Metabolic modulators, including trimetazidine, ranolazine, perhexiline, and etomoxir, have the potential to relieve symptoms in patients with refractory heart failure by modulating cardiac metabolism.
Do metabolic modulators improve symptoms in patients with refractory heart failure?
Metabolic modulators represent a potential adjunctive therapeutic strategy for patients with refractory heart failure by optimizing cardiac energy metabolism.
Treatment of heart failure involves management of risk factors and control of symptoms. Traditional management of heart failure involves the use of angiotensin converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, diuretics, aldosterone antagonists, and digitalis. Metabolic modulators are a newer class of drugs that benefit these patients by modulating cardiac metabolism without altering hemodynamics. They have the potential to relieve symptoms in patients with refractory heart failure who are already on optimal medical therapy. These drugs increase glucose metabolism at the expense of free fatty acid metabolism, thereby enhancing efficient use of oxygen. This review discusses the role of 4 metabolic modulators drugs that could potentially be used for heart failure therapy: trimetazidine, ranolazine, perhexiline, and etomoxir.
Palaniswamy et al. (Wed,) conducted a review in Heart failure. Metabolic modulators (trimetazidine, ranolazine, perhexiline, and etomoxir) was evaluated. Metabolic modulators, including trimetazidine, ranolazine, perhexiline, and etomoxir, have the potential to relieve symptoms in patients with refractory heart failure by modulating cardiac metabolism.
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