Ivabradine plus conventional treatment vs conventional treatment alone in reducing the mean heart rate in heart transplant recipients: A randomized clinical trial.

Autor: Dos Santos CC; Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil., Rossi Neto JM; Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil., Finger MA; Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil., Timerman A; Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil., Contreras C; Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil., Chaccur P; Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2021 Apr; Vol. 35 (4), pp. e14227. Date of Electronic Publication: 2021 Feb 02.
DOI: 10.1111/ctr.14227
Abstrakt: The absence of afferent nerves for heart rate (HR) regulation leaves the transplanted heart under the influence of its internal and hormonal control. The HR of heart transplantation (HTx) recipients varies from to 90-110 bpm, indicating a lack of vagal parasympathetic tone. We hypothesized that the reduction in mean HR using an If-channel antagonist (ivabradine) could be effective and safe in HTx recipients. The primary objective of this open-label randomized clinical trial was to compare the mean HR at 3, 6, 12, 18, 24, 30, and 36 months after randomization between an ivabradine plus conventional treatment group (IG) and conventional treatment alone group (CG). The secondary objectives were reduction in mortality, graft dysfunction, and ventricular mass. All patients were randomized between 1 and 12 months after HTx. Ivabradine started at randomization. Of the 35 patients, 54.28% were in the CG and 45.72% in the IG. There were no significant between-group differences in demographics. Over time, the HR differences between the groups became significant (P < .01). There were no significant between-group differences in mortality, graft dysfunction, and ventricular mass. We conclude that ivabradine could effectively and consistently reduce the HR in HTx recipients.
(© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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