Favourable effects of heart rate reduction with intravenous administration of ivabradine in patients with advanced heart failure

Gaetano M. De Ferrari, Antonio Mazzuero, Laura Agnesina, Alessandra Bertoletti, Maddalena Lettino, Carlo Campana, Peter J. Schwartz, Luigi Tavazzi

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)550-555
Number of pages6
JournalEuropean Journal of Heart Failure
Volume10
Issue number6
DOIs
Publication statusPublished - Jun 2008

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ivabradine
Intravenous Administration
Heart Failure
Heart Rate
Stroke Volume
Hemodynamics
Left Ventricular Function
Cardiac Output

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 journalArticle

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AU - Agnesina, Laura

AU - Bertoletti, Alessandra

AU - Lettino, Maddalena

AU - Campana, Carlo

AU - Schwartz, Peter J.

AU - Tavazzi, Luigi

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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.

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