To assess the effects of ranolazine, a new antiischemic drug, on regional 
myocardium of the left ventricle, left ventricular (LV) hemodynamic and 
angiographic data were obtained in 15 patients with previous transmural 
myocardial infarction before and after intravenous infusion of ranolazine (200 
or 500 micrograms/kg body weight). LV angiogram was analyzed by the area method 
and was divided into six segments. Regional LV segments were classified as 
normal (perfused by intact coronary vessels, n = 20), ischemic (perfused by 
stenotic vessels but without ECG evidence suggesting myocardial necrosis, n = 
25), or infarcted (total coronary occlusion and with the ECG evidence for 
necrosis, n = 45). Regional area fractional shortening, peak filling rate, and 
segmental wall motion during isovolumic relaxation period were analyzed. After 
ranolazine, regional area fractional shortening was unchanged in all segments. 
However, regional peak filling rate was decreased in the normal segments (1499 
+/- 315 to 1368 +/- 303 mm2/sec, p < 0.05). In the ischemic segments, by 
contrast, the administration of ranolazine significantly increased the regional 
peak filling rate (1050 +/- 410 to 1133 +/- 439 mm/sec, p < 0.05) and regional 
wall lengthening during the isovolumic relaxation period (0.9 +/- 4.1% to 2.8 
+/- 5.7% of end-diastolic segmental area, p < 0.05), which indicates an 
improvement of regional diastolic function. Infarct segments were little 
affected by ranolazine. Thus, ranolazine improves diastolic function of the 
noninfarcted myocardium under chronic ischemic conditions and also may exert a 
mild negative lusitropic effect on the normal myocardium, although the former 
beneficial effect appears to be more clinically important.(ABSTRACT TRUNCATED AT 
250 WORDS)