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Effect of late sodium current inhibition on MRI measured diastolic dysfunction in aortic stenosis: a pilot study
BACKGROUND: Ranolazine is a new anti-anginal drug that acts via late sodium current inhibition, and has been shown to improve diastolic dysfunction in isolated myocytes. Diastolic dysfuntion is common in patients with aortic stenosis (AS), and precedes symptom development and systolic dysfunction. T...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743087/ https://www.ncbi.nlm.nih.gov/pubmed/26847571 http://dx.doi.org/10.1186/s13104-016-1874-0 |
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author | Singh, Anvesha Steadman, Christopher D. Khan, Jamal N. Reggiardo, Giorgio McCann, Gerry P. |
author_facet | Singh, Anvesha Steadman, Christopher D. Khan, Jamal N. Reggiardo, Giorgio McCann, Gerry P. |
author_sort | Singh, Anvesha |
collection | PubMed |
description | BACKGROUND: Ranolazine is a new anti-anginal drug that acts via late sodium current inhibition, and has been shown to improve diastolic dysfunction in isolated myocytes. Diastolic dysfuntion is common in patients with aortic stenosis (AS), and precedes symptom development and systolic dysfunction. The purpose of this study was to assess the effects of ranolazine on peak early diastolic strain rate (PEDSR) and exercise capacity in patients with AS. METHODS: Patients with asymptomatic moderate to severe AS and diastolic dysfunction underwent trans-thoracic echocardiography, exercise testing and cardiac magnetic resonance (CMR) imaging at baseline, 6 weeks after commencing ranolazine and at 10 weeks (4 weeks after discontinuation). Diastolic function was assessed using PEDSR measured on tagged CMR images. RESULTS: Fifteen patients (peak pressure gradient 48.8 ± 12.4 mmHg, mean pressure gradient 27.1 ± 7.5 mmHg, aortic valve area 1.26 ± 0.31 cm(2)) completed the week-6 visit and 13 completed the final visit. Global PEDSR did not significantly increase from baseline (0.79 ± 0.15) to week-6 (0.86 ± 0.18, p = 0.198). There was a borderline significant increase in total exercise duration from 10.47 ± 3.68 min to 11.60 ± 3.25 min (p = 0.06). CONCLUSION: This small pilot study did not show a significant improvement in diastolic function with the use of ranolazine in asymptomatic patients with moderate-severe AS. Further studies with a larger population may be indicated. EduraCT number 2011-000111-26 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13104-016-1874-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4743087 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47430872016-02-06 Effect of late sodium current inhibition on MRI measured diastolic dysfunction in aortic stenosis: a pilot study Singh, Anvesha Steadman, Christopher D. Khan, Jamal N. Reggiardo, Giorgio McCann, Gerry P. BMC Res Notes Research Article BACKGROUND: Ranolazine is a new anti-anginal drug that acts via late sodium current inhibition, and has been shown to improve diastolic dysfunction in isolated myocytes. Diastolic dysfuntion is common in patients with aortic stenosis (AS), and precedes symptom development and systolic dysfunction. The purpose of this study was to assess the effects of ranolazine on peak early diastolic strain rate (PEDSR) and exercise capacity in patients with AS. METHODS: Patients with asymptomatic moderate to severe AS and diastolic dysfunction underwent trans-thoracic echocardiography, exercise testing and cardiac magnetic resonance (CMR) imaging at baseline, 6 weeks after commencing ranolazine and at 10 weeks (4 weeks after discontinuation). Diastolic function was assessed using PEDSR measured on tagged CMR images. RESULTS: Fifteen patients (peak pressure gradient 48.8 ± 12.4 mmHg, mean pressure gradient 27.1 ± 7.5 mmHg, aortic valve area 1.26 ± 0.31 cm(2)) completed the week-6 visit and 13 completed the final visit. Global PEDSR did not significantly increase from baseline (0.79 ± 0.15) to week-6 (0.86 ± 0.18, p = 0.198). There was a borderline significant increase in total exercise duration from 10.47 ± 3.68 min to 11.60 ± 3.25 min (p = 0.06). CONCLUSION: This small pilot study did not show a significant improvement in diastolic function with the use of ranolazine in asymptomatic patients with moderate-severe AS. Further studies with a larger population may be indicated. EduraCT number 2011-000111-26 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13104-016-1874-0) contains supplementary material, which is available to authorized users. BioMed Central 2016-02-04 /pmc/articles/PMC4743087/ /pubmed/26847571 http://dx.doi.org/10.1186/s13104-016-1874-0 Text en © Singh et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Singh, Anvesha Steadman, Christopher D. Khan, Jamal N. Reggiardo, Giorgio McCann, Gerry P. Effect of late sodium current inhibition on MRI measured diastolic dysfunction in aortic stenosis: a pilot study |
title | Effect of late sodium current inhibition on MRI measured diastolic dysfunction in aortic stenosis: a pilot study |
title_full | Effect of late sodium current inhibition on MRI measured diastolic dysfunction in aortic stenosis: a pilot study |
title_fullStr | Effect of late sodium current inhibition on MRI measured diastolic dysfunction in aortic stenosis: a pilot study |
title_full_unstemmed | Effect of late sodium current inhibition on MRI measured diastolic dysfunction in aortic stenosis: a pilot study |
title_short | Effect of late sodium current inhibition on MRI measured diastolic dysfunction in aortic stenosis: a pilot study |
title_sort | effect of late sodium current inhibition on mri measured diastolic dysfunction in aortic stenosis: a pilot study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743087/ https://www.ncbi.nlm.nih.gov/pubmed/26847571 http://dx.doi.org/10.1186/s13104-016-1874-0 |
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