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Trimetazidine Therapy in Hypertrophic Cardiomyopathy

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified August 2011 by University College, London.
Recruitment status was:  Recruiting
British Heart Foundation
Information provided by (Responsible Party):
University College, London Identifier:
First received: September 27, 2012
Last updated: February 27, 2013
Last verified: August 2011

Hypertrophic cardiomyopathy (HCM) is a common inherited heart condition that causes breathlessness, chest pain and fatigue. There are few treatments available. The investigators have recently shown that a drug called perhexiline reduced symptoms and improved exercise capacity in patients with HCM. This change appears to be driven by alterations in myocardial energy metabolism. The aim of this trial is to test a similar drug, trimetazidine, in a group of symptomatic patients with non-obstructive HCM.

HYPOTHESIS: trimetazidine will improve symptoms, peak oxygen consumption, cardiac function and arrhythmia burden in medically refractory symptomatic patients with non-obstructive HCM.

Condition Intervention Phase
Hypertrophic Cardiomyopathy
Drug: Trimetazidine
Other: Placebo capsule
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 2b Randomised, Double Blind, Placebo-controlled Trial of Trimetazidine Therapy in Patients With Non-obstructive Hypertrophic Cardiomyopathy

Resource links provided by NLM:

Further study details as provided by University College, London:

Primary Outcome Measures:
  • Peak oxygen consumption [ Time Frame: 3 months ]

Secondary Outcome Measures:
  • Left ventricular function [ Time Frame: 3 months ]
    TDI and 2D strain

  • Symptom status [ Time Frame: 3 months ]

  • Arrhythmia [ Time Frame: 3 months ]
    24 Hour Holter

  • Cardiac biomarkers [ Time Frame: 3 months ]
  • Exercise capacity [ Time Frame: 3 months ]
    6 minute walk test

Estimated Enrollment: 90
Study Start Date: April 2012
Estimated Study Completion Date: April 2014
Estimated Primary Completion Date: April 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Trimetazidine Drug: Trimetazidine
Trimetazidine 20mg three times per day for 3 months
Placebo Comparator: Placebo capsule Other: Placebo capsule
one capsule three times per day for 3 months

Detailed Description:


Hypertrophic cardiomyopathy (HCM) is a common inherited disorder of heart muscle affecting 1 in 500 individuals worldwide. It is associated with arrhythmias, heart failure and sudden death in young people. In the majority of patients, HCM is caused by mutations in genes encoding cardiac contractile proteins. It has been hypothesised that excessive sarcomeric energy consumption is an important and early factor in the pathophysiology of HCM. Therefore modulation of myocardial metabolism presents a novel target for improving myocardial performance and symptoms in patients with HCM. Trimetazidine is an anti-anginal agent which like perhexiline reduces fatty acid oxidation and increases glucose oxidation, thus increasing the efficiency of energy production. Trimetazidine has been shown to significantly improve exercise performance in patients with stable angina, ischaemic and non ischaemic cardiomyopathy, either as monotherapy or in combination with beta-blockers or calcium channel blockers,

DESIGN: A single centre prospective randomised, double blind, placebo-controlled, trial of trimetazidine therapy.

DOSING: 20 mg Trimetazidine or Placebo three times daily for three months

METHODS: The following assessments will be made at baseline and after 3 months treatment: history and physical examination, Minnesota heart failure questionnaire, fasting blood tests, electrocardiogram, echocardiogram, cardiopulmonary exercise test, six minute walk test, 24 hour ECG Holter monitor.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Non-obstructive hypertrophic cardiomyopathy (gradient <30 mmHg at rest)
  • NYHA (New York Heart Association) Class ≥ 2
  • Peak VO2 (maximal oxygen consumption) ≤80% predicted for age and gender
  • Heart rate < 90/minute at rest

Exclusion Criteria:

  • Diabetes Mellitus
  • Abnormal renal function (GFR<60ml/min) or hepatic impairment
  • Female who is pregnant, lactating or planning pregnancy during the course of the study
  Contacts and Locations
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Please refer to this study by its identifier: NCT01696370

Contact: Perry M Elliott, MBBS MD 020 3456 7898
Contact: Caroline J Coats, MBBS 020 3456 7898

United Kingdom
The Heart Hospital, UCLH Recruiting
London, United Kingdom, W1G 8PH
Sponsors and Collaborators
University College, London
British Heart Foundation
Principal Investigator: Perry M Elliott, MBBS MD University College, London
  More Information

Responsible Party: University College, London Identifier: NCT01696370     History of Changes
Other Study ID Numbers: 10/0216
Study First Received: September 27, 2012
Last Updated: February 27, 2013

Keywords provided by University College, London:

Additional relevant MeSH terms:
Cardiomyopathy, Hypertrophic
Heart Diseases
Cardiovascular Diseases
Pathological Conditions, Anatomical
Aortic Stenosis, Subvalvular
Aortic Valve Stenosis
Heart Valve Diseases
Vasodilator Agents processed this record on April 24, 2017