发布日期：2011-08-29
英文标题：Effects of selective heart rate reduction with ivabradine on left ventricular remodeling and function: results from the SHIFT echocardiography substudy.
作者：Jean-Claude Tardif et al.
出处：European Heart Journal, 2011 , 32 (20) :2507
内容介绍：SHIFT 超声心动图亚组旨在评估伊伐布雷定对心衰患者左室重构的影响。
摘要展示：
Aims: The SHIFT echocardiographic substudy evaluated the effects of ivabradine on left ventricular (LV) remodelling in heart failure (HF).
Methods and results: Eligible patients had chronic HF and systolic dysfunction [LV ejection fraction (LVEF) ≤ 35%], were in sinus rhythm,and had resting heart rate ≥ 70 bpm. Patients were randomly allocated to ivabradine or placebo, superimposed on background therapy for HF. Complete echocardiographic data at baseline and 8 months were available for 411 patients (ivabradine 208, placebo 203). Treatment with ivabradine reduced LVESVI (primary substudy endpoint) vs. placebo [27.0+ 16.3 vs. 20.9+17.1 mL/m2; difference (SE), 25.8 (1.6), 95% CI 28.8 to 22.7, P , 0.001]. The reduction in LVESVI was independent of beta-blocker use, HF aetiology, and baseline LVEF. Ivabradine also improved LV end-diastolic volume index (27.9 +18.9 vs. 21.8 +19.0 mL/m2, P ¼ 0.002) and LVEF (+2.4 + 7.7 vs. 20.1+ 8.0%, P , 0.001). The incidence of the SHIFT primary composite outcome (cardiovascular mortality or hospitalization for worsening HF) was higher in patients with LVESVI above the median (59 mL/m2) at baseline (HR 1.62, 95% CI 1.03–2.56, P ¼ 0.04). Patients with the largest relative reductions in LVESVI had the lowest event rates.
Conclusion: Ivabradine reverses cardiac remodelling in patients with HF and LV systolic dysfunction.
