Heart Disease Clinical Trial
Official title:
Impact of Ranolazine on Myocardial Ischemia Detected by High-Field 3T Cardiovascular Magnetic Resonance (CMR) Imaging and P-31 Spectroscopy
Evaluation of use of ranolazine in patients with stable heart pain with cardiac magnetic resonance imaging (CMRI) and phosphorous-31 magnetic resonance spectroscopy (31P MRS). Subsequent testing using these modalities will show improved oxygen to the heart muscle.
Specific Aim:
To determine in patients with stable coronary artery disease with documented inducible
ischemia, if treatment with ranolazine leads to reduced intracellular ischemia as detected
by CMR perfusion imaging and 31P spectroscopy at 3 Tesla.
Abstract:
Despite many advances in cardiovascular medicine for patients with coronary artery disease
(CAD), many patients in the United States continue to have the morbidity and mortality
associated with chronic stable angina. Ranolazine is a novel late sodium current inhibitor
shown to be effective in treating angina in patients with chronic stable coronary artery
disease without affecting the blood pressure heart rate product. It has been shown to reduce
myocardial energy utilization by enhancing diastolic myocardial relaxation and possibly by
increasing myocardial blood flow. While ranolazine has been demonstrated to improve size and
severity of stress-induced myocardial perfusion defects, it's direct effect on myocardial
metabolism and cellular ischemia has not been tested in humans. We propose using cardiac
magnetic resonance imaging (CMRI) and phosphorous-31 magnetic resonance spectroscopy (31P
MRS) to evaluate patients with chronic stable angina before and after 4 weeks of a stable
dose of ranolazine to detect changes in myocardial blood flow, ventricular function,
myocardial scar and metabolic parameters of cellular ischemia.
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Observational Model: Cohort, Time Perspective: Prospective
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