Kurtoglu Ertugrul, Balta Sevket, Karakus Yasin, Yasar Erdogan, Cuglan Bilal, Kaplan Ozgur, Gozubuyuk Gokhan
Department of Cardiology, Malatya State Hospital, Malatya, Turkey.
Department of Cardiology, Eskisehir Military Hospital, Eskisehir, Turkey.
Arq Bras Cardiol. 2014 Oct;103(4):308-14. doi: 10.5935/abc.20140109. Epub 2014 Aug 13.
Ivabradine is a novel specific heart rate (HR)-lowering agent that improves event-free survival in patients with heart failure (HF).
We aimed to evaluate the effect of ivabradine on time domain indices of heart rate variability (HRV) in patients with HF.
Forty-eight patients with compensated HF of nonischemic origin were included. Ivabradine treatment was initiated according to the latest HF guidelines. For HRV analysis, 24-h Holter recording was obtained from each patient before and after 8 weeks of treatment with ivabradine.
The mean RR interval, standard deviation of all normal to normal RR intervals (SDNN), the standard deviation of 5-min mean RR intervals (SDANN), the mean of the standard deviation of all normal-to-normal RR intervals for all 5-min segments (SDNN index), the percentage of successive normal RR intervals exceeding 50 ms (pNN50), and the square root of the mean of the squares of the differences between successive normal to normal RR intervals (RMSSD) were low at baseline before treatment with ivabradine. After 8 weeks of treatment with ivabradine, the mean HR (83.6 ± 8.0 and 64.6 ± 5.8, p < 0.0001), mean RR interval (713 ± 74 and 943 ± 101 ms, p < 0.0001), SDNN (56.2 ± 15.7 and 87.9 ± 19.4 ms, p < 0.0001), SDANN (49.5 ± 14.7 and 76.4 ± 19.5 ms, p < 0.0001), SDNN index (24.7 ± 8.8 and 38.3 ± 13.1 ms, p < 0.0001), pNN50 (2.4 ± 1.6 and 3.2 ± 2.2 %, p < 0.0001), and RMSSD (13.5 ± 4.6 and 17.8 ± 5.4 ms, p < 0.0001) substantially improved, which sustained during both when awake and while asleep.
Our findings suggest that treatment with ivabradine improves HRV in nonischemic patients with HF.
伊伐布雷定是一种新型的特异性降低心率（HR）的药物，可改善心力衰竭（HF）患者的无事件生存期。
我们旨在评估伊伐布雷定对HF患者心率变异性（HRV）时域指标的影响。
纳入48例非缺血性病因的代偿性HF患者。根据最新的HF指南开始伊伐布雷定治疗。为进行HRV分析，在伊伐布雷定治疗8周前后，从每位患者获取24小时动态心电图记录。
在伊伐布雷定治疗前的基线时，平均RR间期、所有正常RR间期的标准差（SDNN）、5分钟平均RR间期的标准差（SDANN）、所有5分钟节段的所有正常RR间期标准差的平均值（SDNN指数）、连续正常RR间期超过50毫秒的百分比（pNN50）以及连续正常RR间期差值平方的平均值的平方根（RMSSD）均较低。伊伐布雷定治疗8周后，平均心率（83.6±8.0和64.6±5.8，p<0.0001）、平均RR间期（713±74和943±101毫秒，p<0.0001）、SDNN（56.2±15.7和87.9±19.4毫秒，p<0.0001）、SDANN（49.5±14.7和76.4±19.5毫秒，p<0.0001）、SDNN指数（24.7±8.8和38.3±13.1毫秒，p<0.0001）、pNN50（2.4±1.6和3.2±2.2%，p<0.0001）以及RMSSD（13.5±4.6和17.8±5.4毫秒，p<0.0001）均有显著改善，且在清醒和睡眠期间均持续存在。
我们的研究结果表明，伊伐布雷定治疗可改善非缺血性HF患者的HRV。
