Background. The effect of ranolazine (RAN) on cardiac autonomic balance in congestive heart failure (CHF) was
studied.
Methods. Fifty-four CHF patients were randomized to (1) open-label RAN (RANCHF) added to usual therapy vs.
(2) usual therapy (NORANCHF). Parasympathetic and sympathetic (P&S) measurements were taken at baseline
and at 12 months.
Results. A total of 16/27 (59%) patients in both groups had initially abnormal P&S measures, including high
sympathovagal balance (SB), cardiovascular autonomic neuropathy (CAN) or both. High SB normalized in 10/12
(83%) RANCHF patients vs. 2/11 (18%) NORANCHF patients. SB became high in 5/11 (45%) NORANCHF vs. 1/11
(9%) RANCHF patients. CAN improved in 4/6 (67%) RANCHF patients vs. 5/7 (45%) NORANCHF patients. CAN
developed in 1/11 (9%) RANCHF vs. 4/11 (36%) NORANCHF patients. Since improved P&S in RANCHF patients
seemed independent of improved brain natriuretic peptide and impedance cardiography (BioZ) measurements,
5 day RAN was given to 30 subjects without CHF but with high SB or CAN. P&S improved in 90% of these subjects.
Conclusions. RAN improves unfavorable P&S activity in CHF possibly by a direct effect upon autonomic sodium
channels.
Cardiovascular autonomic neuropathy, Congestive heart failure, Major adverse cardiac events, Parasympathetic function, Patient outcomes, Ranolazine, Sympathetic function
Financial support: No grants or funding have been received for this
study.
Gary L. Murray Director, The Heart and Vascular Institute 7205 Wolf River Blvd Germantown TN, 38138, USA drglmurray@hotmail.com
Trending Topic
Heart failure (HF), a prevalent disease, is the common final pathway of several conditions, which result in the activation of numerous neurohumoral pathways. Cardiorenal interaction plays an essential role in the progression of the disease, and the use of diuretics is a cornerstone in the treatment of hypervolemic patients, especially in acute decompensated HF (ADHF).1Â The […]
Palliative care (PC) is recommended as a standard of practice for all patients with heart failure (HF) and is supported by evidence of improved patient outcomes (e.g. reduction in symptoms refractory to cardiovascular therapies and improved shared decision-making).1Â PC ...
Heart failure (HF) is a common clinical diagnosis often requiring hospitalization secondary to patient decompensation associated with clinically determined 'dry' or 'wet' volume states. However, fluid overload is the more common basis for clinical deterioration accounting for the majority of ...
Heart failure (HF) is a complex syndrome caused by a variety of cardiac and non-cardiac diseases, and is associated with high mortality and hospitalization rates.1Â Treatment has been traditionally based on a detailed history and physical examination. However, since cardiac ...
Conventionally, according to the European Society of Cardiology pacing and cardiac resynchronization therapy (CRT) guidelines, patients with clinical heart failure and an echocardiographically measured left ventricular (LV) ejection fraction of <35% are considered for CRT implantation or standard right ventricular (...
Atrial fibrillation (AF) and heart failure (HF) often co-exist. The incidence of AF is estimated to reach 45% of patients with HF and rises with the severity of HF symptoms, from about 5% of patients in the New York Heart Association (NYHA) ...
Heart failure (HF) is an increasingly prevalent clinical syndrome resulting from a variety of disease processes impeding the heart’s ability to effectively circulate blood. With advances in care and a steadily growing and aging population, HF management is becoming ...
Heart failure (HF) is a highly prevalent and morbid disease in the USA, imposing a significant burden on patients, hospitals and the health system. The prevalence of HF continues to increase, with over 650,000 new HF cases diagnosed annually.1Â There are ...
Over the past years, several reports have drawn attention to the need to consider sex-specific differences in cardiac resynchronisation therapy (CRT). Most importantly, there is growing concern on the underrepresentation of women in CRT landmark trials which laid the foundation ...
Introduction: Medical therapy for heart failure with reduced ejection fraction (HfrEF) improves quality of life, reduces heart failure hospitalization and mortality, and reduces the risk of ventricular arrhythmias. International guidelines recommend four key drug classes for all patients with HfrEF. ...
Background:Â Trials to detect a mortality benefit in heart failure require long follow up periods and large numbers of participants, which is costly and time-consuming. It is quicker and more feasible to assess quality of life. The Minnesota Living With ...
Background: TriageHF (Medtronic) is a remote monitoring algorithm that stratifies a patient’s risk of a heart failure (HF) event within the next 30 days as high, medium or low, based on integrated cardiac resynchronization therapy (CRT) device diagnostic data. TriageHF ...
Introduction: The relationship between ABO blood group and Rhesus status with survival outcomes in patients with heart failure (HF) managed with CRT-P/D remains unclear. Understanding this association could provide valuable insights for developing innovative therapeutic approaches, guiding risk-stratification methods, ...
Earn and track your CME credits on the go, save articles for later, and follow the latest congress coverage.
Register for free to hear about the latest expert-led education, peer-reviewed articles, conference highlights, and innovative CME activities.
Or use a Social Account.
Explore the latest in medical education and stay current in your field. Create a free account to track your learning.