Effects of Ivabradine on Hemodynamic and Functional Parameters in Left Ventricular Systolic Dysfunction: a Systematic Review and Meta-analysis.

Journal of General Internal Medicine
Peysh A PatelKlaus K Witte

Abstract

Ivabradine is licensed as add-on therapy in patients with severe left ventricular systolic dysfunction (LVSD), normal sinus rhythm, and suboptimal heart rate (HR) control, but effects are not fully established. This study sought to assess the impact of ivabradine therapy on hemodynamic and functional outcome measures in all patients with LVSD. MEDLINE (1996-2017), Embase (1996-2017), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, ClinicalTrials.gov , and ISI Web of Science were searched for randomized clinical trials (RCTs) comparing standard medical therapy (SMT) plus ivabradine to SMT alone for patients with LVSD of any severity. Each trial was assessed using the Cochrane Collaborations Risk of Bias tool. Eight RCTs with 17,823 patients were included. Add-on use of ivabradine reduced resting HR (mean difference [MD] 10.3 bpm; p < 0.001), improved ejection fraction (EF) (MD 3.6%, p < 0.001), and preserved systolic blood pressure (MD 3.4 mmHg; p = 0.09). Stratified analyses according to severity of LVSD did not influence conferred benefits on HR and EF. Small improvements were noted in exercise tolerance (standardized MD 5.9 s; p = 0.004) and peak oxygen consumption (MD 2.9 ml...Continue Reading

References

Oct 22, 2003·The Journal of Pharmacology and Experimental Therapeutics·Patrice ColinAlain Berdeaux
Dec 4, 2010·Journal of the American College of Cardiology·Florian CustodisUlrich Laufs
Jul 19, 2011·International Journal of Cardiology·Maurizio VolterraniGiuseppe M C Rosano
May 12, 2012·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Michael BöhmLuigi Tavazzi
Aug 31, 2013·Circulation Research·Véronique L Roger
Sep 2, 2014·The New England Journal of Medicine·John J V McMurrayUNKNOWN PARADIGM-HF Investigators and Committees
Mar 4, 2015·Cardiology Journal·Serkan OrduHakan Ozhan
Apr 24, 2015·Journal of the American Heart Association·Warren K LaskeyUNKNOWN AHA Get With The Guidelines®‐Heart Failure Program
Jan 15, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroyuki TsutsuiUNKNOWN study investigators
May 25, 2016·Circulation·Mitchell A Psotka, John R Teerlink
Mar 16, 2017·World Journal of Cardiology·Mahesh Anantha NarayananGanesh Raveendran

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Citations

Jul 12, 2020·Heart Failure Reviews·Lino Sérgio Rocha ConceiçãoVitor Oliveira Carvalho

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