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01.03.2013 | Review

Ivabradine: potential clinical applications in critically ill patients

verfasst von: Vincenzo De Santis, Domenico Vitale, Anna Santoro, Aurora Magliocca, Andrea Giuseppe Porto, Cecilia Nencini, Luigi Tritapepe

Erschienen in: Clinical Research in Cardiology | Ausgabe 3/2013

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Abstract

It has been extensively demonstrated that an elevated heart rate is a modifiable, independent risk factor for cardiovascular events. A high heart rate increases myocardial oxygen consumption and reduces diastolic perfusion time. It can also increase ventricular diastolic pressures and induce ventricular arrhythmias. Critical care patients are prone to develop a stress induced cardiac impairment and consequently an increase in sympathetic tone. This in turn increases heart rate. In this setting, however, heart rate lowering might be difficult because the effects of inotropic drugs could be hindered by heart rate reducing drugs like beta-blockers. Ivabradine is a new selective antagonist of funny channels. It lowers heart rate, reducing the diastolic depolarization slope. Moreover, ivabradine is not active on sympathetic pathways, thus avoiding any interference with inotropic amines. We reviewed the literature available regarding heart rate control in critical care patients, focusing our interest on the use of ivabradine to assess the potential benefits of the drug in this particular setting.

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Titel: Ivabradine: potential clinical applications in critically ill patients
verfasst von: Vincenzo De Santis
Domenico Vitale
Anna Santoro
Aurora Magliocca
Andrea Giuseppe Porto
Cecilia Nencini
Luigi Tritapepe
Publikationsdatum: 01.03.2013
Verlag: Springer-Verlag
Erschienen in: Clinical Research in Cardiology / Ausgabe 3/2013
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-012-0516-3

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