Multicentre double-blind randomized controlled trial of perhexiline as a metabolic modulator to augment myocardial protection in patients with left ventricular hypertrophy undergoing cardiac surgery

Eshan L Senanayake, Neil J Howell, Aaron M Ranasinghe, Nigel E Drury, Nick Freemantle, Michael Frenneaux, Tessa Oelofse, David Green, Ian C Wilson, Stephen J Rooney, Jorge Mascaro, Timothy R Graham, Sunil Bhudia, Michael Lewis, Domenico Pagano

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9 Citations (Scopus)


Patients undergoing cardiac surgery require adequate myocardial protection. Manipulating myocardial metabolism may improve the extent of myocardial protection. Perhexiline has been shown to be an effective anti-anginal agent due to its metabolic modulation properties by inhibiting the uptake of free fatty acids into the mitochondrion, and thereby promoting a more efficient carbohydrate-driven myocardial metabolism. Metabolic modulation may augment myocardial protection, particularly in patients with left ventricular hypertrophy (LVH) known to have a deranged metabolic state and are at risk of poor postoperative outcomes. This study aimed to evaluate the role of perhexiline as an adjunct in myocardial protection in patients with LVH secondary to aortic stenosis (AS), undergoing an aortic valve replacement (AVR).
Original languageEnglish
Pages (from-to)354-362
JournalEuropean Journal of Cardio-Thoracic Surgery
Issue number3
Early online date23 Dec 2014
Publication statusPublished - Sep 2015


  • myocardial protection
  • left ventricular hypertrophy
  • perhexiline
  • metabolic modulation
  • aortic stenosis
  • cardiac surgery

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