Jichu yixue yu linchuang (Nov 2021)
Efficacy and safety evaluation of ivabradine in patients with non-ischemic heart failure
Abstract
Objective To investigate the efficacy and safety of ivabradine on cardiomyopathy and heart failure(HF) with non-ischemic etiology. Methods A single-center retrospective study was carried out. Patients who admitted to Peking Union Medical College Hospital from January 2018 to February 2020, with non-ischemic heart failure, left ventricular ejection fraction (LVEF) less than 50%, and treatment of ivabradine for at least 3 months were enrolled. Results Thirty-eight patients (24 males), with a median age of 31.5 (26.0-44.0) years old, were divided into primary (n=17) and secondary (n=21) cardiomyopathies groups. Ivabradine of 5 mg/d was taken in 65.8% of the patients as the initial dose, and 10-15 mg/d was tolerated in 57.9% of patients after 3 months. Six patients withdrew the ivabradine treatment. The mean value of heart rates decreased from (93.7±13.5) beats/min to (75.9±12.4) beats/min after 3 months in all patients and from (99.0±11.4) beats/min to (78.6±13.8) beats/min in the group with secondary cardiomyopathies (P＜0.001, respectively), while no significant changes in blood pressure were observed. NYHA classification, left ventricular end-diastolic diameter and LVEF were signifi- cantly improved in both groups after treatment (P＜0.05). After a median follow-up of 9.5 months, 4 patients died, all of them were patients with secondary cardiomyopathies; Thirteen patients with heart failure re-admitted to hospital, including 10 with secondary and 3 with primary cardiomyopathies (47.6% vs 17.6%,P＜0.001). Only one case of ivabradine-related bradycardia was observed. Conclusions Ivabradine is safe and effective in patients with non-ischemic cardiomyopathy to control heart rates and to improve cardiac functions, especially for heart failure secondary to systemic diseases accompanied by sinus tachycardia.
