W. Hayashida et al., EFFECTS OF RANOLAZINE ON LEFT-VENTRICULAR REGIONAL DIASTOLIC FUNCTIONIN PATIENTS WITH ISCHEMIC-HEART-DISEASE, Cardiovascular drugs and therapy, 8(5), 1994, pp. 741-747
Citations number
21
Categorie Soggetti
Pharmacology & Pharmacy","Cardiac & Cardiovascular System
To assess the effects of ranolazine, a new antiischemic drug, on regio
nal myocardium of the left ventricle, left ventricular (LV) hemodynami
c and angiographic data were obtained in 15 patients with previous tra
nsmural myocardial infarction before and after intravenous infusion of
ranolazine (200 or 500 mu g/kg body weight). LV angiogram was analyze
d by the area method and was divided into six segments. Regional LV se
gments were classified as normal (perfused by intact coronary vessels,
n = 20), ischemic (perfused by stenotic vessels but without ECG evide
nce suggesting myocardial necrosis, n = 25), or infarcted (total coron
ary occlusion and with the ECG evidence for necrosis, n = 45). Regiona
l area fractional shortening, peak filling rate, and segmental wall mo
tion during isovolumic relaxation period were analyzed. After ranolazi
ne, regional area fractional shortening was unchanged in all segments.
However, regional peak filling rate was decreased in the normal segme
nts (1499 +/- 315 to 1368 +/- 303 mm(2)/sec, p < 0.05). In the ischemi
c segments, by constrast, the administration of ranolazine significant
ly increased the regional peak filling rate (1050 +/- 410 to 1133 +/-
439 mm/sec, p < 0.05) and regional wall lengthening during the isovolu
mic relaxation period (0.9 +/- 4.1% to 2.8 +/- 5.7% of end-diastolic s
egmental area, p < 0.05), which indicates an improvement of regional d
iastolic function. Infarct segments were little affected by ranolazine
. Thus, ranolazine improves diastolic function of the noninfarcted myo
cardium under chronic ischemic conditions and also may exert a mild ne
gative lusitropic effect on the normal myocardium, although the former
beneficial effect appears to be more clinically important. This findi
ng supports the hypothesis that chronic myocardial ischemia impairs my
ocardial diastolic function and also opens new therapeutic perspective
s.