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Review Article

. 2020; 11(1): 4-8


Review Article: Impact of Ivabradine on Cardiovascular Morbidity

Gammone M, Riccioni G, D’Orazio.

Abstract
Heart failure is a complex clinical syndrome with a high incidence all over the world. Although various types of pharmacological
and device therapies are available, the control of increased heart rate (HR) is critical. The bradycardic agent, ivabradine (IVA),
has been displayed to reduce HR by inhibiting the funny current (If). The underlying mechanism states that ivabradine can enter
the hyperpolarization-activated cyclic nucleotide-gated (HCN) channels and bind to the intracellular side, subsequently inhibiting
the If. This phenomenon can prolong the slow spontaneous phase in the diastolic depolarization, and thus, reduce HR. Many
epidemiological studies reported a strong independent association between elevated heart rate and major cardiovascular risk
factors including atherosclerosis, ventricular arrhythmias, and left ventricular dysfunction. The heart rate reduction with IVA
is beneficial in patients with coronary artery disease CAD, chronic stable angina pectoris, and chronic heart failure (CHF), with
acceptable tolerance and safety profile. The pharmacodynamic and pharmacokinetic properties of this drug make it an important
agent in the management of patients with CAD and HF. The aim of this short review is to explore recent results with IVA a new
medication that lowers heart rate by selectively inhibiting the If current, and to describe others future potential applications.

Key words: cardiovascular disease, chronic stable angina, chronic heart failure, heart rate, ivabradine.


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