Ivabradine: from molecular basis to clinical effectiveness.
Ivabradine (IVA) is a novel, specific, heart rate (HR)-lowering agent that acts in sinoatrial node (SAN) cells by selectively inhibiting the pacemaker If current in a dose-dependent manner by slowing the diastolic depolarization slope of SAN cells, and reducing HR at rest and during exercise with minimal effect on myocardial contractility, blood pressure, and intracardiac conduction. Many published studies have demonstrated that HR reduction with IVA is beneficial in patients with chronic stable angina. IVA has been shown to be noninferior to beta-blocker and calcium antagonist drugs in HR reduction. The specific pharmacodynamic and pharmacokinetic properties of IVA make it an important agent in the management of patients with coronary artery disease, particularly in those patients with an elevated HR. The aim of this short review is to describe the regulation of HR and If current with IVA, and some beneficial effects of this medication in patients with coronary artery disease.
Riccioni
Graziano
G
Cardiology Unit, San Camillo de Lellis Hospital, Manfredonia, Foggia, Italy. griccioni@hotmail.com
D001552:Benzazepines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000517:prevention & control; D048909:Diabetes Complications / Q000188:drug therapy / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D000077550:Ivabradine; D012849:Sinoatrial Node / Q000187:drug effects / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000187:drug effects
D001552:Benzazepines; D002317:Cardiovascular Agents; D000077550:Ivabradine