Why the study?
Ivabradine is used to slow heart rate in patients with heart failure and sinus rhythm, but its impact on dyssynchrony parameters was unknown.
Does the addition of ivabradine improve cardiac dyssynchrony parameters and reverse remodeling in patients with chronic systolic heart failure in sinus rhythm?
Does the addition of ivabradine improve cardiac dyssynchrony parameters and reverse remodeling in patients with chronic systolic heart failure in sinus rhythm?
The addition of ivabradine to standard heart failure therapy significantly improves echocardiographic parameters of cardiac dyssynchrony and promotes reverse remodeling over 3 months.
Ivabradine was associated with improved dyssynchrony and remodeling in systolic HF; hypothesis-generating and requires RCTs before practice change.
Objectives Ivabradine is a pharmacological agent used in patients with heart failure and sinus rhythm. Its only known pharmacological effect is to slow the heart rate. In this study, we investigated the impact of ivabradine on dyssynchrony parameters in heart failure patients. Methods In this study, we assigned 55 patients taking medication for heart failure to receive ivabradine in addition (Group I). Twenty healthy volunteers comprised Group II. Echocardiographic measurements (dyssynchrony, left ventricular volumes and left ventricular ejection fraction) were taken at baseline, 1 month, and 3 months. Results A total of 32 heart failure patients in Group I completed the study. There was significant improvement in dyssynchrony parameters after ivabradine treatment in Group I. Interventricular dyssynchrony (IVD) decreased from 42.0 ± 24.4 milliseconds at baseline to 33.6 ± 20.7 milliseconds at 1 month ( P = .001) and to 30.7 ± 19.4 milliseconds at 3 months ( P < .001). Septal to posterior wall motion delay decreased from 90.3 ± 21.4 milliseconds to 83.9 ± 26.9 milliseconds ( P = .011) at 1 month and to 81.5 ± 27.3 milliseconds at 3 months ( P = .001). Septal to lateral Ts delay (Ts‐SL) decreased from 42.7 ± 24.5 milliseconds to 35.8 ± 22.6 milliseconds at 1 month ( P < .001) and to 34.8 ± 22.4 milliseconds at 3 months ( P = .002). Left ventricular end‐systolic volume (LVESV) decreased from 139.4 ± 42.2 mL to 135.3 ± 39.6 mL at 1 month ( P = .006) and to 123.3 ± 39.5 mL at 3 months ( P < .001). Conclusion The addition of ivabradine to heart failure treatment improves cardiac dyssynchrony parameters in chronic systolic heart failure patients with sinus rhythm.
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Soylu et al. (2020) studied this question.
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