title: The importance of reducing heart rate in cardiovascular diseases: effects of Ivabradine.
abstract: Heart rate is a major determinant of cardiac output, myocardial oxygen consumption and coronary blood flow under physiological and pathological conditions. Experimental and clinical data have demonstrated that heart rate reduction is the main mechanism for reducing ischemia, improving left ventricular function, decreasing the risk of plaque rupture and post myocardial infarction mortality. Nowadays betablockers are the best class of drugs that can lower heart rate in patients with cardiovascular diseases, but sometimes their use is limited by some contraindications. Ivabradine is a new drug that reduces the firing rate of pacemaker cells in the sinoatrial node through a different mechanism with respect to betablockers. The purpose of this review is to investigate the main trials that support Ivabradine adoption in clinical practice.
authors.affiliation: Department of Experimental and Applied Medicine, University of Study of Brescia, Brescia, Italy. enrico.vizzardi@tin.it
authors.forename: E
authors.initials: E
authors.lastname: Vizzardi
authors.forename: I
authors.initials: I
authors.lastname: Bonadei
authors.forename: A
authors.initials: A
authors.lastname: D'Aloia
authors.forename: F
authors.initials: F
authors.lastname: Del Magro
authors.forename: B
authors.initials: B
authors.lastname: Piovanelli
authors.forename: L
authors.initials: L
authors.lastname: Bontempi
authors.forename: A
authors.initials: A
authors.lastname: Curnis
authors.forename: L
authors.initials: L
authors.lastname: Dei Cas
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology; D000787:Angina Pectoris / Q000188:drug therapy / Q000503:physiopathology; D001552:Benzazepines / Q000494:pharmacology*; D002317:Cardiovascular Agents / Q000494:pharmacology*; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D002986:Clinical Trials as Topic; D054815:Cyclic Nucleotide-Gated Cation Channels / Q000187:drug effects / Q000502:physiology; D006333:Heart Failure / Q000188:drug therapy; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D000077550:Ivabradine; D017202:Myocardial Ischemia / Q000517:prevention & control*; D011379:Prognosis; D012849:Sinoatrial Node / Q000187:drug effects*
chemical_list: D000319:Adrenergic beta-Antagonists; D001552:Benzazepines; D002317:Cardiovascular Agents; D054815:Cyclic Nucleotide-Gated Cation Channels; D000077550:Ivabradine