Effect of heart rate reduction by ivabradine on left ventricular remodelling in the echocardiographic substudy of BEAUTIFUL

Ceconi, C. et al. (2011) Effect of heart rate reduction by ivabradine on left ventricular remodelling in the echocardiographic substudy of BEAUTIFUL. International Journal of Cardiology, 146(3), pp. 408-414. (doi: 10.1016/j.ijcard.2010.10.125)

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<p><b>Aims</b> <br>Occlusive coronary artery disease (CAD) is associated with left ventricular (LV) remodeling, LV systolic dysfunction, and heart failure. The BEAUTIFUL Echo substudy aimed to evaluate the effects of heart rate reduction with ivabradine on LV size (primary end-point: change in LV end-systolic volume index [LVESVI]) and function and the cardiac biomarker N-terminal pro-brain natriuretic peptide (NT-proBNP).</br></p> <p><b>Methods and results</b> <br>The substudy was carried out in 86 centers participating in the BEAUTIFUL study. 2D echocardiography was performed at baseline, and after 3 and 12 months in patients with stable CAD and LV systolic dysfunction receiving ivabradine or placebo at the same time-points. All data were read and analyzed centrally. Of 525 patients completing the study, 426 had adequate echocardiographic readings (n = 220 ivabradine; n = 206 placebo). Treatment with ivabradine was associated with a decrease in the primary end-point LVESVI (change from baseline to last value, − 1.48 ± 13.00 mL/m2) versus an increase with placebo (1.85 ± 10.54 mL/m2) (P = 0.018). There was an increase in LV ejection fraction with ivabradine (2.00 ± 7.02%) versus no change with placebo (0.01 ± 6.20 %) (P = 0.009). Reduction in LVESVI was related to the degree of heart rate reduction with ivabradine. There were no differences in any other echocardiographic parameters or NT-proBNP. Change in LVESVI was related to the log change in NT-proBNP in the ivabradine group only (r = 0.18, P = 0.006).</br></p> <p><b>Conclusions</b> <br>Our observations suggest that ivabradine may reverse detrimental LV remodeling in patients with CAD and LV systolic dysfunction.</br></p>

Item Type:Articles
Glasgow Author(s) Enlighten ID:Robertson, Mrs Michele and Ford, Professor Ian
Authors: Ceconi, C., Freedman, S.B., Tardif, J.C., Hildebrandt, P., McDonagh, T., Gueret, P., Parrinello, G., Robertson, M., Steg, P.G., Tendera, M., Ford, I., Fox, K., and Ferrari, R.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
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Journal Name:International Journal of Cardiology
Publisher:Elsevier Ireland Ltd
ISSN (Online):0167-5273
Published Online:26 November 2010

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