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Heart rate reduction for 12 months with ivabradine reduces left ventricular mass in cardiac allograft recipients.
Transplantation. 2009 Sep 27; 88(6):835-41.T

Abstract

BACKGROUND

Graft denervation in heart transplant recipients causes sinus tachycardia, occasionally requiring pharmacologic heart rate reduction. Currently, no 12-month data regarding effects of the novel I(f) channel antagonist ivabradine on heart rate control, effects on left ventricular mass, tolerability, and safety are available in patients after heart transplantation (HTX).

METHODS

Mean heart rate, left ventricular mass indexed (LVMI) to body surface area, tolerability, and safety of ivabradine therapy were evaluated at baseline and after 12 months in 30 HTX recipients with marked sinus tachycardia.

RESULTS

In three patients (10.0% of total), ivabradine medication was discontinued. Further analysis was based on 27 patients with 12-month drug exposure. Mean patient age was 53.3+/-11.3 years, and mean time after HTX was 5.0+/-4.8 years. Mean ivabradine dose was 12.5 mg/day (+/-3.3 mg). Mean heart rate was reduced from 96.2+/-8.6 beats per minute (bpm) at baseline to 80.9+/-8.1 bpm at follow-up (P<0.0001). A statistically significant effect of heart rate reduction on LVMI was observed (104.3+/-22.7 g at baseline vs. 95.9+/-18.5 g at follow-up, P=0.04). No statistically significant changes in immunosuppressive drug dosage or blood levels were observed, except from a lower mycophenolate mofetil dose at follow-up (P=0.01). Safety laboratory values were unchanged. No phosphenes were observed.

CONCLUSIONS

Heart rate reduction with ivabradine is effective and safe in heart transplant recipients. After 12 months, significant effects on LVMI were observed. Therefore, ivabradine may offer a beneficial effect on left ventricular remodelling in HTX patients.

Authors+Show Affiliations

Department of Cardiology, University of Heidelberg, Heidelberg, Germany. andreas.doesch@med.uni-heidelberg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

19920784

Citation

Doesch, Andreas O., et al. "Heart Rate Reduction for 12 Months With Ivabradine Reduces Left Ventricular Mass in Cardiac Allograft Recipients." Transplantation, vol. 88, no. 6, 2009, pp. 835-41.
Doesch AO, Ammon K, Konstandin M, et al. Heart rate reduction for 12 months with ivabradine reduces left ventricular mass in cardiac allograft recipients. Transplantation. 2009;88(6):835-41.
Doesch, A. O., Ammon, K., Konstandin, M., Celik, S., Kristen, A., Frankenstein, L., Buss, S., Hardt, S., Sack, F. U., Katus, H. A., & Dengler, T. J. (2009). Heart rate reduction for 12 months with ivabradine reduces left ventricular mass in cardiac allograft recipients. Transplantation, 88(6), 835-41. https://doi.org/10.1097/TP.0b013e3181b4e0f5
Doesch AO, et al. Heart Rate Reduction for 12 Months With Ivabradine Reduces Left Ventricular Mass in Cardiac Allograft Recipients. Transplantation. 2009 Sep 27;88(6):835-41. PubMed PMID: 19920784.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Heart rate reduction for 12 months with ivabradine reduces left ventricular mass in cardiac allograft recipients. AU - Doesch,Andreas O, AU - Ammon,Kerstin, AU - Konstandin,Mathias, AU - Celik,Sultan, AU - Kristen,Arnt, AU - Frankenstein,Lutz, AU - Buss,Sebastian, AU - Hardt,Stefan, AU - Sack,Falk-Udo, AU - Katus,Hugo A, AU - Dengler,Thomas J, PY - 2009/11/19/entrez PY - 2009/11/19/pubmed PY - 2009/12/16/medline SP - 835 EP - 41 JF - Transplantation JO - Transplantation VL - 88 IS - 6 N2 - BACKGROUND: Graft denervation in heart transplant recipients causes sinus tachycardia, occasionally requiring pharmacologic heart rate reduction. Currently, no 12-month data regarding effects of the novel I(f) channel antagonist ivabradine on heart rate control, effects on left ventricular mass, tolerability, and safety are available in patients after heart transplantation (HTX). METHODS: Mean heart rate, left ventricular mass indexed (LVMI) to body surface area, tolerability, and safety of ivabradine therapy were evaluated at baseline and after 12 months in 30 HTX recipients with marked sinus tachycardia. RESULTS: In three patients (10.0% of total), ivabradine medication was discontinued. Further analysis was based on 27 patients with 12-month drug exposure. Mean patient age was 53.3+/-11.3 years, and mean time after HTX was 5.0+/-4.8 years. Mean ivabradine dose was 12.5 mg/day (+/-3.3 mg). Mean heart rate was reduced from 96.2+/-8.6 beats per minute (bpm) at baseline to 80.9+/-8.1 bpm at follow-up (P<0.0001). A statistically significant effect of heart rate reduction on LVMI was observed (104.3+/-22.7 g at baseline vs. 95.9+/-18.5 g at follow-up, P=0.04). No statistically significant changes in immunosuppressive drug dosage or blood levels were observed, except from a lower mycophenolate mofetil dose at follow-up (P=0.01). Safety laboratory values were unchanged. No phosphenes were observed. CONCLUSIONS: Heart rate reduction with ivabradine is effective and safe in heart transplant recipients. After 12 months, significant effects on LVMI were observed. Therefore, ivabradine may offer a beneficial effect on left ventricular remodelling in HTX patients. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/19920784/Heart_rate_reduction_for_12_months_with_ivabradine_reduces_left_ventricular_mass_in_cardiac_allograft_recipients_ L2 - http://dx.doi.org/10.1097/TP.0b013e3181b4e0f5 DB - PRIME DP - Unbound Medicine ER -