Abstract
Background: Heart rate (HR) reduction may be useful in treatment of patients with heart failure (HF). There are no data on the haemodynamic effects of ivabradine (a selective If current inhibitor) in advanced HF patients. Aims: To assess the haemodynamic effects of ivabradine in patients with advanced HF and markedly depressed left ventricular (LV) function. Methods and results: Ten NYHA class III patients (50 ± 12 years, LV ejection fraction 21 ± 7%) underwent 24-h haemodynamic monitoring. Ivabradine 0.1 mg/kg was infused over 90′, followed by 0.05-0.075 mg/kg in the subsequent 90′. Baseline HR was 93 ± 8 bpm, cardiac index (CI) 2.2 ± 0.6 l/min*m2; LV stroke volume 44 ± 11 ml and systolic work 39 ± 13 g. Ivabradine significantly reduced HR, by a maximum of 27% (to 68 ± 9 bpm) at 4 h, without decreasing CI. Ivabradine increased stroke volume and LV systolic work by a maximum of 51% (to 66 ± 17 ml) and 53% (to 58 ± 20 g) at 4 h. No serious adverse events occurred. Conclusion: In patients with advanced HF and markedly depressed LV function, the acute administration of ivabradine is well tolerated, effectively reduces HR, markedly increases stroke volume and preserves cardiac output. Ivabradine appears a promising approach for the treatment of patients with moderate and advanced heart failure.
| Original language | English |
|---|---|
| Pages (from-to) | 550-555 |
| Number of pages | 6 |
| Journal | European Journal of Heart Failure |
| Volume | 10 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2008 |
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Keywords
- Haemodynamics
- Heart failure
- Heart rate
- Sinoatrial node
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Favourable effects of heart rate reduction with intravenous administration of ivabradine in patients with advanced heart failure. / De Ferrari, Gaetano M.; Mazzuero, Antonio; Agnesina, Laura; Bertoletti, Alessandra; Lettino, Maddalena; Campana, Carlo; Schwartz, Peter J.; Tavazzi, Luigi.
In: European Journal of Heart Failure, Vol. 10, No. 6, 06.2008, p. 550-555.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Favourable effects of heart rate reduction with intravenous administration of ivabradine in patients with advanced heart failure
AU - De Ferrari, Gaetano M.
AU - Mazzuero, Antonio
AU - Agnesina, Laura
AU - Bertoletti, Alessandra
AU - Lettino, Maddalena
AU - Campana, Carlo
AU - Schwartz, Peter J.
AU - Tavazzi, Luigi
PY - 2008/6
Y1 - 2008/6
N2 - Background: Heart rate (HR) reduction may be useful in treatment of patients with heart failure (HF). There are no data on the haemodynamic effects of ivabradine (a selective If current inhibitor) in advanced HF patients. Aims: To assess the haemodynamic effects of ivabradine in patients with advanced HF and markedly depressed left ventricular (LV) function. Methods and results: Ten NYHA class III patients (50 ± 12 years, LV ejection fraction 21 ± 7%) underwent 24-h haemodynamic monitoring. Ivabradine 0.1 mg/kg was infused over 90′, followed by 0.05-0.075 mg/kg in the subsequent 90′. Baseline HR was 93 ± 8 bpm, cardiac index (CI) 2.2 ± 0.6 l/min*m2; LV stroke volume 44 ± 11 ml and systolic work 39 ± 13 g. Ivabradine significantly reduced HR, by a maximum of 27% (to 68 ± 9 bpm) at 4 h, without decreasing CI. Ivabradine increased stroke volume and LV systolic work by a maximum of 51% (to 66 ± 17 ml) and 53% (to 58 ± 20 g) at 4 h. No serious adverse events occurred. Conclusion: In patients with advanced HF and markedly depressed LV function, the acute administration of ivabradine is well tolerated, effectively reduces HR, markedly increases stroke volume and preserves cardiac output. Ivabradine appears a promising approach for the treatment of patients with moderate and advanced heart failure.
AB - Background: Heart rate (HR) reduction may be useful in treatment of patients with heart failure (HF). There are no data on the haemodynamic effects of ivabradine (a selective If current inhibitor) in advanced HF patients. Aims: To assess the haemodynamic effects of ivabradine in patients with advanced HF and markedly depressed left ventricular (LV) function. Methods and results: Ten NYHA class III patients (50 ± 12 years, LV ejection fraction 21 ± 7%) underwent 24-h haemodynamic monitoring. Ivabradine 0.1 mg/kg was infused over 90′, followed by 0.05-0.075 mg/kg in the subsequent 90′. Baseline HR was 93 ± 8 bpm, cardiac index (CI) 2.2 ± 0.6 l/min*m2; LV stroke volume 44 ± 11 ml and systolic work 39 ± 13 g. Ivabradine significantly reduced HR, by a maximum of 27% (to 68 ± 9 bpm) at 4 h, without decreasing CI. Ivabradine increased stroke volume and LV systolic work by a maximum of 51% (to 66 ± 17 ml) and 53% (to 58 ± 20 g) at 4 h. No serious adverse events occurred. Conclusion: In patients with advanced HF and markedly depressed LV function, the acute administration of ivabradine is well tolerated, effectively reduces HR, markedly increases stroke volume and preserves cardiac output. Ivabradine appears a promising approach for the treatment of patients with moderate and advanced heart failure.
KW - Haemodynamics
KW - Heart failure
KW - Heart rate
KW - Sinoatrial node
UR - http://www.scopus.com/inward/record.url?scp=44649184945&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=44649184945&partnerID=8YFLogxK
U2 - 10.1016/j.ejheart.2008.04.005
DO - 10.1016/j.ejheart.2008.04.005
M3 - Article
C2 - 18486549
AN - SCOPUS:44649184945
VL - 10
SP - 550
EP - 555
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
SN - 1388-9842
IS - 6
ER -