Dynamics of sudden coronary death markers in patients with coronary heart disease and hypertension in combination with left ventricular hypertrophy against Ivabradine therapy
Koziolova N. A., Surovtseva M. V., Eltsova M. А.
Keywords: hypertension, sudden cardiac death, ivabradine, coronary heart disease
Relevance. Excessive ventricular ectopic activity, high HR at rest, values of daily average variability of a rhythm of heart and a dispersion of interval QT, systolic dysfunction of LV myocardium, LV hypertrophy (LVH) are considered as potential markers of sudden coronary death (SCD). Objective. Estimate dynamics of SCD markers in patients with CHD in combination with hypertension and LVH against therapy with Ivabradine as a part of a complex treatment. Materials and methods. The study included 90 patients with stable angina FC II–III in combination with AH and LVH. Depending on an anti-ischemic therapy, patients were into 3 equal groups: in the first group, patients took Perindoplyl and Ivabradine, in the second group, Perindoplyl, Bisopropol and Ivabradine, in the third group – Perindoplyl and Bisopropol. Duration of treatment was 6 months.Results. Inclusion of Ivabradine to the anti-ischemic therapy of patients with stable angina FC II–III in combination with AH and LVH had additional antianginal and anti-ischemic effect and provided suppression of ventricular ectopic activity, reduction of daily average HR, recourse of LV mass index, increase of LVEF and decrease in variability of heart rhythm, optimization myocardial collagenolysis and decrease of myocardial stress without change of QT interval, QTc and daily dispersion of QT interval. The maximum effect was observed at administration of three-component anti-ischemic therapy. Conclusion. Ivabradine in combination with or without a beta-blocker has not only anti-ischemic effect, but also favorably influences markers of sudden coronary death, without extending QT interval within 24 hours.
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Koziolova N. A., Surovtseva M. V., Eltsova M. А. Dynamics of sudden coronary death markers in patients with coronary heart disease and hypertension in combination with left ventricular hypertrophy against Ivabradine therapy. Russian Heart Journal. 2012;11(2):83-88