2017

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2017/№4

The effectof the inhibitor If-channels ivabradine on improving diastolic function of left ventricle in patients with acute decompensated heart failure. Six-months observation

Karchikian P. O., Sayganov S. A.
I.I. Mechnikov North-West State Medical University, Kirochnaya 41, St.-Petersburg 191015, Russia

Keywords: acute decompensated heart failure, diastolic dysfunction, ivabradine

DOI: 10.18087/rhfj.2017.4.2348

Aim. To evaluate additional effects of the inhibitor If-channel ivabradine on the course of acute decompensated heart failure in patients with reduced and preserved ejection fraction of the left ventricle during the 1-month and subsequent 6-month therapy. Material and methods. We examined 48 patients with ejection fraction less than 40% (of which 31 people took ivabradine in addition to standard therapy of heart failure, 17 – control group). Group of patients with preserved ejection fraction included 79 people (36 people took ivabradine in addition to standard therapy of heart failure, and 43 control group). The 6-minute walk test, echocardiographic parameters of systolic and diastolic function, and the heart rate calculations were performed in 1 month and 6 months. Results. It was found that in the groups treated additionally with ivabradine, both among patients with reduced and preserved EF (groups A1 and B1), in comparison with patients with groups without ivabradine therapy (groups A2 and B2), the proportion of patients who increased the distance traveled for the test with 6-minute walking was significantly more, p<0.05. In a subgroup of patients with preserved LVEF taking ivabradine, the dynamics of indices of diastolic LV function improved. Improvement of the parameters of transmittal blood flow was recorded in 33 patients taking ivabradine and having a preserved EF, versus 26 patients who made up the control group (p<0.005). Also in these patients, there was a more pronounced decrease in the pressure in the left atrium, evaluated by decreasing the vE/e' ratio (28 patients improved this undex versus 8 controls). In patients with reduced EF taking ivabradine, similar indices of the dynamics of transmittal blood flow could not be obtained (15 - improved, 16 - worsened). There was also no such good dynamics in reducing ratio vE/e' (21 - improved, 10 - worsened). Conclusion. The data obtained in this study support the use of ivabradine in addition to standard therapy for patients with acute decompensated heart failure at the period of decompensation and then after compensation for the group of patients with diastolic heart failure.
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Karchikian P. O., Sayganov S. A. The effectof the inhibitor If-channels ivabradine on improving diastolic function of left ventricle in patients with acute decompensated heart failure (six-months observation). Russian Heart Failure Journal. 2017;18(4):264–269

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