Document Detail


Impact of ''off-label'' use of ivabradine on exercise capacity, gas exchange, functional class, quality of life, and neurohormonal modulation in patients with ischemic chronic heart failure.
MedLine Citation:
PMID:  20940450     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: epidemiologic studies indicate that elevated heart rate (HR) is an independent risk factor for mortality and morbidity in patients (pts) with chronic heart failure (CHF). Clinical trials with β-blockers suggest that HR reduction is an important mechanism of their benefit in pts with stable CHF. Pharmacologic inhibition of the I(f) current now provides the opportunity of pure HR reduction. The purpose of this study was to evaluate the impact of ''Off-Label'' use of ivabradine on exercise capacity, gas exchange, functional class, quality of life, and neurohormonal modulation in pts with ischemic CHF.
METHODS: between January 2008 and June 2008, a graded maximal exercise test with respiratory gas analysis and an endurance test with constant workload corresponding to 85% of the peak VO(2) at the baseline and after 3 months were performed, and at the same times, N-terminal probrain natriuretic peptide (NT-proBNP) levels were also measured, in 60 pts (45 M, 15 F, mean age 52.7 ± 5.3 years), with stable ischemic CHF, New York Heart Association (NYHA) functional classes II (n = 35)-III (n = 25), with left ventricular ejection fraction (LVEF) ≤ 40%, randomized to a ''off-label'' ivabradine use (n = 30) and a control group (n = 30).
RESULTS: the exercise capacity increased from 14.8 ± 2.5 to 28.2 ± 3.5 min (P < .0001) and the peak oxygen consumption tended to improve from 13.5 ± 1.3 to 17.9 ± 2.4 mL/kg per minute (P < .0001) in ivabradine group. Oxygen consumption at the anaerobic threshold (AT) increased from 11.9 ± 1.4 to 15.3 ± 1.4 mL/kg per minute (P < .0001). NTproBNP levels decreased from 2356 ± 2113 pg/mL to 1434 ± 1273 pg/mL (P = .045). No significant differences were found in control group at 3 months. The positive ivabradine effects were also associated with an improvement in the NYHA functional class and quality of life.
CONCLUSION: the ''Off-Label'' use of ivabradine significantly improves the exercise capacity, gas exchange, functional heart failure class, quality of life, and neurohormonal modulation in pts with ischemic CHF.
Authors:
Filippo M Sarullo; Giovanni Fazio; Danilo Puccio; Sergio Fasullo; Salvatore Paterna; Salvatore Novo; Pietro Di Pasquale
Publication Detail:
Type:  Journal Article     Date:  2010-10-12
Journal Detail:
Title:  Journal of cardiovascular pharmacology and therapeutics     Volume:  15     ISSN:  1940-4034     ISO Abbreviation:  J. Cardiovasc. Pharmacol. Ther.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602617     Medline TA:  J Cardiovasc Pharmacol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  349-55     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Buccheri La Ferla-Fatebenefratelli Hospital, Palermo, Italy. fsarullo@neomedia.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Angiostatic Effects of Aspirin in Hypoxia-Reoxygenation Are Linked to Modulation of TGF{beta}1 Signa...
Next Document:  Atrial fibrillation-the final frontier.