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How does Meldonium improve exercise tolerance?


Xalatan

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Wikipedia says that meldonium inhibits γ-butyrobetaine hydroxylase (IC50 = 62mcM), carnitine biosynthesis, and beta oxidation. How does this mechanistically link up with improved exercise tolerance in stable angina (and athletic performance)?

 

Supposedly myocardial work is reduced decreased by the lack of beta oxidation feeding acetyl CoA into the Kreb's cycle, and this improves cardiac endurance?

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