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A Pilot Trial of Ranolazine to Treat Patients With Dilated Cardiomyopathy

Phase 2
Completed
Conditions
Dilated Cardiomyopathy
Interventions
Registration Number
NCT02133911
Lead Sponsor
University Medical Centre Ljubljana
Brief Summary

Recent data suggest that areas of fibrosis and hibernating myocardium develop in patients with non ischemic dilated cardiomyopathy. Ranolazine is a new drug, developed to releave symptoms of angina in patients with stable coronary disease that is not suitable for surgical or percutaneous revascularization. It has been shown that in patients with stable coronary disease Ranolazine improves myocardial perfusion as shown with myocardial nuclear imaging. The aim of this trial is to evaluate effects of ranolazine on myocardial perfusion in patients with dilated cardiomyopathy.

Detailed Description

Recent data suggest that areas of fibrosis and hibernating myocardium develop in patients with non ischemic dilated cardiomyopathy. Ranolazine is a new drug, developed to releave symptoms of angina in patients with stable coronary disease that is not suitable for surgical or percutaneous revascularization. The main mechanism of action of Ranolazine is the inhibition of late I(Na) thus decreasing the Ca++ load in the cardiomyocites. Consequently oxygen consumption also decreases. It has also been shown that in patients with stable coronary disease Ranolazine improves myocardial perfusion as shown with myocardial nuclear imaging. The aim of this trial is to evaluate effects of ranolazine on myocardial perfusion in patients with dilated cardiomyopathy.

Primary end-point: To determine wheather Ranolazine improves perfusion of the myocardium in patients with non-ischemic dilated cardiomyopathy.

Secondary end-points: To determine wheather Ranolazine improves patients' NYHA functional class, excercise capacity, LV systolic and diastolic function and weather ranolazine affects supraventricular and ventricular arrhythmia occurance/frequency.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
10
Inclusion Criteria
  • established diagnosis of non-ischemic dilated cardiomyopathy
  • EF < 35%
  • NYHA f.c. II - IV
  • Optimal medical management > 6 months
  • Age < 75 years and > 18 years
Exclusion Criteria
  • known hypersensitivity to the medication
  • age > 75 years or < 18 years
  • EF > 35%
  • renal insufficiency (GF < 30)
  • liver dysfunction (liver tests > 3x the upper normal limit))
  • LQT syndrome
  • drugs that affect CYP3A4 metabolism (azoles, macrolides, calcineurin inhibitors etc.)
  • dementia
  • active hemathological or malignant disease

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
RanolazineRanolazineInitial dose is 375 mg bid. After 2 - 4 weeks the dose is increased to 500 mg bid and after another 2-4 weeks to 750 mg bid. In case of side effects the dose of the drug is to be decreased to the highest dose that the patient is still able to tolerate.
Primary Outcome Measures
NameTimeMethod
Myocardial perfusion6 months

To determine wheather Ranolazine improves perfusion of the myocardium in patients with non-ischemic dilated cardiomyopathy assesed by myocardial nuclear imaging.

Secondary Outcome Measures
NameTimeMethod
Excercise capacity1, 3 and 6 months

To determine wheather Ranolazine improves patients' excercise capacity, assesed by 6' walk test

Left ventricular systolic and diastolic function1, 3 and 6 months

To determine wheather Ranolazine improves patients' LV systolic and diastolic function, assesed by LVEF, TDI, LV longitudinal strain and strain rate

Supraventricular and ventricular arrhythmias6 months

To determine wheather Ranolazine affects the occurence of supraventricular and ventricular arrhythmia occurance/frequency using 24 holter monitor.

Trial Locations

Locations (1)

Advanced Heart Failure and Transplantation Programme, University Medical Center Ljubljana, Slovenia

🇸🇮

Ljubljana, Slovenia

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