title: Ivabradine for the treatment of chronic heart failure.
abstract: Several studies have underlined the beneficial effects of a lower heart rate on mortality in patients with chronic heart failure and reduced ejection fraction. In clinical practice, achieving a heart rate ≤70 bpm with beta-blockers is not always possible. In this context, the more recent guidelines added ivabradine to the management of those patients if heart rate remains ≥70 bpm in sinus rhythm and symptoms persist despite treatment with an evidence-based or maximum tolerated dose of a beta-blocker, an angiotensin converting enzyme inhibitor or angiotensin-receptor blocker, and a mineralocorticoid receptor antagonist. Ivabradine is a well-tolerated, safe and effective treatment option with the objective to improve prognosis, left ventricular structure and function, exercise tolerance and quality of life. Accordingly, the following article will evaluate the benefits of a combination of the currently recommended pharmacological therapy in chronic heart failure with the selective heart rate reducing agent ivabradine.
authors.affiliation: a Research Center and Department of Medicine, Montreal Heart Institute , Université de Montréal , Montréal , Québec , Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Henri
authors.affiliation: a Research Center and Department of Medicine, Montreal Heart Institute , Université de Montréal , Montréal , Québec , Canada.
authors.forename: Eileen
authors.initials: E
authors.lastname: O'Meara
authors.affiliation: a Research Center and Department of Medicine, Montreal Heart Institute , Université de Montréal , Montréal , Québec , Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: De Denus
authors.affiliation: a Research Center and Department of Medicine, Montreal Heart Institute , Université de Montréal , Montréal , Québec , Canada.
authors.forename: Lynn
authors.initials: L
authors.lastname: Elzir
authors.affiliation: a Research Center and Department of Medicine, Montreal Heart Institute , Université de Montréal , Montréal , Québec , Canada.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Tardif
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D001552:Benzazepines / Q000627:therapeutic use*; D002908:Chronic Disease; D017079:Exercise Tolerance; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D000077550:Ivabradine; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001552:Benzazepines; D000077550:Ivabradine
keywords: Ivabradine; beta-blockers; exercise tolerance; heart failure; heart rate reduction; left ventricular function; quality of life