-
Views
-
Cite
Cite
Friedrich Fruhwald, Burkert Pieske, Left ventricular remodelling in systolic heart failure using ivabradine. Slower is smaller is better?, European Heart Journal, Volume 32, Issue 20, October 2011, Pages 2481–2482, https://doi.org/10.1093/eurheartj/ehr317
Close - Share Icon Share
Extract
This commentary refers to ‘Effects of selective heart rate reduction with ivabradine on left ventricular remodelling and function: results from the SHIFT echocardiographic substudy’†, by J.-C. Tardif et al., on page 2507
Tardif and co-workers have published the echocardiographic substudy of the SHIFT trial.1 This pre-defined substudy included 611 out of 6505 patients from SHIFT, or, in other words, 9.3% of the entire cohort studied in SHIFT.2 The authors report that of these 611 patients, 96 ivabradine- and 104 placebo-treated patients had to be excluded, mainly due to incomplete or unreadable echo recordings, which left 208 patients in the ivabradine group and 203 in the placebo group for analysis. The echoes were analysed centrally and the investigations were done at baseline and after 8 months, with the primary endpoint of change of left ventricular systolic volume index (LVESVI) at 8 months. This well-treated population [92% were on beta-blockers, with 56% taking 50% of the recommended dose, and 94% were treated with a renin–angiotensin system (RAS) antagonist] was not different from the entire SHIFT cohort, except for a lower rate of hypertension and a higher rate of use of mineralocorticoid receptor antagonists. Eight months of ivabradine treatment resulted in a 7 mL/m2 reduction of LVESVI, as compared with 0.9 mL/m2 in the placebo group, and an increase in left ventricular ejection fraction (LVEF; a secondary endpoint) of 2.4%, whereas there was no change in the placebo group at all.
