Efficacy of Ranolazine to Improve Diastolic Performance in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-analysis

Putri, Desak Ketut Sekar Cempaka; Andrianto, Andrianto; Al-Farabi, Makhyan Jibril; Saputra, Pandit Bagus Tri; Nugraha, Ricardo Adrian

doi:10.15420/ecr.2022.10

Cited by 5 publications

(1 citation statement)

References 46 publications

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“…Результаты метаанализа 8 рандомизированных клинических исследований [15], в ходе выполнения которых оценивали влияние приема ранолазина на показатели диастолической функции ЛЖ, свидетельствовали о положительном влиянии по сравнению с приемом плацебо. Диастолическую функцию сердца оценивали с помощью эхокардиографии.…”

Section: влияние приема ранолазина на диастолическую функцию у пациен...unclassified

Current ideas about the role of ranolazine in patients’ treatment with angina pectoris

Gilyarevskiy,

Tkacheva

2024

Medicinskij sovet

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The article presents modern views on the role of the anti-ischemic agent, ranolazine, in the treatment of a wide range of patients with angina pectoris. It also provides data on a percentage increase in the number of patients with chronic coronary artery disease who need improved anti-ischemic therapy. The need to use alternative agents for the treatment of angina, which is highlighted in the article, is determined by a percentage increase in the number of elderly and senile patients with angina, as such patients often have concomitant diseases that limit the use of haemodynamic anti-ischemic agents. The authors consider various pathophysiological links in the development of myocardial ischemia, which may become the background for choosing a specific anti-ischemic agent. Amongst others, the article provides evidence data on the effectiveness of the usage of ranolazine in patients with angina pectoris and myocardial ischemia, but in the absence of coronary artery obstruction. The mechanisms of action of ranolazine, which determine both its anti-ischemic and pleiotropic effects, are discussed in detail. Special effects of ranolazine that may be beneficial for patients with coronary artery disease and clinically significant diastolic dysfunction are observed. This effect consisted of a positive effect of ranolazine on the left ventricular diastolic function. Data on the cost-effectiveness of the usage of ranolazine in the treatment of angina pectoris are provided. The antiarrhythmic action of ranolazine is considered separately. The article discusses the tolerability of ranolazine and its possible side effects. The all-round good tolerability and high safety of ranolazine in a wide range of patients with coronary artery disease are emphasized.

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Section: влияние приема ранолазина на диастолическую функцию у пациен...unclassified

Current ideas about the role of ranolazine in patients’ treatment with angina pectoris

Gilyarevskiy,

Tkacheva

2024

Medicinskij sovet

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The role of coronary microcirculation in heart failure with preserved ejection fraction: An unceasing odyssey

Dimitriadis,

Theofilis,

Koutsopoulos

et al. 2024

Heart Fail Rev

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Advances in myocardial energy metabolism: metabolic remodelling in heart failure and beyond

Sun,

Karwi,

Wong

et al. 2024

Cardiovascular Research

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The very high energy demand of the heart is primarily met by ATP production from mitochondrial oxidative phosphorylation, with glycolysis providing a smaller amount of ATP production. This ATP production is markedly altered in heart failure, primarily due to a decrease in mitochondrial oxidative metabolism. Although an increase in glycolytic ATP production partly compensates for the decrease in mitochondrial ATP production, the failing heart faces an energy deficit, that contributes to the severity of contractile dysfunction. The relative contribution of the different fuels for mitochondrial ATP production dramatically changes in the failing heart, which depends to a large extent on the type of heart failure. A common metabolic defect in all forms of heart failure (including HFrEF, HFpEF, and diabetic cardiomyopathies) is a decrease in mitochondrial oxidation of pyruvate originating from glucose (i.e. glucose oxidation). This decrease in glucose oxidation occurs regardless of whether glycolysis is increased, resulting in an uncoupling of glycolysis from glucose oxidation that can decrease cardiac efficiency. The mitochondrial oxidation of fatty acids by the heart increases or decreases, depending on the type of heart failure. For instance, in HFpEF and diabetic cardiomyopathies myocardial fatty acid oxidation increases, while in HFrEF myocardial fatty acid oxidation either decreases or remains unchanged. The oxidation of ketones (which provides the failing heart with an important energy source) also differs depending on the type of heart failure, being increased in HFrEF, and decreased in HFpEF and diabetic cardiomyopathies. The alterations in mitochondrial oxidative metabolism and glycolysis in the failing heart are due to transcriptional changes in key enzymes involved in the metabolic pathways, as well as alterations in redox state, metabolic signaling, and posttranslational epigenetic changes in energy metabolic enzymes. Of importance, targeting the mitochondrial energy metabolic pathways has emerged as a novel therapeutic approach to improving cardiac function and cardiac efficiency in the failing heart.

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Efficacy of Ranolazine to Improve Diastolic Performance in Heart Failure with Preserved Ejection Fraction: A Systematic Review and Meta-analysis

Cited by 5 publications

References 46 publications

Current ideas about the role of ranolazine in patients’ treatment with angina pectoris

Current ideas about the role of ranolazine in patients’ treatment with angina pectoris

The role of coronary microcirculation in heart failure with preserved ejection fraction: An unceasing odyssey

Advances in myocardial energy metabolism: metabolic remodelling in heart failure and beyond

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