Key result
Adding ivabradine to standard care is linked to improved functional capacity and LV dimension in DCM.
Why the study?
Elevated heart rate is a risk factor for morbidity and mortality in heart failure, and the role of ivabradine in idiopathic dilated cardiomyopathy needed assessment.
Does ivabradine improve functional capacity and echocardiographic parameters in patients with idiopathic dilated cardiomyopathy?
Cohort (n=80)
Open-label
No
Does ivabradine improve functional capacity and echocardiographic parameters in patients with idiopathic dilated cardiomyopathy?
In patients with idiopathic dilated cardiomyopathy, adding ivabradine to standard therapy improves functional capacity and LV dimensions, though it may not improve NYHA class or ejection fraction in the short term.
Hypothesis-generating for ivabradine in DCM; prospective trials needed before clinical adoption.
BACKGROUND prevalence of chronic heart failure (HF) in the general population has been estimated to be around 2–3%.1 Dilated (DCM) is the most common cause of HF in young adults.2 The recognition of elevated heart rate as a risk for cardiovascular morbidity and mortality and its association with sudden cardiac death has made lowering the heart in HF patients one of the most important therapeutic approaches. aim of the study is to assess the role of ivabradine in idiopathic dilated cardiomyopathy by modulating heart rate, on functional class, and echocardiographic parameters. AND METHODS this study, a prospective, non-randomised, double arm, open label, longitudinal one, 80 patients of DCM (idiopathic) were into study after exercising the inclusion and exclusion criteria as per the study protocol. Subjects were selected from attending Cardiology OPD or admitted to Cardiology ward of S.C.B. Medical College, Cuttack, Odisha during period of 2016-Aug 2017. They were divided into Ivabradine group (cases/group A) and standard tt. Group (controls/group B). baseline data of the 40 cases and 40 controls are presented. The reasons for patients not receiving target doses of were hypotension, asthma, chronic obstructive airway disease, and fatigue. The reasons for not achieving target of ACEI were development of hypotension and severe dizziness. As shown in the table the baseline HR, blood pressure, tolerance, Minnesota questionnaire score, and LV systolic function were all comparable between the two groups (p >0.05) for all. conclude the addition of Ivabradine in patients with dilated (idiopathic) cardiomyopathy resulted in significant improvement functional capacity, Minnesota questionnaire score and LV dimension. The lack of improvement in NYHA class and EF(%) be due to limitations of the study like small sample volume and short duration of follow up. However, it should be that all patients must receive the maximally tolerated doses of beta blockers, ACEI/ARBs, MRAs before starting ; and Ivabradine should not be used as an alternative of beta blockers.
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Mohanty et al. (2018) conducted a cohort in Idiopathic dilated cardiomyopathy (n=80). Ivabradine vs. Standard treatment was evaluated on Functional capacity, Minnesota questionnaire score, and LV dimension. The addition of ivabradine to standard treatment in patients with idiopathic dilated cardiomyopathy significantly improved functional capacity, Minnesota questionnaire score, and LV dimension.
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