Efficacy of metabolic therapy with trimetazidine MR and 3-(2,2,2-trimethylhydrazyn) propionatodihydratum (3-TMHP) was compared in patients with chronic heart failure (CHF) of ischemic genesis. Clinico-functional examination included dobutamine stress echocardiography single photon emission computer tomography (SPECT) with 99mTc-technetril, and positron emission tomography (PET) with 18F-Fluoro-2-deoxyglucose. Clinical course of CHF improved during therapy with both trimetazidine MR, and 3-TMHP. According to PET data therapy with trimetazidine MR and 3-TMHP exerted antiischemic action which appeared as significant diminishment of glucose hypermetabolism in ischemic segments down to normal values. However significant improvement of regional systolic thickening in hibernating segments according to SPECT data, significant increase of left ventricular ejection fraction at rest and peak load according to data of stress-echocardiography took place only during therapy with trimetazidine.