Abstract
Metabolic modulation during myocardial ischemia is possible by the use of specific drugs, which may induce a shift from free fatty acid towards predominantly glucose utilization by the myocardium to increase ATP generation per unit oxygen consumption. Three agents (trimetazidine, ranolazine, and perhexiline) have well-documented anti-ischaemic effects. However, perhexiline, the most potent agent currently available, requires plasma-level monitoring to avoid hepatoneuro- toxicity. Besides, the long-term safety of trimetazidine and ranolazine has yet to be established. In addition to their effect in ischemia, the potential use of these drugs in chronic heart failure is gaining recognition as clinical and experimental data are showing the improvement of myocardial function following treatment with several of them, even in the absence of ischemia. Future applications for this line of treatment is promising and deserves additional research. In particular, large, randomised, controlled trials investigating the effects of these agents on mortality and hospitalization rates due to coronary artery disease are needed.
Keywords: Metabolic modulation, cardiac ischemia, myocardial infarct, reperfusion, ischemic preconditioning
Current Pharmaceutical Design
Title: Modulation of Cardiac Metabolism During Myocardial Ischemia
Volume: 14 Issue: 25
Author(s): Antonio C.P. Chagas, Paulo M.M. Dourado and Tatiana de Fatima Goncalves Galvao
Affiliation:
Keywords: Metabolic modulation, cardiac ischemia, myocardial infarct, reperfusion, ischemic preconditioning
Abstract: Metabolic modulation during myocardial ischemia is possible by the use of specific drugs, which may induce a shift from free fatty acid towards predominantly glucose utilization by the myocardium to increase ATP generation per unit oxygen consumption. Three agents (trimetazidine, ranolazine, and perhexiline) have well-documented anti-ischaemic effects. However, perhexiline, the most potent agent currently available, requires plasma-level monitoring to avoid hepatoneuro- toxicity. Besides, the long-term safety of trimetazidine and ranolazine has yet to be established. In addition to their effect in ischemia, the potential use of these drugs in chronic heart failure is gaining recognition as clinical and experimental data are showing the improvement of myocardial function following treatment with several of them, even in the absence of ischemia. Future applications for this line of treatment is promising and deserves additional research. In particular, large, randomised, controlled trials investigating the effects of these agents on mortality and hospitalization rates due to coronary artery disease are needed.
Export Options
About this article
Cite this article as:
Chagas C.P. Antonio, Dourado M.M. Paulo and Goncalves Galvao de Fatima Tatiana, Modulation of Cardiac Metabolism During Myocardial Ischemia, Current Pharmaceutical Design 2008; 14 (25) . https://dx.doi.org/10.2174/138161208786071236
DOI https://dx.doi.org/10.2174/138161208786071236 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Antithrombotic Treatment in Diabetes Mellitus: A Review of the Literature about Antiplatelet and Anticoagulation Strategies Used for Diabetic Patients in Primary and Secondary Prevention
Current Pharmaceutical Design New Sides of Aldosterone Action in Cardiovascular System as Potential Targets for Therapeutic Intervention
Current Drug Targets Mineralocorticoid Receptor Antagonists in Primary Aldosteronism
Current Pharmaceutical Design Treatment of Tachycardia in Hypertension: Where Do We Stand Now?
Current Hypertension Reviews Anorexia Nervosa and the Use of Total Parenteral Nutrition Refeeding
Current Nutrition & Food Science Approaches to the Management of Acute Kidney Injury in Children
Recent Patents on Biomarkers Acute Coronary Syndromes as Auto-Inflammatory Disorders
Current Pharmaceutical Design Cellular Mechanisms of Bypass Vein Graft Arterialization and Approaches to Attenuate Graft Remodeling
Vascular Disease Prevention (Discontinued) Myocardial Infarction. Pathological Relevance and Relationship with Coronary Risk Factors
Current Pharmaceutical Design The Role of Endothelial Progenitor Cells and Statins in Endothelial Function: A Review
Cardiovascular & Hematological Agents in Medicinal Chemistry Redox mechanisms in pathological angiogenesis in the retina: roles for NADPH oxidase
Current Pharmaceutical Design Mitochondrial MMP Activation, Dysfunction and Arrhythmogenesis in Hyperhomocysteinemia
Current Vascular Pharmacology Significance of P2X7 Receptor Variants to Human Health and Disease
Recent Patents on DNA & Gene Sequences Neurotoxicity by Synthetic Androgen Steroids: Oxidative Stress, Apoptosis, and Neuropathology: A Review
Current Neuropharmacology Incretin-Based Therapies, Glucometabolic Health and Endovascular Inflammation
Current Pharmaceutical Design The Roles of Phosphodiesterase 2 in the Central Nervous and Peripheral Systems
Current Pharmaceutical Design Current Evaluation of the Millennium Phytomedicine- Ginseng (II): Collected Chemical Entities, Modern Pharmacology, and Clinical Applications Emanated from Traditional Chinese Medicine
Current Medicinal Chemistry Cyclic Nucleotide and Protein Kinase Signaling in Hypertensive Pulmonary Arterial Smooth Muscle
Current Respiratory Medicine Reviews Bilosomes: A Novel Approach to Meet the Challenges in Oral Immunization
Recent Patents on Drug Delivery & Formulation Editorial [Hot topic: MDMA (Ecstasy) Toxicity: Pharmacokinetic, Metabolism, Cell Response and Pathological Consequences (Guest Editor: Vittorio Fineschi)]
Current Pharmaceutical Biotechnology