Effect of ivabradine on left ventricular diastolic function of patients with heart failure with preserved ejection fraction -IVA-PEF study

• Published in: Journal of cardiology Vol. 77; no. 6; pp. 641 - 644
• Main Authors: Tanaka, Hidekazu, Yamauchi, Yuki, Imanishi, Junichi, Hatani, Yutaka, Hayashi, Takatoshi, Hirata, Ken-ichi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2021
• Subjects: Heart failure; Heart rate; Ivabradine; Left ventricular diastolic function; Heart rate; Heart failure; Left ventricular diastolic function; Ivabradine
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2020.12.012

•Heart rate (HR) is a known marker of cardiovascular outcomes for heart failure (HF) patients.•Ivabradine significantly improves outcome for HF with reduced ejection fraction with HR ≥70 bpm in sinus rhythm.•Association between HR reduction and left ventricular (LV) diastolic function for HF with preserved ejection fraction (pEF) is unclear.•IVA-PEF investigates the effect of ivabradine on LV diastolic function of HFpEF.
High resting heart rate (HR) is a known marker of cardiovascular outcomes for heart failure (HF) patients. Ivabradine is a new class of HR lowering drug and a specific inhibitor of the If current in the sinoatrial node. Ivabradine substantially and significantly reduces major risks associated with HF when added to guideline-based treatment for left ventricular (LV) ejection fraction ≤35% and HR ≥70 bpm in sinus rhythm. On the other hand, HF with preserved ejection fraction (HFpEF) currently accounts for roughly half of all HF cases and usually presents as LV diastolic dysfunction. However, the association between HR reduction and LV diastolic function for HFpEF patients remains uncertain.
This investigation into the effect of IVAbradine on left ventricular diastolic function of patients with heart failure with Preserved Ejection Fraction (IVA-PEF) is a multicenter, prospective, uncontrolled, open-label, single assignment, and an interventional single-arm study to investigate the effect of ivabradine on LV diastolic function of HFpEF patients. The key inclusion criterion is HFpEF with resting HR ≥75bpm in sinus rhythm. After completed informed consent forms are obtained, patients will be given 5 mg/day of ivabradine during the study. LV diastolic function is assessed in terms of mitral inflow E and mitral e’ annular velocities (E/e’). The primary endpoint will be defined as a change in E/e′ between baseline and 3 months after the start of administration of ivabradine.
The findings of our trial may provide a new perspective on ivabradine for the treatment of HFpEF.