EFFECTS OF RANOLAZINE ON LEFT-VENTRICULAR REGIONAL DIASTOLIC FUNCTIONIN PATIENTS WITH ISCHEMIC-HEART-DISEASE

Citation
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
ISSN journal
09203206
Volume
8
Issue
5
Year of publication
1994
Pages
741 - 747
Database
ISI
SICI code
0920-3206(1994)8:5<741:EOROLR>2.0.ZU;2-W
Abstract
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.