Abstract 18974: A Pilot Study of the Effects of Ranolazine on Right Ventricular Structure and Function, Exercise Capacity, and Symptoms in Pulmonary Arterial Hypertension
Bibliographic record
Abstract
Introduction: Right ventricular (RV) failure is a major cause of death in pulmonary arterial hypertension (PAH). RV ischemia, which is common in PAH, plays a major role in the development of RV failure. We hypothesized that ranolazine, a late Na+ current inhibitor, would be beneficial in patients with PAH by increasing RV perfusion. Methods: We prospectively enrolled 10 patients with World Health Organization (WHO) Group I PAH and symptoms of angina (or anginal equivalent) in an observational, 3-month study of the effects of ranolazine (1000 mg PO BID) in PAH. All patients were on chronic pulmonary vasodilator therapy. At baseline and 3 months, patients underwent functional class assessment, 6-minute walk test, bicycle echocardiography with speckle-tracking for assessment of RV mechanics, right heart catheterization, and adenosine perfusion cardiac MRI. Data was compared at baseline vs. 3-months using paired t-tests. Results: The mean age was 47±13 y, and 80% were female. At baseline, patients had moderate or greater PAH (Table 1) with evidence of RV dysfunction (7/10 patients had reduced RV fractional area change [<0.35], and all patients had septal flattening indicative of RV overload). Ranolazine was well tolerated in 90% of patients (7 patients tolerated the full dose and 2 patients required a dose reduction due to side effects, after which the drug was well tolerated). Ranolazine was discontinued in 1 patient due to a medication interaction. After 3 mo. of ranolazine therapy, symptoms improved, exercise capacity increased, RV size decreased, and tricuspid annular plane systolic excursion (TAPSE) increased (Table 1). There were no changes in invasive hemodynamics, and no major adverse events. Conclusions: Ranolazine is well tolerated and safe in patients with WHO Group I PAH. After 3 mo. of therapy, ranolazine improved RV size and function and resulted in symptomatic improvement. These findings support the development of clinical trials for ranolazine in PAH.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".