Key result
Echo-guided ivabradine improves LVEF, BNP, and 6MWD in a single patient with systolic heart failure.
Why the study?
The ideal target heart rate and the implication of Doppler echocardiography-guided heart rate modulation therapy using ivabradine in systolic heart failure remain uncertain.
Does Doppler echocardiography-guided heart rate modulation therapy using ivabradine improve cardiac function in a patient with systolic heart failure?
Case Report (n=1)
Does Doppler echocardiography-guided heart rate modulation therapy using ivabradine improve cardiac function in a patient with systolic heart failure?
Doppler echocardiography-guided heart rate modulation using ivabradine to minimize E and A wave overlap may be a promising strategy to improve cardiac function in systolic heart failure.
May support echocardiography-guided ivabradine in systolic HF; hypothesis-generating and leaves open confirmation in prospective trials.
channel blocker that purely decreases heart rate without affecting hemodynamics, improves clinical outcomes in patients with systolic heart failure. However, the ideal heart rate that should be a target remains unknown. Our team recently proposed a methodology using Doppler echocardiography to estimate ideal heart rate, at which E-wave and A-wave stand adjacent without overlap. However, the implication of Doppler echocardiography-guided heart rate modulation therapy using ivabradine remains uncertain. We had a 72-year-old man with systolic heart failure and sinus tachycardia who initiated ivabradine therapy. Ivabradine dose was adjusted between 5.0 mg/day and 10.0 mg/day and continued for 12 weeks to minimize the overlap between the two echocardiography waves, accompanying improvement in cardiac output, left ventricular ejection fraction, plasma B-type natriuretic peptide, and six-minute walk distance. Doppler echocardiography-guided heart rate regulation therapy using ivabradine may be a promising strategy to improve cardiac function and clinical outcomes in patients with systolic heart failure, although further studies are required to validate this hypothesis.
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Imamura et al. (2022) conducted a case report in Systolic heart failure and sinus tachycardia (n=1). Doppler echocardiography-guided ivabradine therapy was evaluated on Cardiac output, left ventricular ejection fraction, plasma B-type natriuretic peptide, and six-minute walk distance. Doppler echocardiography-guided ivabradine therapy for 12 weeks improved cardiac output, LVEF, BNP, and 6-minute walk distance in a patient with systolic heart failure.
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