Addition of Ivabradine to β-Blocker Improves Exercise Capacity in Systolic Heart Failure Patients in a Prospective, Open-Label Study

Bagriy, A. E.; Schukina, Elena V.; Samoilova, O. V.; Pricolota, O. A.; Malovichko, SI; Pricolota, A. V.; Bagriy, E. A.

doi:10.1007/s12325-015-0185-5

Cited by 33 publications

(42 citation statements)

References 25 publications

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“…Although HR during exercise was not assessed in this study, ivabradine is also reported to reduce HR during exercise and to improve exercise tolerance. 29 In the present study, the reduction in resting HR was similar among the final doses of ivabradine ranging from 2.5 to 7.5 mg BID (15.2-17.0 beats/min). These findings suggest that the range of appropriate dose adjustment for Japanese HF patients is similar to that for non-Japanese patients (ie, 2.5-7.5 mg BID).…”

Section: Discussionsupporting

confidence: 70%

Heart Rate Control With I<sub>f</sub> Inhibitor, Ivabradine, in Japanese Patients With Chronic Heart Failure　– A Randomized, Double-Blind, Placebo-Controlled Phase II Study –

Tsutsui

Momomura

Yamashina

et al. 2016

Circ J

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Section: Discussionsupporting

confidence: 70%

Heart Rate Control With I<sub>f</sub> Inhibitor, Ivabradine, in Japanese Patients With Chronic Heart Failure　– A Randomized, Double-Blind, Placebo-Controlled Phase II Study –

Tsutsui

Momomura

Yamashina

et al. 2016

Circ J

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“…[21,22] Carvedilol and bisoprolol have consistently been shown to be inferior to ivabradine in their effects on symptomatic improvement and on exercise capacity in separate well sized studies. [23,24] Therefore, despite their prognostic benefits beta-blockers do not improve symptoms and functional tolerance in patients with heart failure, but other treatments may do so. Higher doses of betablockers are associated with fatigue and with reduced exercise tolerance and therefore it is unlikely that merely increasing the dose of beta-blockade will improve functional capacity in HF patients.…”

Section: Beta-blockersmentioning

confidence: 99%

“…A further study showed a similar effect with ivabradine added to carvedilol being more effective than uptitrating the dose of cavedilol in patients with HFrEF ( Figure 5). [23] In another large randomised study Volterrani et al compared the effect of heart rate reduction with carvedilol, ivabradine, and their combination on exercise capacity in patients with HFrEF receiving maximal dose of ACE inhibitors. [24] The maximal dose of study treatment was more frequently tolerated in patients receiving ivabradine than in those receiving carvedilol.…”

Section: Ivabradinementioning

confidence: 99%

Medical Treatment of Heart Failure with Reduced Ejection Fraction – Improving Clinical Status and Functional Capacity

Vitale¹,

Rosano²

2017

ICFJ

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A contemporary review of treatments that have been shown to improve functional capacity in patients with Heart Failure and reduced Ejection Fraction (HFrEF). The improvement of functional capacity is one of the main goals of treatment in patients with HFrEF. In the past, despite significant effects on exercise capacity some drugs (e.g. ibopamine, flosequinan) have shown detrimental effects on long- term outcomes in patients with HFrEF. It is perhaps notable that both of these drugs had shown signals of increased safety concerns during the earlier clinical phases of their development. The challenge is to encourage a timely identification of effective treatments that can enhance functional performance in HF without the more difficult and more expensive path to prove all drugs also reduce mortality. It is valuable to have approved and effective treatments that can do the first without the need for the second in all cases, provided adequate safety can be assured. Ivabradine, trimetazidine, ferric carboxymaltose and diuretics have consistently shown to improve functional capacity and symptoms in patients with HFrEF because of their effect on long term prognosis these drugs should always be considered in patients with heart failure. Diuretics improve functional capacity and should be prescribed in patients with signs and symptoms of congestions. Cardiac resynchronisation therapy improves functional capacity in patients with HFrEF in whom it is appropriately applied (QRS >130/150 msec according to morphology).

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“…The addition of ivabradine to carvedilol in 69 patients in sinus rhythm, ischaemic HF (NYHA class II-III) and HR ≥70 beats per minute (bpm) revealed a shorter beta-blocker up-titration period, higher final beta-blocker dose as well as greater heart rate reduction and better exercise capacity. 20 …”

Section: Functional Improvement and Symptoms Reliefmentioning

confidence: 99%

The Role of Ivabradine and Trimetazidine in the New ESC HF Guidelins

Milinković

Rosano

Lopatin

et al. 2016

Cardiac Failure Review

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TherapeuticsAccess at: www.CFRjournal.com Chronic heart failure (HF), a complex and heterogeneous clinical syndrome, is a major cause of morbidity and mortality worldwide, and represents a major challenge to health care systems. The prevalence of HF and the number of hospitalisations is rising, even more in the ageing population.1 The direct costs of HF management reached 1-2 % of total health care expenditure and approximately two-thirds are attributable to hospitalisations. In 2012, in 197 countries, covering 99 % of the world's population, the overall cost of HF management was estimated at US$108 billion per annum, and is predicted to rise. 4 Around 60 % of total HF patients has HFrEF, which is associated with high reninangiotensin-aldosterone and sympathetic nervous systems activation.Most recent therapeutic improvements in these patients are due to the use of pharmacological agents that modulate these neuro-hormonal axes, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), beta-blockers and mineralocorticoid receptor antagonists (MRAs). The beneficial effects of these treatments include the reduction of HF mortality by approximately one-third in a period of two decades. Despite this success, HF mortality rates remain high:the 5-year survival is worse than in many cancers. 5,6The 2016 European Society of Cardiology (ESC) HF guidelines recommend ACEI and beta-blockers as first-line therapy in symptomatic patients with HFrEF. 4 However, both registries and clinical reports underline that the treatment of HF patients is suboptimal much more than expected, and that the heart rate is increased despite beta-blocker therapy.7-12 The registry of 12,440 patients demonstrated heterogeneity in treatment strategies, due to the drug side effects and contraindications.7 A European registry 13 reported that only 17 % of patients were receiving the optimal combination and recommended dose of diuretic, ACEI and beta-blockers. Results from a French registry on 50,000 HF patients 14 also confirmed suboptimal treatment of HF, demonstrating that after the first month following hospitalisation for worsening HF, only 47 % received an ACEI, 54 % a beta-blocker, and 17 % MRAs. The I Brazilian Registry of Heart Failure (BREATHE) 15 , conducted in 57 hospitals in Brazil, revealed that 69 % of HF patients were receiving an ACEI or ARB, 60 % a beta-blocker, and 49 % MRAs. However, only 17 % were receiving all three drugs together. Therefore, a need to identify a novel pathways and strategies for HF treatment is obvious and clinically justified. This article reviews the clinical evidence and guidelines recommendations for the use of two novel therapies in HF: ivabradine and trimetazidine. AbstractThe prevalence of heart failure (HF) is increasing, representing a major cause of death and disability, and a growing financial burden on healthcare systems. Despite the use of effective treatments with both drugs and devices, mortality remains high. There is therefore a need for new and effective therapeutic a...

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Addition of Ivabradine to β-Blocker Improves Exercise Capacity in Systolic Heart Failure Patients in a Prospective, Open-Label Study

Abstract: Adding ivabradine to carvedilol in patients with chronic heart failure improves the uptitration of β-blocker. The results merit further verification in a prospective double-blind study.

Cited by 33 publications

References 25 publications

Heart Rate Control With I<sub>f</sub> Inhibitor, Ivabradine, in Japanese Patients With Chronic Heart Failure　– A Randomized, Double-Blind, Placebo-Controlled Phase II Study –

Heart Rate Control With I<sub>f</sub> Inhibitor, Ivabradine, in Japanese Patients With Chronic Heart Failure　– A Randomized, Double-Blind, Placebo-Controlled Phase II Study –

Medical Treatment of Heart Failure with Reduced Ejection Fraction – Improving Clinical Status and Functional Capacity

The Role of Ivabradine and Trimetazidine in the New ESC HF Guidelins

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Addition of Ivabradine to β-Blocker Improves Exercise Capacity in Systolic Heart Failure Patients in a Prospective, Open-Label Study

Abstract: Adding ivabradine to carvedilol in patients with chronic heart failure improves the uptitration of β-blocker. The results merit further verification in a prospective double-blind study.

Cited by 33 publications

References 25 publications

Heart Rate Control With I<sub>f</sub> Inhibitor, Ivabradine, in Japanese Patients With Chronic Heart Failure – A Randomized, Double-Blind, Placebo-Controlled Phase II Study –

Heart Rate Control With I<sub>f</sub> Inhibitor, Ivabradine, in Japanese Patients With Chronic Heart Failure – A Randomized, Double-Blind, Placebo-Controlled Phase II Study –

Medical Treatment of Heart Failure with Reduced Ejection Fraction – Improving Clinical Status and Functional Capacity

The Role of Ivabradine and Trimetazidine in the New ESC HF Guidelins

Contact Info

Product

Resources

About

Heart Rate Control With I<sub>f</sub> Inhibitor, Ivabradine, in Japanese Patients With Chronic Heart Failure　– A Randomized, Double-Blind, Placebo-Controlled Phase II Study –

Heart Rate Control With I<sub>f</sub> Inhibitor, Ivabradine, in Japanese Patients With Chronic Heart Failure　– A Randomized, Double-Blind, Placebo-Controlled Phase II Study –