Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazine
Introduction: Patients with coronary microvascular dysfunction (CMD) are at increased risk of developing heart failure with preserved ejection fraction (HFpEF). We hypothesized that higher myocardial biomarkers (ultra-high sensitivity cardiac troponin I [u-hs-TnI]) and ventricular dysfunction (N-ter...
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Elsevier
2025-04-01
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| Series: | American Heart Journal Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602225000163 |
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| author | Katherine E. Hampilos Anum Asif Puja K. Mehta Daniel S. Berman Galen Cook-Wiens Michael D. Nelson Carl J. Pepine C. Noel Bairey Merz Janet Wei |
| author_facet | Katherine E. Hampilos Anum Asif Puja K. Mehta Daniel S. Berman Galen Cook-Wiens Michael D. Nelson Carl J. Pepine C. Noel Bairey Merz Janet Wei |
| author_sort | Katherine E. Hampilos |
| collection | DOAJ |
| description | Introduction: Patients with coronary microvascular dysfunction (CMD) are at increased risk of developing heart failure with preserved ejection fraction (HFpEF). We hypothesized that higher myocardial biomarkers (ultra-high sensitivity cardiac troponin I [u-hs-TnI]) and ventricular dysfunction (N-terminal pro-BNP [NT-proBNP]) would be related to greater ischemia improvement on the late sodium channel inhibitor ranolazine. Methods: We analyzed CMD participants with baseline myocardial biomarkers randomized to ranolazine or placebo (RWISE trial: NCT01342029). Ischemia response was change in global myocardial perfusion reserve index (∆MPRI) or Seattle Angina Questionnaire (∆SAQ). Results: Among 64 randomized participants with u-hs-TnI and 40 with NT-proBNP, higher u-hs-TnI related to improved ∆MPRI (r = 0.26, p = 0.04), but not ∆SAQ (r = 0.03, p = 0.80) on ranolazine. There was no relation with NT-proBNP. Conclusions: These findings suggest that higher u-hs-TnI signals greater ischemia improvement on ranolazine. Further studies evaluating ischemia therapies in CMD are needed to develop potential HFpEF prevention targets. |
| format | Article |
| id | doaj-art-d98613eaac944dd9af3f36550a9d28ec |
| institution | DOAJ |
| issn | 2666-6022 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj-art-d98613eaac944dd9af3f36550a9d28ec2025-08-20T03:02:19ZengElsevierAmerican Heart Journal Plus2666-60222025-04-015210051310.1016/j.ahjo.2025.100513Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazineKatherine E. Hampilos0Anum Asif1Puja K. Mehta2Daniel S. Berman3Galen Cook-Wiens4Michael D. Nelson5Carl J. Pepine6C. Noel Bairey Merz7Janet Wei8Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USADivision of Cardiology, University of Texas San Antonio, San Antonio, TX, USADivision of Cardiology, Emory University School of Medicine, Atlanta, GA, USAS. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, CA, USABiostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA, USADepartment of Kinesiology, University of Texas in Arlington, Arlington, TX, USADivision of Cardiology, University of Florida, Gainesville, FL, USABarbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA; Corresponding author at: Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA.Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USAIntroduction: Patients with coronary microvascular dysfunction (CMD) are at increased risk of developing heart failure with preserved ejection fraction (HFpEF). We hypothesized that higher myocardial biomarkers (ultra-high sensitivity cardiac troponin I [u-hs-TnI]) and ventricular dysfunction (N-terminal pro-BNP [NT-proBNP]) would be related to greater ischemia improvement on the late sodium channel inhibitor ranolazine. Methods: We analyzed CMD participants with baseline myocardial biomarkers randomized to ranolazine or placebo (RWISE trial: NCT01342029). Ischemia response was change in global myocardial perfusion reserve index (∆MPRI) or Seattle Angina Questionnaire (∆SAQ). Results: Among 64 randomized participants with u-hs-TnI and 40 with NT-proBNP, higher u-hs-TnI related to improved ∆MPRI (r = 0.26, p = 0.04), but not ∆SAQ (r = 0.03, p = 0.80) on ranolazine. There was no relation with NT-proBNP. Conclusions: These findings suggest that higher u-hs-TnI signals greater ischemia improvement on ranolazine. Further studies evaluating ischemia therapies in CMD are needed to develop potential HFpEF prevention targets.http://www.sciencedirect.com/science/article/pii/S2666602225000163Coronary microvascular dysfunctionIschemia and no obstructive coronary artery diseaseRanolazineMyocardial perfusion reserve indexN-terminal pro-BNPUltra-high sensitivity cardiac troponin I |
| spellingShingle | Katherine E. Hampilos Anum Asif Puja K. Mehta Daniel S. Berman Galen Cook-Wiens Michael D. Nelson Carl J. Pepine C. Noel Bairey Merz Janet Wei Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazine American Heart Journal Plus Coronary microvascular dysfunction Ischemia and no obstructive coronary artery disease Ranolazine Myocardial perfusion reserve index N-terminal pro-BNP Ultra-high sensitivity cardiac troponin I |
| title | Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazine |
| title_full | Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazine |
| title_fullStr | Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazine |
| title_full_unstemmed | Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazine |
| title_short | Myocardial biomarkers in coronary microvascular dysfunction: Response to ranolazine |
| title_sort | myocardial biomarkers in coronary microvascular dysfunction response to ranolazine |
| topic | Coronary microvascular dysfunction Ischemia and no obstructive coronary artery disease Ranolazine Myocardial perfusion reserve index N-terminal pro-BNP Ultra-high sensitivity cardiac troponin I |
| url | http://www.sciencedirect.com/science/article/pii/S2666602225000163 |
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