Journal
AMERICAN JOURNAL OF THERAPEUTICS
Volume 18, Issue 6, Pages E197-E201Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MJT.0b013e3181d70453
Keywords
etomoxir; metabolic modulators; perhexiline; ranolazine; trimetazidine
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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.
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