Effects of selective heart rate reduction with ivabradine on left ventricular remodelling and function: results from the SHIFT echocardiography substudy

Tardif, J.-C., O'Meara, E., Komajda, M., Bohm, M., Borer, J. S., Ford, I. , Tavazzi, L. and Swedberg, K. (2011) Effects of selective heart rate reduction with ivabradine on left ventricular remodelling and function: results from the SHIFT echocardiography substudy. European Heart Journal, 32(20), pp. 2507-2515. (doi: 10.1093/eurheartj/ehr311)

Abstract

Eligible patients had chronic HF and systolic dysfunction [LV ejection fraction (LVEF) 35], were in sinus rhythm, and had resting heart rate epsilon 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 [7.0 16.3 vs. 0.9 17.1 mL/m(2); difference (SE), 5.8 (1.6), 95 CI 8.8 to 2.7, 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 (7.9 18.9 vs. 1.8 19.0 mL/m(2), P 0.002) and LVEF (2.4 7.7 vs. 0.1 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/m(2)) at baseline (HR 1.62, 95 CI 1.032.56, P 0.04). Patients with the largest relative reductions in LVESVI had the lowest event rates.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ford, Professor Ian
• Authors: Tardif, J.-C., O'Meara, E., Komajda, M., Bohm, M., Borer, J. S., Ford, I., Tavazzi, L., and Swedberg, K.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: European Heart Journal
• ISSN: 0195-668X