title: Heart rate and heart failure: the role of ivabradine therapy.
abstract: OBJECTIVE
  The clinical data about the impact of heart rate reduction in heart failure therapy will be reviewed.
  
  
  RESULTS
  Clinical and experimental studies showed an association between elevated resting heart rate and mortality risk in heart failure patients. This review summarizes that heart rate level at rest and its extent of reduction is a sensitive indicator for outcome in heart failure. In addition to the nonspecific heart rate reducing drugs like β-blockers, cardiac glycosides and Ca(2+) antagonists, ivabradine is a highly selective heart rate reducing agent without modifying ventricular contractility and atrioventricular conduction in humans and animals, and has recently been shown to improve cardiovascular outcomes in patients with systolic heart failure by lowering the heart rate only. The present and future role of heart rate reduction in the spectrum of heart failure disease and therapy will be outlined and evaluated.
  
  
  CONCLUSIONS
  Elevated heart rate at rest represents a key indicator of adverse outcome in heart failure and implies a major treatment target in these patients.
authors.affiliation: Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg, Saar, Germany. Jan.Reil@uniklinikum-saarland.de
authors.forename: Jan-Christian
authors.initials: JC
authors.lastname: Reil
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001552:Benzazepines / Q000494:pharmacology / Q000627:therapeutic use*; D003864:Depression, Chemical; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D054144:Heart Failure, Diastolic / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D054143:Heart Failure, Systolic / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D000077550:Ivabradine; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D001552:Benzazepines; D000077550:Ivabradine