Effects of Ivabradine on Residual Myocardial Ischemia after PCI Evaluated by Stress Echocardiography
Background. Residual angina after PCI is a frequently occurring disease. Ivabradine improves symptoms but its role in patients without left ventricular systolic dysfunction is still unclear. The aim was to quantify the effects of ivabradine in terms of MVO2 indicators and diastolic function. Methods...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/9185876 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832559921751654400 |
|---|---|
| author | Simone Calcagno Fabio Infusino Olga Dettori Temistocle Taccheri Pasqualina Bruno Viviana Maestrini Gennaro Sardella Massimo Mancone Francesco Fedele |
| author_facet | Simone Calcagno Fabio Infusino Olga Dettori Temistocle Taccheri Pasqualina Bruno Viviana Maestrini Gennaro Sardella Massimo Mancone Francesco Fedele |
| author_sort | Simone Calcagno |
| collection | DOAJ |
| description | Background. Residual angina after PCI is a frequently occurring disease. Ivabradine improves symptoms but its role in patients without left ventricular systolic dysfunction is still unclear. The aim was to quantify the effects of ivabradine in terms of MVO2 indicators and diastolic function. Methods. Twenty-eight consecutive patients with residual angina after PCI were randomized to ivabradine 5 mg twice/day (IG) or standard therapy (CG). All patients performed a stress echocardiography at the enrollment and after 30 days. MVO2 was estimated from double product (DP) and triple product (TP) integrating DP with ejection time (ET). Diastolic function was evaluated determining E and A waves, E′ measurements, and E/E′ ratio both at rest and at the peak of exercise. Results. The exercise time was longer in IG 9′49″ ± 48″ vs 8′09″ ± 59″ in CG (p=0.0001), reaching a greater workload (IG 139.3 ± 13.4 vs CG 118.7 ± 19.6 Watts; p=0.003). MVO2 expressed with DP and TP was significantly higher in IG (DP: IG 24194 ± 2697 vs CG 20358 ± 4671.8, p=0.01; TP: IG 17239 ± 4710 vs CG 12206 ± 4413, p=0.007). At peak exercise, the ET was diminished in IG than CG. The analysis of diastolic function after the exercise revealed an increase of E and A waves, without difference in the E/A ratio. The E′ wave was higher in IG than CG, and in the same group, the differences between baseline and peak exercise were greater (∆E′3.14 ± 0.7 vs 2.4 ± 1.13, p=0.047). The E/E′ ratio was reduced in patients treated with ivabradine (IG 10.2 ± 2.0 vs CG 7.9 ± 1.6, p=0.002). Conclusions. Ivabradine seems to produce a significant improvement of ischemic threshold, chronotropic reserve, and diastolic function. |
| format | Article |
| id | doaj-art-a08b9e487bd545b095f621b46dc5d9c8 |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-a08b9e487bd545b095f621b46dc5d9c82025-02-03T01:28:59ZengWileyCardiology Research and Practice2090-80162090-05972019-01-01201910.1155/2019/91858769185876Effects of Ivabradine on Residual Myocardial Ischemia after PCI Evaluated by Stress EchocardiographySimone Calcagno0Fabio Infusino1Olga Dettori2Temistocle Taccheri3Pasqualina Bruno4Viviana Maestrini5Gennaro Sardella6Massimo Mancone7Francesco Fedele8Cardiovascular, Respiratory, Geriatric, Anesthesiologic and Nephrologic Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, ItalyCardiovascular, Respiratory, Geriatric, Anesthesiologic and Nephrologic Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, ItalyCardiovascular, Respiratory, Geriatric, Anesthesiologic and Nephrologic Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, ItalyCardiovascular, Respiratory, Geriatric, Anesthesiologic and Nephrologic Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, ItalyCardiovascular, Respiratory, Geriatric, Anesthesiologic and Nephrologic Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, ItalyCardiovascular, Respiratory, Geriatric, Anesthesiologic and Nephrologic Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, ItalyCardiovascular, Respiratory, Geriatric, Anesthesiologic and Nephrologic Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, ItalyCardiovascular, Respiratory, Geriatric, Anesthesiologic and Nephrologic Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, ItalyCardiovascular, Respiratory, Geriatric, Anesthesiologic and Nephrologic Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, ItalyBackground. Residual angina after PCI is a frequently occurring disease. Ivabradine improves symptoms but its role in patients without left ventricular systolic dysfunction is still unclear. The aim was to quantify the effects of ivabradine in terms of MVO2 indicators and diastolic function. Methods. Twenty-eight consecutive patients with residual angina after PCI were randomized to ivabradine 5 mg twice/day (IG) or standard therapy (CG). All patients performed a stress echocardiography at the enrollment and after 30 days. MVO2 was estimated from double product (DP) and triple product (TP) integrating DP with ejection time (ET). Diastolic function was evaluated determining E and A waves, E′ measurements, and E/E′ ratio both at rest and at the peak of exercise. Results. The exercise time was longer in IG 9′49″ ± 48″ vs 8′09″ ± 59″ in CG (p=0.0001), reaching a greater workload (IG 139.3 ± 13.4 vs CG 118.7 ± 19.6 Watts; p=0.003). MVO2 expressed with DP and TP was significantly higher in IG (DP: IG 24194 ± 2697 vs CG 20358 ± 4671.8, p=0.01; TP: IG 17239 ± 4710 vs CG 12206 ± 4413, p=0.007). At peak exercise, the ET was diminished in IG than CG. The analysis of diastolic function after the exercise revealed an increase of E and A waves, without difference in the E/A ratio. The E′ wave was higher in IG than CG, and in the same group, the differences between baseline and peak exercise were greater (∆E′3.14 ± 0.7 vs 2.4 ± 1.13, p=0.047). The E/E′ ratio was reduced in patients treated with ivabradine (IG 10.2 ± 2.0 vs CG 7.9 ± 1.6, p=0.002). Conclusions. Ivabradine seems to produce a significant improvement of ischemic threshold, chronotropic reserve, and diastolic function.http://dx.doi.org/10.1155/2019/9185876 |
| spellingShingle | Simone Calcagno Fabio Infusino Olga Dettori Temistocle Taccheri Pasqualina Bruno Viviana Maestrini Gennaro Sardella Massimo Mancone Francesco Fedele Effects of Ivabradine on Residual Myocardial Ischemia after PCI Evaluated by Stress Echocardiography Cardiology Research and Practice |
| title | Effects of Ivabradine on Residual Myocardial Ischemia after PCI Evaluated by Stress Echocardiography |
| title_full | Effects of Ivabradine on Residual Myocardial Ischemia after PCI Evaluated by Stress Echocardiography |
| title_fullStr | Effects of Ivabradine on Residual Myocardial Ischemia after PCI Evaluated by Stress Echocardiography |
| title_full_unstemmed | Effects of Ivabradine on Residual Myocardial Ischemia after PCI Evaluated by Stress Echocardiography |
| title_short | Effects of Ivabradine on Residual Myocardial Ischemia after PCI Evaluated by Stress Echocardiography |
| title_sort | effects of ivabradine on residual myocardial ischemia after pci evaluated by stress echocardiography |
| url | http://dx.doi.org/10.1155/2019/9185876 |
| work_keys_str_mv | AT simonecalcagno effectsofivabradineonresidualmyocardialischemiaafterpcievaluatedbystressechocardiography AT fabioinfusino effectsofivabradineonresidualmyocardialischemiaafterpcievaluatedbystressechocardiography AT olgadettori effectsofivabradineonresidualmyocardialischemiaafterpcievaluatedbystressechocardiography AT temistocletaccheri effectsofivabradineonresidualmyocardialischemiaafterpcievaluatedbystressechocardiography AT pasqualinabruno effectsofivabradineonresidualmyocardialischemiaafterpcievaluatedbystressechocardiography AT vivianamaestrini effectsofivabradineonresidualmyocardialischemiaafterpcievaluatedbystressechocardiography AT gennarosardella effectsofivabradineonresidualmyocardialischemiaafterpcievaluatedbystressechocardiography AT massimomancone effectsofivabradineonresidualmyocardialischemiaafterpcievaluatedbystressechocardiography AT francescofedele effectsofivabradineonresidualmyocardialischemiaafterpcievaluatedbystressechocardiography |