scholarly journals The role of heart rate and ivabradine in acute heart failure

2019 ◽  
Vol 89 (3) ◽  
Author(s):  
Edoardo Sciatti ◽  
Enrico Vizzardi ◽  
Ivano Bonadei ◽  
Lucia Dallapellegrina ◽  
Valentina Carubelli
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Healthy Subjects ◽  
Beta Blockers ◽  
Resting Heart Rate ◽  
Powerful Predictor ◽  
Treatment Target ◽  
Reduced Ejection Fraction ◽  
Lowering Drug

Resting heart rate (HR) is considered a powerful predictor of mortality both in healthy subjects and in cardiovascular (CV) patients, including those affected by heart failure (HF). Its reduction below 70 bpm is the treatment target in chronic HF with reduced ejection fraction (HFrEF) when sinus rhythm is present. In acute HF (AHF) HR is usually elevated but its role as risk marker is still unknown. Notably, in unstable patients, beta-blockers can be reduced or stopped, thus enhancing this phenomenon. Moreover, some data in literature suggest that HR reduction during hospitalization or HR at discharge or in the vulnerable phase after it are more predictive of early-term events and may be therapeutic targets. On the other hand, ivabradine is a pure HR-lowering drug with no effects on inotropism. Its role in the AHF setting has been recently investigated and is the object of this review.

scholarly journals Resting heart rate in ambulatory heart failure with reduced ejection fraction treated with beta‐blockers

2020 ◽  
Vol 7 (5) ◽  
pp. 3049-3058
Author(s):  
Kenneth D. Varian ◽  
Xinge Ji ◽  
Justin L. Grodin ◽  
Frederik H. Verbrugge ◽  
Alex Milinovich ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Beta Blockers ◽  
Resting Heart Rate ◽  
Reduced Ejection Fraction

Role of High-Dose Beta-Blockers in Patients with Heart Failure with Preserved Ejection Fraction and Elevated Heart Rate

2018 ◽  
Vol 131 (12) ◽  
pp. 1473-1481 ◽  
Author(s):  
Phillip H. Lam ◽  
Neha Gupta ◽  
Daniel J. Dooley ◽  
Steven Singh ◽  
Prakash Deedwania ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Beta Blockers ◽  
High Dose ◽  
Preserved Ejection Fraction ◽  
Patients With Heart Failure ◽  
Elevated Heart Rate

HFrEF pharmacological treatment: ivabradine

ESC CardioMed ◽  
2018 ◽  
pp. 1863-1867
Author(s):  
Michel Komajda
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Heart Rate ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Sinus Rhythm ◽  
Pharmacological Treatment ◽  
Beta Blockers ◽  
Reduced Ejection Fraction ◽  
Background Therapy

Ivabradine slows down the heart rate through a blockade of the funny current channels in the sinoatrial node cells. The efficacy of the drug was tested in a large outcome clinical trial in stable chronic heart failure with reduced ejection fraction, in sinus rhythm, on a contemporary background therapy including beta blockers.

HFrEF pharmacological treatment: ivabradine

ESC CardioMed ◽  
2018 ◽  
pp. 1863-1867
Author(s):  
Michel Komajda
Keyword(s):  
Heart Failure ◽  
Clinical Trial ◽  
Heart Rate ◽  
Chronic Heart Failure ◽  
Ejection Fraction ◽  
Sinus Rhythm ◽  
Pharmacological Treatment ◽  
Beta Blockers ◽  
Reduced Ejection Fraction ◽  
Background Therapy

Ivabradine slows down the heart rate through a blockade of the funny current channels in the sinoatrial node cells. The efficacy of the drug was tested in a large outcome clinical trial in stable chronic heart failure with reduced ejection fraction, in sinus rhythm, on a contemporary background therapy including beta blockers.

Prognostic significance of resting heart rate in atrial fibrillation patients with heart failure with reduced ejection fraction

2020 ◽  
Vol 35 (8) ◽  
pp. 1109-1115 ◽  
Author(s):  
Sho Suzuki ◽  
Hirohiko Motoki ◽  
Yusuke Kanzaki ◽  
Takuya Maruyama ◽  
Naoto Hashizume ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Heart Rate ◽  
Ejection Fraction ◽  
Prognostic Significance ◽  
Resting Heart Rate ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure

scholarly journals Crossing the chasm: caution for use of angiotensin receptor-neprilysin inhibition in patients with cardiogenic shock– a case report

2020 ◽  
Author(s):  
Loai Almazroa ◽  
Vesna Mihajlovic ◽  
Patrick R Lawler ◽  
Adriana Luk
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Cardiogenic Shock ◽  
Beta Blockers ◽  
Supportive Therapy ◽  
Kidney Injury ◽  
Angiotensin Receptor ◽  
Reduced Ejection Fraction ◽  
Risk Of Death

Abstract Background Vasoplegia has been reported in patients receiving angiotensin receptor-neprilysin inhibitors (ARNI) with heart failure with reduced ejection fraction (HFrEF). We present a case of vasoplegic shock after initiation of ARNI in a hospitalized 65-year-old man recovering from cardiogenic shock (CS) and acute kidney injury (AKI). Case summary A 65-year-old man with HFrEF presented to a community hospital with CS with evidence of poor perfusion with a lactate of 5.6 mmol/L and creatinine (Cr) 125 µmol/L. He was treated with intravenous furosemide infusion. Subsequently, his lactate normalized but he developed an AKI with a Cr of 176 µmol/L. He was then started on ARNI and beta blockers. Over the next 24 h, he developed a vasoplegic shock necessitating multiple vasopressors and a transfer to a tertiary academic centre. With supportive therapy, his vasoplegic shock improved and he was discharged home. Discussion PARADIGM-HF found that the introduction of an ARNI in patients with ambulatory symptomatic HFrEF reduces the risk of death and heart failure hospitalization. Most recently, PIONEER-HF showed that ARNI reduced N-terminal pro-B-type natriuretic peptide levels at 4 and 8 weeks, without significantly different rates of medication-related adverse effects. However, thus far, no clinical trials have examined the role of ARNI in CS. Our case report highlights the risk of vasoplegic shock caused by initiation of ARNI in patients hospitalized with CS especially in whom renal and hepatic impairment is present.

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