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- W2183675949 abstract "Heart rate is a major determinant of myocardial oxygen demand, coronary blood flow and myocardial performance and affects nearly all stages of cardiovascular disease. The recent literature indicates that an elevated resting heart rate represents a cardiovascular risk factor, independent of currently accepted risk factors and other potentially confounding demographic and physiological characteristics. Elevated heart rate is one of the key findings in acute and chronic heart failure and has been shown to be an important predictor of morbidity and mortality. Ivabradine, an inhibitor of the I(f) channel in the sinoatrial node, reduces heart rate without any effect on cardiac contractility and without lowering blood pressure. The effects of additive heart rate reduction on outcomes in patients with heart failure were tested in the BEAUTIFUL and the SHIFT trial. Results of the BEAUTIFUL trial show that patients with ischemic heart disease and a heart rate above 70 bpm exhibit an adverse prognosis concerning coronary events, however the trial showed no effect with regard to the primary endpoint. However heart rate reduction with ivabradine added to the standard pharmacologic treatment improved the prognosis in the subgroup of CAD patients with reduced left ventricular function and a resting heart rate of more than 70 bpm. Results of the SHIFT trial support the importance of heart-rate reduction with ivabradine for improvement of clinical outcomes in heart failure and confirm the role of heart rate as a risk factor for patients with severe left ventricular dysfunction." @default.
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- W2183675949 date "2010-01-01" @default.
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- W2183675949 title "The importance of heart rate control in the management of heart failure" @default.
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