Ranolazine improves right ventricular function in patients with precapillary pulmonary hypertension: results from a double blinded randomized placebo-controlled trial

Abstract Introduction A major outcome determinant in patients with pre-capillary pulmonary hypertension (PH) is right ventricular (RV) function. We studied the effect of ranolazine on RV function over 6 months using cardiovascular magnetic resonance (CMR) in patients with pre-capillary PH (Groups I, III, IV). Methods We enrolled subjects with PH and RV dysfunction (CMR ejection fraction (EF) Results Twenty-two patients were enrolled, and nine patients completed follow-up CMR after ranolazine treatment and 6 completed placebo treatment. There was significant increase in RVEF at end-treatment compared to baseline in the ranolazine group adjusted for baseline values, age, and sex. There were no statistically significant changes in secondary outcomes such as changes in NYHA class, 6-minute walk distance, NT-proBNP, or quality of life measures. Ranolazine treated patients experienced a higher number of adverse events, but only one was discontinued due to side effects. Conclusions Ranolazine may improve RV function in patients with pre-capillary PH. Larger studies are need to confirm the beneficial effects of ranolazine.