Clin Res Cardiol 101, Suppl 1, April 2012

P697 - Heart rate reduction for 36 months with ivabradine reduces left ventricular mass in cardiac allograft recipients
A. Dösch1, C. Erbel1, A. Ruhparwar2, L. Frankenstein1, C. Zugck1, P. Ehlermann1, T. J. Dengler3, H. A. Katus1
1Innere Med. III, Kardiologie, Angiologie u. Pneumologie, Universitätsklinikum Heidelberg, Heidelberg; 2Klinik für Herzchirurgie, Universitätsklinikum Heidelberg, Heidelberg; 3Medizinische Klinik I - Kardiologie, Angiologie u. Intensivmed., SLK-Kliniken Heilbronn GmbH, Klinikum am Plattenwald, Bad Friedrichshall;
Background: Graft denervation in heart transplant recipients causes sinus tachycardia, occasionally requiring pharmacologic heart rate reduction. Currently, no long term data regarding effects of the novel If channel antagonist ivabradine on heart rate control, effects on left ventricular (LV) mass, tolerability, and safety are available in patients after heart transplantation (HTX).
Methods: Resting heart rate, left ventricular mass indexed to body surface area (LVMI), tolerability, and safety of ivabradine therapy were evaluated at baseline and after 36 months in 30 HTX recipients with marked sinus tachycardia.
Results: In three patients (10.0% of total) ivabradine medication was discontinued. Further analysis was based on 27 patients with 36-month drug exposure. Mean patient age was 53.3±11.3 years and mean time after HTX was 5.0±4.8 years. Mean ivabradine dose was 12.0 mg/day (±3.4 mg). Resting heart rate was reduced from 91.0±10.7 beats per minute (bpm) at baseline to 81.2±9.8 bpm at follow-up (p=0.0006).  A statistically significant effect of heart rate reduction on LVMI was observed (104.3±22.7 g at baseline vs. 93.95±18.4 g at follow-up, p=0.002). No statistically significant changes in immunosuppressive drug dosage or blood levels were observed, except from a lower mycophenolate mofetil (MMF) dose at follow-up (p=0.02). Safety laboratory values were unchanged. No phosphenes were observed.
Conclusions: Heart rate reduction with ivabradine is effective and safe in heart transplant recipients. After 36 months significant effects on LVMI were observed. Therefore ivabradine may offer a beneficial effect on LV remodelling in HTX patients.
Clin Res Cardiol 101, Suppl 1, April 2012
Zitierung mit Vortrags- oder Posternummer s.o.
DOI 10.1007/s00392-012-1100-6