The effectof ivabradine in patients with chronic systolic heart failure

AIM To assess the clinical effects of ivabradine in patients with chronic heart failure. METHODS 76 patients (baseline HR ≥70 bpm) with chronic heart failure were randomly divided into an Ivabradine group (treatment group 39 cases) and a conventional therapy group (control group 37 cases). Dosages of ivabradine were recorded at every routine patient visit (at 2, 4, and 6 weeks, and then 3 months), along with resting heart rate (by electrocardiogram), blood pressure, and major adverse cardiovascular events. A 6-min walking test and echocardiography were performed at baseline and at 3 months. Patients with and without ivabradine were compared for performance on the 6-min walking test at 3months (primary endpoint) and echocardiographic parameters at 3 months (LV ejection fraction, LV end-diastolic diameter, LV end-systolic diameter, and left atrial dimension). RESULTS Patients receiving ivabradine had lower resting heart rate at 3 months ［(62±4) bpmversus (72±5) bpm, P<0.05］. In addition, the patients in the treatment group had higher systolic blood pressure ［(123±7) mmHg versus (116±8) mmHg, P<0.05］, a significant rise in left ventricular ejection fraction (P<0.05), and significantly reduced LV end-systolic diameter and left atrial dimension ［(4.6±0.3) cm vs.(4.1±0.2) cm, (4.0±0.4) cm vs.(3.7±0.2) cm, P<0.05］. The distance reached in 6-min walking test was significantly longer in the ivabradine group than in the control group (P<0.05). Significantly, more patients in the ivabradine group (62%) had an improvement of at least one NYHA class than in the control group (35%) (P<0.05). CONCLUSION Clinical effects of ivabradine administration in patients with chronic heart failure are superior to conventional treatment.