Department of Experimental and Applied Medicine, University of Study of Brescia, Brescia, Italy.
Minerva Med. 2011 Oct;102(5):373-9.
Heart rate is a major determinant of cardiac output, myocardial oxygen consumption and coronary blood flow under physiological and pathological conditions. Experimental and clinical data have demonstrated that heart rate reduction is the main mechanism for reducing ischemia, improving left ventricular function, decreasing the risk of plaque rupture and post myocardial infarction mortality. Nowadays betablockers are the best class of drugs that can lower heart rate in patients with cardiovascular diseases, but sometimes their use is limited by some contraindications. Ivabradine is a new drug that reduces the firing rate of pacemaker cells in the sinoatrial node through a different mechanism with respect to betablockers. The purpose of this review is to investigate the main trials that support Ivabradine adoption in clinical practice.
心率是生理和病理条件下心输出量、心肌耗氧量和冠状动脉血流的主要决定因素。实验和临床数据表明，降低心率是减少缺血、改善左心室功能、降低斑块破裂风险和心肌梗死后死亡率的主要机制。如今，β受体阻滞剂是降低心血管疾病患者心率的最佳药物类别，但有时由于某些禁忌症，其使用受到限制。伊伐布雷定是一种新药，它通过与β受体阻滞剂不同的机制降低窦房结起搏细胞的发放频率。本综述的目的是研究支持伊伐布雷定在临床实践中应用的主要试验。
