NDLI: Effects of ranolazine on noninvasive coronary flow reserve in patients with myocardial ischemia but without obstructive coronary artery disease.

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Effects of ranolazine on noninvasive coronary flow reserve in patients with myocardial ischemia but without obstructive coronary artery disease.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Tagliamonte, Ercole Rigo, Fausto Cirillo, Teresa Astarita, Costantino Quaranta, Gaetano Marinelli, Umberto Caruso, Archimede Romano, Carlo Capuano, Nicola
Description	Country affiliation: Italy Author Affiliation: Tagliamonte E ( Cardiology Division, 'Umberto I' Hospital, Nocera Inferiore, Italy.)
Abstract	INTRODUCTION: Ranolazine reduces the Na-dependent calcium overload via inhibition of the late sodium current, improving diastolic tone and oxygen handling during myocardial ischemia. In patients with angina, evidence of myocardial ischemia, but no obstructive coronary artery disease (CAD), abnormal coronary autoregulation plays a key role. Transthoracic Doppler-derived coronary flow reserve (CFR) is an index of coronary arterial reactivity and decreases in both microvascular dysfunction and coronary artery stenosis. The aim of this study was to assess the effect of ranolazine on CFR in this group of patient. METHODS: Fifty-eight (39M, 19F) patients with angina and evidence of myocardial ischemia, but no obstructive CAD, were enrolled in a double-blind, placebo-controlled trial. Participants were assigned to ranolazine (29) or placebo (29) for 8 weeks (up to 500 mg twice a day). CFR was determined as the ratio of hyperemic, induced by intravenous dypiridamole administration, to baseline diastolic coronary flow velocity. CFR was assessed before and after 8-week therapy. RESULTS: CFR was successfully performed in all patients. There were no significant differences in baseline characteristics and CFR between ranolazine and placebo group. After 8 weeks CFR significantly increased in ranolazine group (2.54 ± 0.44 vs. 1.91 ± 0.31; P = 0.005) but not in placebo group (1.99 ± 0.32 vs. 1.94 ± 0.29; P = ns). No patient dropped out during 8 weeks therapy. Side effects were similar in both groups. CONCLUSIONS: Ranolazine is able to improve CFR in these patients. This is probably due to improvement in abnormal coronary autoregulation, both reducing baseline diastolic coronary flow velocity and increasing hyperemic diastolic coronary flow velocity.
File Format	HTM / HTML
ISSN	07422822
Issue Number	3
Volume Number	32
e-ISSN	15408175
Journal	Echocardiography
Language	English
Publisher	Wiley
Publisher Date	2015-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Echocardiography Sensitivity And Specificity Complications Placebo Effect Humans Drug Therapy Coronary Stenosis Double-blind Method Male Treatment Outcome Administration & Dosage Cardiovascular Agents Myocardial Ischemia Randomized Controlled Trial Drug Effects Journal Article Ranolazine Reproducibility Of Results Fractional Flow Reserve, Myocardial Etiology Discipline Cardiology Female Methods
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Cardiology and Cardiovascular Medicine

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