Abstract 16580: Ivabradine Improves Physical Performance and Neurohormonal Parameters in Patients With Diastolic Heart Failure
Purpose: Heart failure with normal ejection fraction (HFNEF) is present in about 50% of all CHF patients and mortality is similarly compared to patients with heart failure and reduced LVEF. Up to date, there is no evidence for a treatment available for improving outcome in HFNEF patients. High heart rates might be detrimental for HFNEF patients with diastolic dysfunction, since this will further limit LV filling. The purpose of this study is to investigate if the addition of ivabradine to optimal medical treatment might be of benefit in this patients subset in terms of physical performance and improvement of the neurohormonal parameters.
Methods: 110 pts (30% female, mean age 61±13 yrs) with HFNEF NYHA II/IV, Heart rate > 70/min, LVEF ≥ 50%, with optimal medical treatment, were randomized to two groups in order to receive ivabradine 5 mg uptitrated to 7.5 mg bid (IVA Group, n = 53) or placebo (P Group, n = 58). Clinical examination (NYHA class), cardiopulmonary test (pVO2, exercise duration ED) and plasma levels of circulating neurohormones (NT-proBNP), were performed at baseline and after 3 months.
Results: After 3 months, resting HR was decreased significantly in IVA Group compared to P Group (IVA from 83.2±5.2 to 67.4±3.1 bpm vs P from 81.3±2.9 to 80.4±2.0 bpm, P<0.05). Exercise capacity was significantly improved by ivabradine (ED IVA Group 5.4±2.1 min vs 6.9±2.9 min, P<0.05; PVO2 ml/Kg/min IVA Group 15.7±2.8 vs 19.1±3.6 P<0.05) but not by placebo (PVO2 ml/Kg/min P Group 15.7±3.1 vs 16.0±2.3 P=n.s.). NT-proBNP levels (pg/ml) was significantly decreased only in IVA Group (IVA 2674±903 vs 1998±748 P < 0.05) but not in P Group (2432±927 vs 2312±636 P=n.s ).
Conclusions: Thus the data of our study suggest that the addition of Ivabradine to optimal medical treatment for the HFNF improves physical performance and neurohormonal parameters.
- © 2013 by American Heart Association, Inc.