Key result
Ivabradine reduces heart rate to ~71 bpm and improves walk distance in COPD with cor pulmonale.
Why the study?
The study evaluated the effects of heart rate reduction by adding ivabradine to standard therapy in patients with chronic obstructive pulmonary disease and cor pulmonale.
Does ivabradine improve functional capacity and pulmonary artery pressure in patients with COPD and cor pulmonale?
RCT (n=100)
1:1
No
Does ivabradine improve functional capacity and pulmonary artery pressure in patients with COPD and cor pulmonale?
p-value: p=<0.001
In patients with COPD and cor pulmonale, heart rate reduction with ivabradine significantly improves functional capacity and dyspnea symptoms, though it does not alter pulmonary artery pressure or lung function.
Supports ivabradine for functional gains in COPD cor pulmonale; extends heart-rate reduction evidence to this population.
We studied the effects of heart rate reduction by ivabradine to the ongoing therapy in patients with chronic obstructive pulmonary disease (COPD) and cor pulmonale.100 patients of COPD with cor pulmonale with sinus heart rate ≥ 90 bpm were randomly assigned to either ivabradine 5 mg twice daily (50 patients) or placebo (50 patients) alongwith standard therapy. Assessment was done at baseline and after 6 months which included 6 min walk test (6MWT), dyspnea scoring by modified borg scale, Lung function test by forced expiratory volume in 1 s (FEV1) and pulmonary artery systolic pressure (PASP) by echocardiogram. The drug group showed a significant reduction in heart rate from 95.1 ± 8.2 bpm to 71.1 ± 6.2 bpm (p < 0.001). This group also showed significant improvement in 6-min walk distance and dyspnea on modified Borg scale (p < 0.001) at 6 months follow up. However no significant difference was found between both groups regarding PASP or FEV1 at 6 months.
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Kaleem et al. (2021) conducted an RCT in COPD with cor pulmonale (n=100). Ivabradine vs. Placebo was evaluated on Heart rate at 6 months (p=<0.001). Ivabradine significantly reduced heart rate to 71.1 bpm and improved 6-minute walk distance and dyspnea scores compared to placebo in patients with COPD and cor pulmonale.
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