ObjectiveTo observe the effects of trimetazidine (TMZ) on left ventricular remodeling and plasma brain natriuretic peptide (BNP) level in rats with chronic renal failure (CRF). MethodsMale Sprague-dawley (SD) rats were randomly divided into sham group, CRF group, small- (3 mg/kg), medium- (6 mg/kg), and high-TMZ (9 mg/kg) treatment groups, with each group containing 10 rats. Animals in the latter four groups received 5/6 subtotal nephrectomies. TMZ was intragastrically administered to rats for 17 weeks in three TMZ groups, while normal saline was given to rats in CRF group. At the end of the study, transthoracic echocardiography was performed, the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MBP), and BNP were measured, and the cardiac tissues were obtained for pathological examination. ResultsEchocardiography showed that the left ventricle end-systolic dimensions, anterior wall end-diastolic and end-systolic thicknesses, and posterior wall end-diastolic thickness in the medium- and high-TMZ groups were significantly decreased compared with those in the sham control group (P<0.05). Compared with the sham control group, the rest four groups had significantly higher systolic/diastolic blood pressure, mean arterial pressure and BNP level (P<0.01, P<0.05). The BNP levels in medium- and high-TMZ groups were significantly lower than that in the sham control group (P<0.05). Irregular arrangement and hypertrophy of the cardiomyocytes and myocardial fibrosis were observed in the control group under light microscope, and mitochondrial swelling, vacuolation and focal muscle fiber dissolution were observed under electron microscope. The pathological changes were improved by TMZ treatment in a dose-dependent manner. ConclusionTMZ may improve left ventricular remodeling and decrease BNP level in CRF rats.