Effect of ivabradine-induced heart rate reduction on flow-mediated dilation measured with high-sensitivity ultrasound in patients with stable coronary heart disease

Cardiovascular Ultrasound

Research

Nicoline Jochmann¹  Christine Gericke²  Franziska Schröter³  Fabian Knebel³  Verena Stangl³  Robert Hättasch³  Karl Stangl³  Gert Baumann³ 

[1] Asklepios Klinik St. Georg, Klinische und interventionelle Angiologie, 20099, Hamburg, Lohmühlenstraße 5, Germany;Institut für Biometrie und Klinische Epidemiologie, Charité – Universitätsmedizin Berlin, Charité Campus Benjamin Franklin, 12203, Berlin, Hindenburgdamm 30, Germany;Medizinische Klinik m.S. Kardiologie und Angiologie, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, 10117, Berlin, Charitéplatz 1, Germany;

关键词: Flow-mediated dilation;    Heart rate;    Endothelial function;    Ivabradine;   

DOI  :  10.1186/1476-7120-12-5

 received in 2013-06-06, accepted in 2014-01-21,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundExperimental data suggests that exclusive heart rate reduction with ivabradine is associated with the amelioration of the endothelial function. Since it is presently unknown whether this also applies to humans, the aim of this pilot study was to investigate whether heart rate reduction with ivabradine modulates the endothelial function in humans with an established coronary heart disease.MethodsUsing high-sensitivity ultrasound, we analysed the flow-mediated (FMD) and nitro-mediated dilation (NMD) of the brachial artery in 25 patients (62.9 ± 8.4 years) with a stable coronary heart disease and a resting heart rate of ≥70 beats per minute (bpm). To assess acute effects, measurements were performed before and 4 hours after the first intake of ivabradine 7.5 mg. Sustained effects of an ivabradine therapy (5 mg to 7.5 mg twice daily) were investigated after 4 weeks.ResultsWe found a significant decrease in heart rate, both 4 hours after the intake of 7.5 mg of ivabradine (median -8 [interquartile range (IQR) -14 to -4] bpm) and after 4 weeks of twice daily intake (median -10 [IQR-17 to -5] bpm) (p < 0.05). However, the FMD did not change significantly: neither after first dose of ivabradine nor after sustained therapy (baseline FMD: median 5.0 [IQR 2.4 to 7.9]%; FMD 4 hours after 7.5 mg of ivabradine: median 4.9 [IQR 2.7 to 9.8]%; FMD after 4 weeks of ivabradine therapy: median 6.1 [IQR 4.3 to 8.2]%). No significant changes of the NMD were observed. In regression analysis, the heart rate and FMD did not correlated, irrespective of the ivabradine intake (r2 = 0.086).ConclusionIn conclusion, in our study heart rate reduction through ivabradine does not improve the endothelial function in patients with a stable coronary heart disease. Moreover, we found no correlation between the heart rate and the endothelial function.

【 授权许可】

CC BY   
© Jochmann et al.; licensee BioMed Central Ltd. 2014