Effect of Selective Heart Rate Slowing in Heart Failure With Preserved Ejection Fraction.

Circulation
Nikhil PalHouman Ashrafian

Abstract

Heart failure with preserved ejection fraction (HFpEF) is associated with significant morbidity and mortality but is currently refractory to therapy. Despite limited evidence, heart rate reduction has been advocated, on the basis of physiological considerations, as a therapeutic strategy in HFpEF. We tested the hypothesis that heart rate reduction improves exercise capacity in HFpEF. We conducted a randomized, crossover study comparing selective heart rate reduction with the If blocker ivabradine at 7.5 mg twice daily versus placebo for 2 weeks each in 22 symptomatic patients with HFpEF who had objective evidence of exercise limitation (peak oxygen consumption at maximal exercise [o2 peak] <80% predicted for age and sex). The result was compared with 22 similarly treated matched asymptomatic hypertensive volunteers. The primary end point was the change in o2 peak. Secondary outcomes included tissue Doppler-derived E/e' at echocardiography, plasma brain natriuretic peptide, and quality-of-life scores. Ivabradine significantly reduced peak heart rate compared with placebo in the HFpEF (107 versus 129 bpm; P<0.0001) and hypertensive (127 versus 145 bpm; P=0.003) cohorts. Ivabradine compared with placebo significantly worsened the ...Continue Reading

References

Jan 14, 2003·American Journal of Respiratory and Critical Care Medicine·UNKNOWN American Thoracic Society, UNKNOWN American College of Chest Physicians
May 7, 2004·The New England Journal of Medicine·Michael R ZileWilliam H Gaasch
Mar 30, 2006·Journal of Cardiopulmonary Rehabilitation·Peter H BrubakerDalane W Kitzman
Jul 21, 2006·The New England Journal of Medicine·Theophilus E OwanMargaret M Redfield
Jul 21, 2006·The New England Journal of Medicine·R Sacha BhatiaPeter P Liu
Dec 25, 2007·European Heart Journal·Christophe TribouilloyZiad Massy
Nov 13, 2008·The New England Journal of Medicine·Barry M MassieUNKNOWN I-PRESERVE Investigators
Dec 5, 2008·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Olatz GarinJordi Alonso
Feb 20, 2010·Circulation Research·Dario DiFrancesco
Jun 15, 2010·Circulation. Heart Failure·Barry A BorlaugMargaret M Redfield
Jul 9, 2011·Journal of the American College of Cardiology·Mark J HaykowskyDalane W Kitzman
May 23, 2012·Circulation·Benjamin A SteinbergUNKNOWN Get With the Guidelines Scientific Advisory Committee and Investigators
Feb 22, 2013·European Journal of Heart Failure·Muaz M AbudiabBarry A Borlaug
Jul 11, 2013·JAMA : the Journal of the American Medical Association·Frank EdelmannBurkert Pieske
Apr 11, 2014·The New England Journal of Medicine·Bertram PittUNKNOWN TOPCAT Investigators
Jun 25, 2014·Nature Reviews. Cardiology·Barry A Borlaug
Sep 2, 2014·The New England Journal of Medicine·Kim FoxUNKNOWN SIGNIFY Investigators

❮ Previous
Next ❯

Citations

Mar 10, 2016·Current Problems in Cardiology·Yogesh N V Reddy, Barry A Borlaug
Mar 12, 2016·Expert Review of Cardiovascular Therapy·Christine HenriJean-Claude Tardif
Apr 23, 2016·Journal of the American College of Cardiology·Neal A Chatterjee, Gregory D Lewis
Oct 22, 2016·Journal of the American College of Cardiology·Wojciech KosmalaThomas H Marwick
Apr 5, 2017·Expert Opinion on Pharmacotherapy·Elles M ScreeverRudolf A de Boer
Mar 21, 2017·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Bharathi Upadhya, Dalane W Kitzman
May 4, 2017·Clinical Pharmacology and Therapeutics·S Nanayakkara, D M Kaye
Aug 31, 2018·European Journal of Preventive Cardiology·Kazufumi AiharaTakeshi Yamashita
Aug 26, 2017·Circulation. Cardiovascular Imaging·Sherif F NaguehJerry D Estep
May 25, 2016·Circulation·Mitchell A Psotka, John R Teerlink
Mar 30, 2019·Journal of the American Heart Association·Sathish K ParasuramanMichael P Frenneaux
Oct 5, 2016·Clinical Medicine : Journal of the Royal College of Physicians of London·Kareem MahmoudHossam Kandil
Apr 28, 2018·Clinical Medicine : Journal of the Royal College of Physicians of London·Andrew R HarperAlexander R Lyon
Mar 14, 2020·Circulation. Heart Failure·Van-Khue Ton, Gregory D Lewis
Dec 17, 2016·Current Opinion in Cardiology·Robert J H Miller, Jonathan G Howlett
Feb 8, 2018·Annual Review of Medicine·James D GladdenMargaret M Redfield
Dec 14, 2018·Expert Opinion on Investigational Drugs·Juan TamargoEva Delpón
Jun 1, 2019·European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology·Patricia PalauJulio Núñez
Sep 17, 2019·Circulation. Heart Failure·Markus Meyer, Martin M LeWinter
May 4, 2017·European Journal of Heart Failure·Michel KomajdaUNKNOWN prEserveD left ventricular ejectIon fraction chronic heart Failure with ivabradine studY (EDIFY) Investigators
Apr 3, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Jan WintrichMichael Böhm
Jul 12, 2020·Heart Failure Reviews·Lino Sérgio Rocha ConceiçãoVitor Oliveira Carvalho
Mar 30, 2018·Heart Failure Reviews·Agata Bielecka-DabrowaMaciej Banach
Aug 5, 2020·Journal of Cardiovascular Translational Research·Anzhela SolovevaMarat Fudim

❮ Previous
Next ❯

Software Mentioned

SPSS Statistics

Related Concepts

Related Feeds

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.