Introduction: Ivabradine has proved effective in patients with systolic heart failure.The aim of the present study is to evaluate prospectively the effect of ivabradine on diastolic function in addition to optimum guideline-based treatment, and its impact on exercise capacity and echocardiographic indexes of diastolic heart failure.
Methods: We enrolled 30 patients with diastolic heart failure, NYHA class II/III and optimal medical treatment.Before the initiation of ivabradine and three months later the patients underwent clinical evaluation, cardiopulmonary test (exercise duration ED, peak oxygen uptake V02max) and echocardiographic evaluation (assessment of E-wave deceleration time EDT, isovolumic relaxation time IVRT, tissue Doppler assessment at the mitral annulus E/Em).
Results: After 3 months of follow up heart rate has decreased from 85±5 to 68±3bpm. Exercise capacity ameliorated (ED from 6,1±1,9 vs 7.3±1,4, P<0.05, PeakVO2 ml/Kg/min from 15,6±2,1 to 17,9±2,8 P<0.05). Echocardiographic indexes have also improved EDT from 257±12 ms to 240±12ms p<0.02, IVRT from 83±9ms to 75±13ms, p<0.05, E/Em from 12,2±2,2 to 10,5±1,6 p<0,05).
Conclusions: Addition of ivabradine to optimum medical treatment seems to improve functional status, exercise capacity and diastolic function.