title: Favourable effects of heart rate reduction with intravenous administration of ivabradine in patients with advanced heart failure.
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 I(f) current inhibitor) in advanced HF patients.
  
  
  OBJECTIVE
  To assess the haemodynamic effects of ivabradine in patients with advanced HF and markedly depressed left ventricular (LV) function.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. g.deferrari@smatteo.pv.it <g.deferrari@smatteo.pv.it>
authors.forename: Gaetano M
authors.initials: GM
authors.lastname: De Ferrari
authors.forename: Antonio
authors.initials: A
authors.lastname: Mazzuero
authors.forename: Laura
authors.initials: L
authors.lastname: Agnesina
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bertoletti
authors.forename: Maddalena
authors.initials: M
authors.lastname: Lettino
authors.forename: Carlo
authors.initials: C
authors.lastname: Campana
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Schwartz
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
mesh_terms: D000328:Adult; D001552:Benzazepines / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D007262:Infusions, Intravenous; D000077550:Ivabradine; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*
chemical_list: D001552:Benzazepines; D000077550:Ivabradine