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Santoro A, Schiano Lomoriello V, Santoro C, et al. Resolution of angina pectoris and improvement of the coronary flow reserve after ranolazine treatment in a woman with isolated impaired coronary microcirculation. Case Rep Cardiol. 2013;2013:343027doi: 10.1155/2013/343027.
Santoro, A., Schiano Lomoriello, V., Santoro, C., Muscariello, R., & Galderisi, M. (2013). Resolution of angina pectoris and improvement of the coronary flow reserve after ranolazine treatment in a woman with isolated impaired coronary microcirculation. Case reports in cardiology, 2013343027. https://doi.org/10.1155/2013/343027
Santoro, Alessandro, et al. "Resolution of angina pectoris and improvement of the coronary flow reserve after ranolazine treatment in a woman with isolated impaired coronary microcirculation." Case reports in cardiology vol. 2013 (2013): 343027. doi: https://doi.org/10.1155/2013/343027
Santoro A, Schiano Lomoriello V, Santoro C, Muscariello R, Galderisi M. Resolution of angina pectoris and improvement of the coronary flow reserve after ranolazine treatment in a woman with isolated impaired coronary microcirculation. Case Rep Cardiol. 2013;2013:343027. doi: 10.1155/2013/343027. Epub 2013 Mar 13. PMID: 24826280; PMCID: PMC4008276.
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Case Rep Cardiol. 2013;2013:343027. doi: 10.1155/2013/343027. Epub 2013 Mar 13.

Resolution of angina pectoris and improvement of the coronary flow reserve after ranolazine treatment in a woman with isolated impaired coronary microcirculation.

Case reports in cardiology

Alessandro Santoro, Vincenzo Schiano Lomoriello, Ciro Santoro, Riccardo Muscariello, Maurizio Galderisi

Affiliations

  1. Cardioangiology with CCU, Department of Clinical and Experimental Medicine, Federico II University Hospital, 80131 Naples, Italy.
  2. Cardioangiology with CCU, Department of Clinical and Experimental Medicine, Federico II University Hospital, 80131 Naples, Italy ; Laboratory of Echocardiography, Cardioangiology with CCU, Department of Clinical and Experimental Medicine, Federico II University Hospital, 80131 Naples, Italy.

PMID: 24826280 PMCID: PMC4008276 DOI: 10.1155/2013/343027

Abstract

In a 61-year-old woman with well controlled arterial hypertension, hypercholesterolemia, and smoke and suffering from recurrent angina pectoris despite angiographically normal epicardial coronary vessels and maximal therapy, the replacement of nitrates with novel antiangina drug ranolazine, after 6-month therapy, induced a complete relief of angina and a relevant rising of the transthoracic Doppler-derived coronary flow reserve (CFR). The present clinical case underlines therefore how in patients with chronic ischemic heart disease without epicardial coronary stenosis ranolazine can induce an improvement till the complete solution of the angina symptoms and a substantial increase of CFR as expression of the enhancement of the microvascular coronary function. The improvement of both symptoms and coronary microvascular function is strictly linked to the mechanism of action of the drug. Ranolazine induces in fact a reduction of the intracellular late sodium current that leads to a reduction of the intracellular calcium concentration thus producing a better myocardial diastolic relaxation process which in its turns enhances the myocardial perfusion. The ranolazine acts therefore as a lusitropic drug that improves the diastolic dysfunction and the segmental ischemia thus affecting one of the first steps of the ischemic cascade.

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