PMID- 24479706
OWN - NLM
STAT- MEDLINE
DCOM- 20141003
LR  - 20211021
IS  - 1476-7120 (Electronic)
IS  - 1476-7120 (Linking)
VI  - 12
DP  - 2014 Jan 31
TI  - Effect of ivabradine-induced heart rate reduction on flow-mediated dilation 
      measured with high-sensitivity ultrasound in patients with stable coronary heart 
      disease.
PG  - 5
LID - 10.1186/1476-7120-12-5 [doi]
AB  - BACKGROUND: Experimental 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. METHODS: Using 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. RESULTS: We 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). CONCLUSION: In 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.
FAU - Jochmann, Nicoline
AU  - Jochmann N
AD  - Asklepios Klinik St, Georg, Klinische und interventionelle Angiologie, 
      Lohmuhlenstrasse 5, 20099 Hamburg, Germany. n.jochmann@asklepios.com.
FAU - Schroter, Franziska
AU  - Schroter F
FAU - Knebel, Fabian
AU  - Knebel F
FAU - Hattasch, Robert
AU  - Hattasch R
FAU - Gericke, Christine
AU  - Gericke C
FAU - Stangl, Karl
AU  - Stangl K
FAU - Baumann, Gert
AU  - Baumann G
FAU - Stangl, Verena
AU  - Stangl V
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140131
PL  - England
TA  - Cardiovasc Ultrasound
JT  - Cardiovascular ultrasound
JID - 101159952
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Benzazepines)
RN  - 3H48L0LPZQ (Ivabradine)
SB  - IM
MH  - Anti-Arrhythmia Agents/therapeutic use
MH  - Benzazepines/*therapeutic use
MH  - Coronary Artery Disease/diagnostic imaging/*drug therapy/*physiopathology
MH  - Coronary Circulation/*drug effects
MH  - Echocardiography/methods
MH  - Female
MH  - Heart Rate/*drug effects
MH  - Humans
MH  - Image Enhancement/*methods
MH  - Ivabradine
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
PMC - PMC3922062
EDAT- 2014/02/01 06:00
MHDA- 2014/10/04 06:00
PMCR- 2014/01/31
CRDT- 2014/02/01 06:00
PHST- 2013/06/06 00:00 [received]
PHST- 2014/01/21 00:00 [accepted]
PHST- 2014/02/01 06:00 [entrez]
PHST- 2014/02/01 06:00 [pubmed]
PHST- 2014/10/04 06:00 [medline]
PHST- 2014/01/31 00:00 [pmc-release]
AID - 1476-7120-12-5 [pii]
AID - 10.1186/1476-7120-12-5 [doi]
PST - epublish
SO  - Cardiovasc Ultrasound. 2014 Jan 31;12:5. doi: 10.1186/1476-7120-12-5.