Published online before print July 17, 2003, doi: 10.1161/01.RES.0000086943.72932.71
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© 2003 American Heart Association, Inc.
Research Commentary |
The Antianginal Agent Trimetazidine Does Not Exert Its Functional Benefit via Inhibition of Mitochondrial Long-Chain 3-Ketoacyl Coenzyme A Thiolase
From Discovery Biology, Pfizer Global Research and Development, Sandwich, Kent, UK.
Correspondence to Alan MacInnes, Discovery Biology (IPC351), Pfizer Global Research and Development, Ramsgate Road, Sandwich, Kent, CT13 9NJ, UK. E-mail Alan_MacInnes{at}sandwich.pfizer.com
Abstract
Trimetazidine acts as an effective antianginal clinical agent by modulating cardiac energy metabolism. Recent published data support the hypothesis that trimetazidine selectively inhibits long-chain 3-ketoacyl CoA thiolase (LC 3-KAT), thereby reducing fatty acid oxidation resulting in clinical benefit. The aim of this study was to assess whether trimetazidine and ranolazine, which may also act as a metabolic modulator, are specific inhibitors of LC 3-KAT. We have demonstrated that trimetazidine and ranolazine do not inhibit crude and purified rat heart or recombinant human LC 3-KAT by methods that both assess the ability of LC 3-KAT to turnover specific substrate, and LC 3-KAT activity as a functional component of intact cellular ß-oxidation. Furthermore, we have demonstrated that trimetazidine does not inhibit any component of ß-oxidation in an isolated human cardiomyocyte cell line. Ranolazine, however, did demonstrate a partial inhibition of ß-oxidation in a dose-dependent manner (12% at 100 µmol/L and 30% at 300 µmol/L). Both trimetazidine (10 µmol/L) and ranolazine (20 µmol/L) improved the recovery of cardiac function after a period of no flow ischemia in the isolated working rat heart perfused with a buffer containing a relatively high concentration (1.2 mmol/L) of free fatty acid. In summary, both trimetazidine and ranolazine were able to improve ischemic cardiac function but inhibition of LC 3-KAT is not part of their mechanism of action. The full text of this article is available online at http://www.circresaha.org.
Key Words: cardiac • metabolism • ischemia • trimetazidine
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