title: Ivabradine: Heart Failure and Beyond.
abstract: Heart failure affects over 5 million people in the United States and carries a high rate of mortality. Ivabradine, a new agent has been added to the current medical options for managing heart failure. It is a selective funny current (If) inhibitor in sinoatrial node and slows its firing rate, prolonging diastolic depolarization without a negative inotropic effect. Ivabradine was only recently approved by Food and Drug administration after the results of Systolic Heart Failure Treatment with the If Inhibitor Ivabradine (SHIFT) trial, for a reduction in rehospitalizations from chronic heart failure. This trial assessed patients with stable heart failure with reduced ejection fraction and a heart rate of at least 70 beats per minute at rest on maximally tolerated beta-blocker therapy and demonstrated statistically significant reduction in heart failure hospitalization and deaths. Additionally, ivabradine has been associated with reduced cardiac remodeling, reduced heart rate variability, improvement in exercise tolerance, improved heart failure class of New York Heart Association, and better quality of life. It has also been tried in other conditions, such as inappropriate sinus tachycardia and cardiogenic shock, and is currently in phase II trial for patients with newly diagnosed multiple organ dysfunction syndrome.
authors.affiliation: Department of Medicine, Sinai Hospital of Baltimore, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Chaudhary
authors.affiliation: Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, USA garg.jalaj@yahoo.com.
authors.forename: Jalaj
authors.initials: J
authors.lastname: Garg
authors.affiliation: Department of Medicine, Englewood Hospital and Medical Center, Mount Sinai School of Medicine, Englewood, NJ, USA.
authors.forename: Parasuram
authors.initials: P
authors.lastname: Krishnamoorthy
authors.affiliation: Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, USA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Shah
authors.affiliation: Division of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Gregg
authors.initials: G
authors.lastname: Lanier
authors.affiliation: Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, USA.
authors.forename: Mathew W
authors.initials: MW
authors.lastname: Martinez
authors.affiliation: Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Freudenberger
mesh_terms: D000818:Animals; D001552:Benzazepines / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006329:Heart Conduction System / Q000187:drug effects* / Q000503:physiopathology; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D064428:Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels / Q000037:antagonists & inhibitors* / Q000378:metabolism; D000077550:Ivabradine; D011788:Quality of Life; D020127:Recovery of Function; D016896:Treatment Outcome; D016276:Ventricular Function / Q000187:drug effects
chemical_list: D001552:Benzazepines; D002317:Cardiovascular Agents; D064428:Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels; D000077550:Ivabradine
keywords: HCN; SHIFT; SIGNIFY; funny current; heart failure; ivabradine