title: [Antianginal efficacy of ivabradine in a very old patient with aortic stenosis: effects on cardiac output and transvalvular aortic gradients].
abstract: Ivabradine is a selective I(f) current inhibitor in the sinus node that decreases heart rate without negative inotropic effects. We report the case of an 88-year-old diabetic patient with arterial hypertension and peripheral arterial disease who experienced an antero-lateral non-ST-elevation myocardial infarction following post-surgical anemia. After admission, the patient complained of anginal pain at rest with ischemic alterations of ST-T at the ECG and mild increase in troponin T levels. According to the clinical status, the association of ivabradine with beta-blockers was started. The addition of ivabradine reduced heart rate, improved symptoms (CCS class I-II) without modifying the main hemodynamic (non-invasively measured cardiac output, stroke volume and cardiac index) and echocardiographic parameters (left ventricular ejection fraction and aortic transvalvular gradients). In conclusion, the antianginal effect of ivabradine seems to be sure in very old ischemic patients with aortic stenosis.
authors.affiliation: Riabilitazione Cardiologica-Unità Scompenso Cardiaco, Ospedale SS. Trinità, Fossano (CN).
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Nervo
authors.forename: Elena
authors.initials: E
authors.lastname: Menditto
authors.forename: Camillo
authors.initials: C
authors.lastname: Taglieri
authors.forename: Enrico
authors.initials: E
authors.lastname: Lombardo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Piccolo
authors.forename: Mauro
authors.initials: M
authors.lastname: Feola
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000188:drug therapy*; D001024:Aortic Valve Stenosis; D001552:Benzazepines / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D000077550:Ivabradine; D008297:Male; D009203:Myocardial Infarction
chemical_list: D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D002316:Cardiotonic Agents; D000077550:Ivabradine