title: Ivabradine during cardiogenic shock: a clinical case and review of the literature.
abstract: Although the introduction of novel medical and invasive therapies in recent years has led to a significant reduction in mortality from heart failure, the same cannot be said for mortality due to cardiogenic shock. Drug therapy with inotropic agents and catecholamines has the disadvantage of causing increased myocardial oxygen consumption resulting in increased heart rate which may lead to the widening of the ischemic area. A reduction in heart rate with the administration of β-blockers is contraindicated due to negative inotropic and blood pressure lowering effects, typical of this group of drugs. Thus the theoretical possibility of ivabradine administration for an isolated reduction in heart rate, associated with the absence of a negative inotropic effect, could favorably influence hemodynamics in patients with cardiogenic shock. We report a case of cardiogenic shock treated by adding ivabradine to the currently used therapy.
authors.affiliation: Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Study of Brescia, Italy.
authors.forename: Ivano
authors.initials: I
authors.lastname: Bonadei
authors.affiliation: Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Study of Brescia, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Sciatti
authors.affiliation: Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Study of Brescia, Italy. Electronic address: enrico.vizzardi@tin.it.
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizzardi
authors.affiliation: Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Study of Brescia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Aloia
authors.affiliation: Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Study of Brescia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Metra
mesh_terms: D000369:Aged, 80 and over; D001552:Benzazepines / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D000077550:Ivabradine; D012770:Shock, Cardiogenic / Q000188:drug therapy* / Q000209:etiology
chemical_list: D001552:Benzazepines; D000077550:Ivabradine
keywords: Cardiogenic shock; Coronary artery diseases; Inotropic agents; Ivabradine; β-blockers