INTRODUCTION: One form of the hereditary long-QT syndrome, LQT3-Delta KPQ, is associated with sustained inward sodium current during membrane depolarization. Ranolazine reduces late sodium channel current, and we hypothesized that ranolazine would have beneficial effects on electrical and mechanical cardiac function in LQT3 patients with the SCN5A-DeltaKPQ mutation. METHODS: We assessed the effects of 8-hour intravenous ranolazine infusions (45 mg/h for 3 hours followed by 90 mg/h for 5 hours) on ventricular repolarization and myocardial relaxation in 5 LQT3 patients with the SCN5A-Delta KPQ mutation. Changes in electrocardiographic repolarization parameters from before to during ranolazine infusion were evaluated by time-matched, paired t-test analyses. Cardiac ultrasound recordings were obtained before ranolazine infusion and just before completion of the 8-hour ranolazine infusion. RESULTS:Ranolazine shortened QTc by 26 +/- 3 ms (P < 0.0001) in a concentration-dependent manner. At peak ranolazine infusion, there was a significant 13% shortening in left ventricular isovolumic relaxation time, a significant 25% increase in mitral E-wave velocity, and a meaningful 22% decrease in mitral E-wave deceleration time compared with the baseline. No adverse effects of ranolazine were observed in the study patients. CONCLUSION:Ranolazine at therapeutic concentrations shortened a prolonged QTc interval and improved diastolic relaxation in patients with the LQT3-Delta KPQ mutation, a genetic disorder that is known to cause an increase in late sodium current.
RCT Entities:
INTRODUCTION: One form of the hereditary long-QT syndrome, LQT3-Delta KPQ, is associated with sustained inward sodium current during membrane depolarization. Ranolazine reduces late sodium channel current, and we hypothesized that ranolazine would have beneficial effects on electrical and mechanical cardiac function in LQT3patients with the SCN5A-DeltaKPQ mutation. METHODS: We assessed the effects of 8-hour intravenous ranolazine infusions (45 mg/h for 3 hours followed by 90 mg/h for 5 hours) on ventricular repolarization and myocardial relaxation in 5 LQT3patients with the SCN5A-Delta KPQ mutation. Changes in electrocardiographic repolarization parameters from before to during ranolazine infusion were evaluated by time-matched, paired t-test analyses. Cardiac ultrasound recordings were obtained before ranolazine infusion and just before completion of the 8-hour ranolazine infusion. RESULTS:Ranolazine shortened QTc by 26 +/- 3 ms (P < 0.0001) in a concentration-dependent manner. At peak ranolazine infusion, there was a significant 13% shortening in left ventricular isovolumic relaxation time, a significant 25% increase in mitral E-wave velocity, and a meaningful 22% decrease in mitral E-wave deceleration time compared with the baseline. No adverse effects of ranolazine were observed in the study patients. CONCLUSION:Ranolazine at therapeutic concentrations shortened a prolonged QTc interval and improved diastolic relaxation in patients with the LQT3-Delta KPQ mutation, a genetic disorder that is known to cause an increase in late sodium current.
Authors: Arthur J Moss; John R Windle; W Jackson Hall; Wojciech Zareba; Jennifer L Robinson; Scott McNitt; Patricia Severski; Spencer Rosero; James P Daubert; Ming Qi; Michael Cieciorka; Allan S Manalan Journal: Ann Noninvasive Electrocardiol Date: 2005-10 Impact factor: 1.468
Authors: Roberto M Lang; Michelle Bierig; Richard B Devereux; Frank A Flachskampf; Elyse Foster; Patricia A Pellikka; Michael H Picard; Mary J Roman; James Seward; Jack S Shanewise; Scott D Solomon; Kirk T Spencer; Martin St John Sutton; William J Stewart Journal: J Am Soc Echocardiogr Date: 2005-12 Impact factor: 5.251
Authors: Yejia Song; John C Shryock; Stefan Wagner; Lars S Maier; Luiz Belardinelli Journal: J Pharmacol Exp Ther Date: 2006-03-24 Impact factor: 4.030
Authors: Peter Sogaard; Henrik Egeblad; Anders K Pedersen; Won Yong Kim; Bent O Kristensen; Peter S Hansen; Peter T Mortensen Journal: Circulation Date: 2002-10-15 Impact factor: 29.690
Authors: Benjamin M Scirica; David A Morrow; Hanoch Hod; Sabina A Murphy; Luiz Belardinelli; Chester M Hedgepeth; Peter Molhoek; Freek W A Verheugt; Bernard J Gersh; Carolyn H McCabe; Eugene Braunwald Journal: Circulation Date: 2007-09-05 Impact factor: 29.690
Authors: Hai Huang; Silvia G Priori; Carlo Napolitano; Michael E O'Leary; Mohamed Chahine Journal: Am J Physiol Heart Circ Physiol Date: 2010-11-12 Impact factor: 4.733
Authors: Arthur A M Wilde; Arthur J Moss; Elizabeth S Kaufman; Wataru Shimizu; Derick R Peterson; Jesaia Benhorin; Coeli Lopes; Jeffrey A Towbin; Carla Spazzolini; Lia Crotti; Wojciech Zareba; Ilan Goldenberg; Jørgen K Kanters; Jennifer L Robinson; Ming Qi; Nynke Hofman; David J Tester; Connie R Bezzina; Marielle Alders; Takeshi Aiba; Shiro Kamakura; Yoshihiro Miyamoto; Mark L Andrews; Scott McNitt; Bronislava Polonsky; Peter J Schwartz; Michael J Ackerman Journal: Circulation Date: 2016-08-26 Impact factor: 29.690
Authors: Pieter G Postema; Jon Neville; Jonas S S G de Jong; Klaus Romero; Arthur A M Wilde; Raymond L Woosley Journal: Europace Date: 2013-03-26 Impact factor: 5.214