Cardiac and Hemodynamic Benefits: Mode of Action of Ivabradine in Heart Failure

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorPEREIRA-BARRETTO, Antonio Carlos
dc.date.accessioned2016-02-11T14:05:40Z
dc.date.available2016-02-11T14:05:40Z
dc.date.issued2015
dc.description.abstractHeart failure has seen a number of therapeutic advances in recent years. Despite this, heart failure is still related to increasing rates of morbidity, repeated hospitalizations, and mortality. Ivabradine is a recent treatment option for heart failure. It has a mode of action that includes reduction in heart rate, and leads to improvement in outcomes related to heart failure mortality and morbidity, as demonstrated by the results of the SHIFT trial in patients with systolic heart failure, functional classes II and III on the NewYork Heart Association classification, and left ventricular ejection fraction B35%. These results are intriguing since many heart failure drugs reduce heart rate without such benefits, or with quite different effects, making it more difficult to understand the novelty of ivabradine in this setting. Many of the drugs used in heart failure modify heart rate, but most have other pathophysiological effects beyond their chronotropic action, which affect their efficacy in preventing morbidity and mortality outcomes. For instance, heart rate reduction at rest or exercise with ivabradine prolongs diastolic perfusion time, improves coronary blood flow, and increases exercise capacity. Another major difference is the increase in stroke volume observed with ivabradine, which may underlie its beneficial cardiac effects. Finally, there is mounting evidence from both preclinical and clinical studies that ivabradine has an anti-remodeling effect, improving left ventricular structures and functions. All together, these mechanisms have a positive impact on the prognosis of ivabradine-treated patients with heart failure, making a compelling argument for use of ivabradine in combination with other treatments. Funding: Servier.
dc.description.indexMEDLINE
dc.description.sponsorshipLaboratoires Servier, Brazil, an incorporated company of Servier
dc.identifier.citationADVANCES IN THERAPY, v.32, n.10, p.906-919, 2015
dc.identifier.doi10.1007/s12325-015-0257-6
dc.identifier.eissn1865-8652
dc.identifier.issn0741-238X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/12645
dc.language.isoeng
dc.publisherSPRINGER
dc.relation.ispartofAdvances in Therapy
dc.rightsrestrictedAccess
dc.rights.holderCopyright SPRINGER
dc.subjectCardiology
dc.subjectHeart failure
dc.subjectHeart rate
dc.subjectIvabradine
dc.subjectMorbidity
dc.subjectMortality
dc.subjectStroke volume
dc.subject.otherinduced myocardial-ischemia
dc.subject.otherdiastolic perfusion time
dc.subject.othercoronary-artery-disease
dc.subject.otherleft-ventricular mass
dc.subject.otherrate reduction
dc.subject.otherexercise capacity
dc.subject.otherejection fraction
dc.subject.otherinfarcted rats
dc.subject.otherbeta-blockade
dc.subject.othereuropean-society
dc.subject.wosMedicine, Research & Experimental
dc.subject.wosPharmacology & Pharmacy
dc.titleCardiac and Hemodynamic Benefits: Mode of Action of Ivabradine in Heart Failure
dc.typearticle
dc.type.categoryreview
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.citation.scopus6
hcfmusp.contributor.author-fmusphcANTONIO CARLOS PEREIRA BARRETTO
hcfmusp.description.beginpage906
hcfmusp.description.endpage919
hcfmusp.description.issue10
hcfmusp.description.volume32
hcfmusp.origemWOS
hcfmusp.origem.pubmed26521191
hcfmusp.origem.scopus2-s2.0-84946501249
hcfmusp.origem.wosWOS:000365796200003
hcfmusp.publisher.cityNEW YORK
hcfmusp.publisher.countryUSA
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