title: The Effects of Ivabradine on Left Ventricular Synchronization and Tei Index in Patients with Systolic Heart Failure.
abstract: BACKGROUND
  The aim of our study was to evaluate in stable outpatients with systolic heart failure (HF) the 3 months effect of ivabradine on LV synchronization and Tei index in stable outpatients with systolic HF.
  
  
  METHODS
  We evaluated prospectively 40 (30 males, 10 females) patients with HF. All patients were evaluated before and after treatment by transthoracic M mode, two dimensional (2D), pulsed-wave (PW), continuous wave (CW), color flow and tissue Doppler imaging (TDI) and tissue synchronization imaging (TSI). Standard deviation of Ts of the 12 LV segments (Ts-SD-12) is the most widely used parameter of intra-LV asynchrony.
  
  
  RESULTS
  Thirty men and 10 women with mean ± SD age of 64.7 ± 9.9 years were included in this study. Most of the patients benefitted from some degree of clinical improvement, 12/16 (75.0%) from NYHA III to II and 18/24 (75.0%) from II to I, respectively. Resting heart rate was significantly reduced after ivabradine treatment (84.3 ± 11.4 vs. 66.5 ± 11.5 bpm, p < 0.001). E/E' and Tei index were significantly changed after ivabradine treatment (17.3 ± 9.0 vs. 14.8 ± 7.1, p = 0.02 and 0.86 ± 0.74 vs. 0.81 ± 0.69, p = 0.02). Intra-LV synchrony parameters Ts-SD-12 and Ts-12 were significantly reduced after ivabradine (46.8 ± 13.6 vs. 42.7 ± 13.1, p = 0.01 and 142.5 ± 44.0 vs. 128.5 ± 45.2, p = 0.009).
  
  
  CONCLUSIONS
  The present study demonstrated that adding ivabradine to the standard therapy reduced HR and significantly improved LV ventricular asynchrony and Tei index in systolic HF patients.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu.
authors.forename: Fatma Hizal
authors.initials: FH
authors.lastname: Erdem
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu.
authors.forename: Serkan
authors.initials: S
authors.lastname: Ozturk
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Öztürk
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu.
authors.forename: Alim
authors.initials: A
authors.lastname: Erdem
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu.
authors.forename: Selim
authors.initials: S
authors.lastname: Ayhan
authors.affiliation: Cardiology Clinic, Caycuma Public Hospital, Zonguldak.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Öztürk
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Dönmez
authors.affiliation: Family Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey.
authors.forename: Davut
authors.initials: D
authors.lastname: Baltacı
authors.affiliation: Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yazıcı
keywords: Heart failure; Ivabradine; Left ventricular function