Future directions: what data do we need?
Pure heart rate reduction by ivabradine during exercise results in the decrease in oxygen demand and the increase in oxygen supply through the prolongation of diastole. These properties are crucial for its beneficial effect in patients with chronic stable angina. The ability of ivabradine to reduce the heart rate at rest can also have a potential use in clinical practice. In fact, the new directions for future clinical research are focused on this property. Chronic coronary artery disease, acute coronary syndromes and heart failure represent the areas in which resting heart rate reduction may improve cardiovascular prognosis. Application of ivabradine in these conditions deserves full attention, with dedicated and properly powered outcome trials.
Tendera
Michal
M
3rd Division of Cardiology, Silesian School of Medicine, Katowice, Poland.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D001552:Benzazepines / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000503:physiopathology; D002986:Clinical Trials as Topic; D003971:Diastole / Q000187:drug effects; D006329:Heart Conduction System / Q000187:drug effects / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007473:Ion Channels / Q000187:drug effects; D000077550:Ivabradine
D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D002316:Cardiotonic Agents; D007473:Ion Channels; D000077550:Ivabradine