Dominguez-Rodriguez Alberto, Blanco-Palacios Gabriela, Abreu-Gonzalez Pedro
Alberto Dominguez-Rodriguez, Gabriela Blanco-Palacios, Department of Cardiology, Hospital Universitario de Canarias, Tenerife, E-38320, La Laguna, Spain.
World J Cardiol. 2011 Apr 26;3(4):101-4. doi: 10.4330/wjc.v3.i4.101.
Despite all the therapeutic advances in the field of cardiology, cardiovascular diseases, and in particular coronary artery disease, remain the leading cause of death and disability worldwide, thereby underlining the importance of acquiring new therapeutic options in this field. A reduction in elevated resting heart rate (HR) has long been postulated as a therapeutic approach in the management of cardiovascular disease. An increased HR has been shown to be associated with increased progression of coronary atherosclerosis in animal models and patients. A high HR has also been associated with a greatly increased risk of plaque rupture in patients with coronary atherosclerosis. Endothelial function may be an important link between HR and atherosclerosis. An increased HR has been shown experimentally to cause endothelial dysfunction. Inflammation plays a significant role in the pathogenesis and progression of atherosclerosis. In the literature, there is data that shows an association between HR and circulating markers of vascular inflammation. In addition, HR reduction by pharmacological intervention with ivabradine (a selective HR-lowering agent that acts by inhibiting the pacemaker ionic current I(f) in sinoatrial node cells) reduces the formation of atherosclerotic plaques in animal models of lipid-induced atherosclerosis. The aim of this editorial is to review the possible role of ivabradine on atherosclerosis.
尽管心脏病学领域在治疗方面取得了诸多进展，但心血管疾病，尤其是冠状动脉疾病，仍然是全球范围内导致死亡和残疾的主要原因，这凸显了在该领域获取新治疗方案的重要性。长期以来，降低静息心率（HR）一直被认为是心血管疾病管理中的一种治疗方法。在动物模型和患者中，已证明心率增加与冠状动脉粥样硬化进展加快有关。高心率还与冠状动脉粥样硬化患者斑块破裂风险大幅增加有关。内皮功能可能是心率与动脉粥样硬化之间的重要联系。实验表明，心率增加会导致内皮功能障碍。炎症在动脉粥样硬化的发病机制和进展中起重要作用。文献中有数据表明心率与血管炎症循环标志物之间存在关联。此外，通过使用伊伐布雷定（一种通过抑制窦房结细胞起搏离子电流I(f)起作用的选择性降心率药物）进行药物干预降低心率，可减少脂质诱导的动脉粥样硬化动物模型中动脉粥样硬化斑块的形成。这篇社论的目的是综述伊伐布雷定对动脉粥样硬化可能的作用。
