Ivabradine plus conventional treatment vs conventional treatment alone in reducing the mean heart rate in heart transplant recipients: A randomized clinical trial
| Autor: | Carolina Casadei Dos Santos, Carlos Contreras, João Manoel Rossi Neto, Paulo Chaccur, Ari Timerman, Marco Aurélio Finger |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Afferent nerves Randomization medicine.medical_treatment 030230 surgery law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Heart Rate Internal medicine Heart rate medicine Humans Ivabradine Heart transplantation Transplantation business.industry Antagonist Conventional treatment Heart Benzazepines Treatment Outcome Cardiology Heart Transplantation 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | Clinical transplantationREFERENCES. 35(4) |
| ISSN: | 1399-0012 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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