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
-
Modulation of Neuro-Inflammation and Vascular Response by Oxidative Stress Following Cerebral Ischemia-Reperfusion Injury
Current Medicinal Chemistry Flavonoids Influence Epigenetic-Modifying Enzyme Activity: Structure-Function Relationships and the Therapeutic Potential for Cancer
Current Medicinal Chemistry Combination of Statin Plus Renin Angiotensin System Inhibition for the Prevention or the Treatment of Atherosclerotic Cardiovascular Disease
Current Pharmaceutical Design Angiotensin-TGF-β1 Crosstalk in Human Idiopathic Pulmonary Fibrosis:Autocrine Mechanisms in Myofibroblasts and Macrophages
Current Pharmaceutical Design Tapping into Mitochondria to Find Novel Targets for Diabetes Complications
Current Drug Targets Pulmonary Hypertension in COPD: Pathophysiology and Therapeutic Targets
Current Drug Targets Protective Effects of TRPV1 Activation Against Cardiac Ischemia/ Reperfusion Injury is Blunted by Diet-Induced Obesity
Cardiovascular & Hematological Disorders-Drug Targets The Heme Oxygenase System and Type-1 Diabetes
Current Pharmaceutical Design Diabetic Cardiomyopathy and its Prevention by Metallothionein: Experimental Evidence, Possible Mechanisms and Clinical Implications
Current Medicinal Chemistry Synergistic Effect of the Combination of Novel Suberoylanilide Hydroxamic Acid Derivatives with Cisplatin on Anti-proliferation of Human Cancer Cells
Medicinal Chemistry Anticancer Properties of Flavonoids: Roles in Various Stages of Carcinogenesis
Cardiovascular & Hematological Agents in Medicinal Chemistry Beneficiary and Adverse Effects of Phytoestrogens: A Potential Constituent of Plant-based Diet
Current Pharmaceutical Design Pentraxin Level is the Key to Determine Primary Percutaneous Coronary Intervention (PCI) or Fibrinolysis
Cardiovascular & Hematological Disorders-Drug Targets Evaluating the Safety and Tolerability of Azilsartan Medoxomil Alone or in Combination With Chlorthalidone in the Management of Hypertension: A Systematic Review
Current Hypertension Reviews Stable Gastric Pentadecapeptide BPC 157-NO-system Relation
Current Pharmaceutical Design Current Management of Intermittent Claudication: The Role of Pharmacological and Nonpharmacological Symptom-Directed Therapies
Current Vascular Pharmacology Membrane Transporters as Determinants of the Pharmacology of Platinum Anticancer Drugs
Current Cancer Drug Targets Clinical Applicability of Conditioning Techniques in Ischemia-Reperfusion Injury: A Review of the Literature
Current Cardiology Reviews The mTOR Signaling Network: Insights from Its Role During Embryonic Development
Current Medicinal Chemistry Platelet Function in Inflammatory Diseases: Insights from Clinical Studies
Inflammation & Allergy - Drug Targets (Discontinued)