trimetazidine in limiting periprocedural myocardial injury in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis[J]. Angiology, 2021, 72(6): 511-523. doi: 10.1177/0003319720987745
[15]	AMINI N, SARKAKI A, DIANAT M, et al. Protective effects of naringin and trimetazidine on remote effect of acute renal injury on oxidative stress and myocardial injury through Nrf-2 regulation[J]. Pharmacol Rep, 2019, 71(6): 1059-1066. doi: 10.1016/j.pharep.2019.06.007
[16]	ZHOU L Y, ZHAI M, HUANG Y, et al. The circular RNA ACR attenuates myocardial ischemia/reperfusion injury by suppressing autophagy via modulation of the Pink1/FAM65B pathway[J]. Cell Death Differ, 2019, 26(7): 1299-1315. doi: 10.1038/s41418-018-0206-4
[17]	刘耀武. 四逆汤联合溶栓治疗急性心肌梗死缺血再灌注损伤及对患者动态心电图和SOD、CK-MB、LDH的影响[J]. 陕西中医, 2019, 40(7): 858-860. doi: 10.3969/j.issn.1000-7369.2019.07.012
[18]	范致星, 张伟, 唐艳红, 等. 人参皂苷Rh2对大鼠心肌缺血再灌注损伤中NLRP3、IL-1β、TNF-α表达及SOD活性的影响研究[J]. 中国中医急症, 2021, 30(9): 1541-1544, 1549. doi: 10.3969/j.issn.1004-745X.2021.09.09
[19]	赵桂峰, 张运娇, 唐耿义. 基于NF-κB信号通路探讨中医药防治心肌缺血再灌注损伤的研究进展[J]. 天津中医药, 2018, 35(9): 714-717. https://www.cnki.com.cn/Article/CJFDTOTAL-TJZY201809020.htm
[20]	黎真真, 陈飞任, 吴红发, 等. 异丙酚对心肌缺血再灌注损伤大鼠模型Toll样受体4及高迁移率族蛋白1表达的影响[J]. 实用临床医药杂志, 2021, 25(3): 13-18. doi: 10.7619/jcmp.20201602
[21]	贺素红, 户学敏, 胡金涛, 等. 尼可地尔联合丹红注射液治疗对经皮冠状动脉介入术后心肌缺血再灌注损伤、氧化应激反应、免疫细胞因子影响的临床观察[J]. 临床和实验医学杂志, 2020, 19(19): 2033-2037. doi: 10.3969/j.issn.1671-4695.2020.19.005
[22]	ZHONG B H, MA S T, WANG D H. Protease-activated receptor 2 protects against myocardial ischemia-reperfusion injury through the lipoxygenase pathway and TRPV₁ channels[J]. Exp Ther Med, 2019, 18(5): 3636-3642.
[23]	ZHENG Y J, GU S S, LI X X, et al. Berbamine postconditioning protects the heart from ischemia/reperfusion injury through modulation of autophagy[J]. Cell Death Dis, 2017, 8(2): e2577. doi: 10.1038/cddis.2017.7
[24]	TAN C F, WANG C, DU L, et al. Effect of electroacupuncture and moxibustion pretreatment on expression of autophagy related proteins LC 3 and beclin 1 in rats with myocardial ischemia-reperfusion injury[J]. Acupunct Res, 2018, 43(1): 1-7.
[25]	李武, 蒋全睿, 张婉娟, 等. 按法刺激心俞、大杼对缺血再灌注损伤模型兔血清心肌肌钙蛋白、磷酸肌酸激酶同工酶水平的影响[J]. 辽宁中医杂志, 2020, 47(9): 188-191, 228. https://www.cnki.com.cn/Article/CJFDTOTAL-LNZY202009059.htm
[26]	靳绵绵. 缺血修饰白蛋白对STEMI病人溶栓后早期PCI术后继发心肌缺血再灌注损伤的风险评估价值[J]. 中西医结合心脑血管病杂志, 2018, 16(24): 3659-3663. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY201824024.htm

[1]	WU Miao, CHEN Xing, NIU Jingfen, WANG Jun. Effect and mechanism of remimazolam on retinal ischemia-reperfusion injury in rats[J]. Journal of Clinical Medicine in Practice, 2025, 29(4): 16-22. DOI: 10.7619/jcmp.20245427
[2]	XIONG Huazhao, YAN Mingquan, XIAO Weiming, ZHANG Siqin. Differential expression and core genes mining of mitophagy-related genes in stomach adenocarcinoma[J]. Journal of Clinical Medicine in Practice, 2023, 27(19): 1-6, 11. DOI: 10.7619/jcmp.20231748
[3]	SHENG Yuping, MA Xiaoying, SUN Fuyun, YANG Xingmeng, WANG Na, ZHANG Haoran, XU Haiping. Correlations of platelet-derived growth factor and Beclin1 with vascular calcification in hemodialysis patients[J]. Journal of Clinical Medicine in Practice, 2022, 26(21): 60-64. DOI: 10.7619/jcmp.20221842
[4]	CAO Juan, WANG Hongyi, WANG Lixin, CHEN Xiaoning, LIN Qiu, YANG Qinghong, CHEN Dongzhui, FU Yuxiu. Effects of electroacupuncture on hippocampal neuron autophagy and IGF-1/PI3K/Akt pathway in rats with hypoxic-ischemic brain damage[J]. Journal of Clinical Medicine in Practice, 2022, 26(14): 38-45. DOI: 10.7619/jcmp.20214746
[5]	XU Huafen, FENG Qiong, LI Chunlei. Expressions of matrix metalloproteinase-16, autophagy-related gene 5 and autophagy-related gene 7 in children with bronchial asthma and their correlations with pulmonary function[J]. Journal of Clinical Medicine in Practice, 2022, 26(9): 35-39. DOI: 10.7619/jcmp.20214839
[6]	LI Zhenzhen, CHEN Feiren, WU Hongfa, ZHONG Youqing. Influence of propofol on expressions of Toll-like receptor 4 and high mobility group box 1 in the rat model of myocardial ischemia reperfusion injury[J]. Journal of Clinical Medicine in Practice, 2021, 25(3): 13-18. DOI: 10.7619/jcmp.20201602
[7]	YU Xin, MI Zhihua, GAO Ju. Role of autophagy in apoptosis of neurons in brain tissue of rats induced by mechanical ventilation[J]. Journal of Clinical Medicine in Practice, 2019, 23(8): 12-15, 21. DOI: 10.7619/jcmp.201908003
[8]	LU Xia, LI Junlin, WANG Yafei, LI Li. Correlation between PTEN and Beclin1 in Xinjiang Uygur and Han population with endometriosis[J]. Journal of Clinical Medicine in Practice, 2017, (24): 13-15. DOI: 10.7619/jcmp.201724004
[9]	HUANG Huairong, HU Fanrong. Correlation between macrophage inflammation protein-1α as well as tumor necrosis factor-α in gingival sulcus fluid and the condition of chronic periodontitis and its therapeutic efficacy[J]. Journal of Clinical Medicine in Practice, 2017, (17): 42-44. DOI: 10.7619/jcmp.201717012
[10]	Protective effect of different dose of 1,25-dihydroxyvitamin preconditioningon focal cerebral ischemia reperfusion injury[J]. Journal of Clinical Medicine in Practice, 2015, (9): 28-31. DOI: 10.7619/jcmp.201509008

Cited By

Cited by

Periodical cited type(3)

1.	方海鹰，张琳倩. 胃液及外周血总胆汁酸在儿童胆汁反流性胃炎诊断中的价值. 中华全科医学. 2024(10): 1718-1721+1749 .
2.	张婉玲，何婉笑，唐剑峰，黄礼云. 血清胃蛋白酶原检测在慢性萎缩性胃炎诊断中的应用价值分析. 中国社区医师. 2024(33): 110-112 .
3.	石敬斌. 瑞巴派特联合伊托必利对慢性萎缩性胃炎患者的影响. 中外医学研究. 2023(12): 57-60 .

Other cited types(0)

Get Citation

PDF

XML

Article views (216) PDF downloads (15) Cited by(3)

Turn off MathJax

Article Contents

Abstract

References

Effect of trimetazidine in the treatment of myocardial ischemia-reperfusion injury

Abstract

References

Related Articles

Cited by

Periodical cited type(3)

Other cited types(0)

Catalog

Effect of trimetazidine in the treatment of myocardial ischemia-reperfusion injury

Abstract

References

Related Articles

Cited by

Periodical cited type(3)

Other cited types(0)

Catalog

Export File

Citation

Format

Content