背景：研究了雷诺嗪（RAN）对充血性心力衰竭（CHF）心脏自主神经平衡的影响。
方法：将54例CHF患者随机分为（1）常规治疗与常规治疗中添加的开放标签RAN（RANCHF）。(2)常规治疗(NORANCHF)。在基线和12个月时进行副交感神经和交感神经(P&S)测量。
结果：两组中共有16/27（59％）患者最初的P&S测量异常，包括高交感迷走神经平衡(SB)，心血管自主神经病变（CAN）或两者。10/12（83％）RANCHF患者的高SB正常化与2/11(18%)NORANCHF患者。SB在5/11（45％）NORANCHF与1/11(9%)RANCHF患者。4/6（67%）RANCHF患者的CAN改善与5/7(45%)NORANCHF患者。CAN在1/11（9％）RANCHF与4/11（36%）NORANCHF患者。由于改善RANCHF患者的P&S似乎独立于改善的脑钠肽和阻抗心动图(BioZ)测量,对30名没有CHF但具有高SB或CAN的受试者给予5天RAN。这些受试者中90%的P&S有所改善。
结论：RAN可能通过对自主性钠通道的直接作用来改善CHF中不利的P&S活性。
BACKGROUND: The effect of ranolazine (RAN) on cardiac autonomic balance in congestive heart failure (CHF) was studied.
METHODS: Fifty-four CHF patients were randomized to (1) open-label RAN (RANCHF) added to usual therapy vs. (2) usual therapy (NORANCHF). Parasympathetic and sympathetic (P&S) measurements were taken at baseline and at 12 months.
RESULTS: A total of 16/27 (59%) patients in both groups had initially abnormal P&S measures, including high sympathovagal balance (SB), cardiovascular autonomic neuropathy (CAN) or both. High SB normalized in 10/12 (83%) RANCHF patients vs. 2/11 (18%) NORANCHF patients. SB became high in 5/11 (45%) NORANCHF vs. 1/11 (9%) RANCHF patients. CAN improved in 4/6 (67%) RANCHF patients vs. 5/7 (45%) NORANCHF patients. CAN developed in 1/11 (9%) RANCHF vs. 4/11 (36%) NORANCHF patients. Since improved P&S in RANCHF patients seemed independent of improved brain natriuretic peptide and impedance cardiography (BioZ) measurements, 5 day RAN was given to 30 subjects without CHF but with high SB or CAN. P&S improved in 90% of these subjects.
CONCLUSIONS: RAN improves unfavorable P&S activity in CHF possibly by a direct effect upon autonomic sodium channels.
