В статье дана оценка клинических свойств ивабрадина. Уникальность препарата заключается в блокировании тока ионных If-каналов синусового узла. Это приводит к урежению синусового ритма и не влияет на уровень артериального давления, сократимость миокарда и периферическое сопротивление сосудов. Разобраны клинические ситуации, при которых эффективно применение ивабрадина.
The article assesses the clinical properties of ivabradine. The uniqueness of the drug consists in blocking ion flow through the If channel of the sinus node. This leads to a decrease in the sinus rhythm, without affecting the level of arterial pressure, myocardial contractility and peripheral vascular resistance. Clinical situations have been disassembled in which ivabradine is effectively used.
1. Bocchi EA, Böhm M, Borer JS et al on behalf of SHIFT investigators. Effect of combining ivabradine and b-blockers: Focus on the use of carvedilol in the SHIFT population. Cardiology 2015; 131: 218–24.
2. Swedberg K, Komajda M, Bohm M et al on behalf of the SHIFT investigators. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet 2010; 376: 875–85.
3. Di Franco A, Sarullo FM, Salerno Y et al. Beta-blockers and ivabradine in chronic heart failure: from clinical trials to clinical practice. Am J Cardiovasc Drugs 2014; 14: 101–10.
4. Yancy CW, Jessup M, Bozkurt B et al. 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure. J Am Coll Cardiol 2016. DOI: 10.1016/j.jacc.2016.05.011
5. Fox K, Ford I, Steg G et al, for the BEAUTIFUL investigators. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial. Lancet 2008; 372 (9641): 807–16.
6. Tardif JC, Ponikowski P, Kahan T, for the ASSOCIATE study investigators. Efficacy of the If current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial. Eur Heart J 2009; 30 (5): 540–8.
7. Fox K, Ford I, Steg PG et al, for the SIGNIFY investigators. Ivabradine in stable coronary artery disease without clinical heart failure. N Engl J Med 2014; 371 (12): 1091–9.
8. Martin R, Pogoryelova O, Santibáñex Koreg M et al. Atrial fibrillation associated with ivabradine treatment: meta-analysis of randomized controlled trials. Heart 2014; 100: 1506–10.
9. Сыров А.В., Стуров Н.В. Идиопатическая синусовая тахикардия. Трудный пациент. 2015; 7: 21–4. / Syrov A.V., Sturov N.V. Idiopaticheskaia sinusovaia takhikardiia. Trudnyi patsient. 2015; 7: 21–4. [in Russian]
10. Hersi AS. Potentially new indication of ivabradine: treatment of a patient with postural orthostatic tachycardia syndrome. Open Cardiovasc Med 2010; 4: 166–7.
11. Raj SR. Postural tachycardia syndrome (POTS). Circulation 2013; 127: 2336–42.
12. Benezet-Mazuecos J, Rubio JM, Farre J et al. Long-term outcomes of ivabradine in inappropriate sinus tachycardia patients: appropriate efficacy or inappropriate patients. PACE 2013; 36: 830–6.
13. Calo L, Rebecchi M, Sette A et al. Efficacy of ivabradine administration in patients affected by inappropriate sinus tachycardia. Heart Rhythm 2010; 7: 1318–23.
14. Cappato R, Castelvecchio S, Ricci C et al. Clinical efficacy of ivabradine in patients with inappropriate sinus tachycardia: a prospective, randomized, placebo-controlled, double-blind, crossover evaluation. J Am Coll Cardiol 2012; 60: 1323–9.
15. Retegui G, Quintero M, Ruiz-Borrell M, Revello A. Ivabradine as a treatment option for inappropriate sinus tachycardia. Rev Esp Cardiol 2009; 62: 576–88.
16. Babu K, Gadzik F, Holgate S. Absence of respiratory effects with ivabradine in patients with asthma. BJ of Clin Pharm 2008; 66: 96–101.
17. Kim BH, Cho KI, Kim SM et al. Heart rate reduction with ivabradine prevents thyroid hormone-induced cardiac remodeling in rat. Heart Vessels 2013; 28 (4): 524–35.
18. Celik O, Atasoy MM, Ertürk M et al. Single dose ivabradine versus intravenous metoprolol for heart rate reduction before coronary computed tomography angiography (CCTA) in patients receiving long-term calcium channel-blocker therapy. Acta Radiol 2014; 55: 676–81.
19. Pichler P, Pichler-Cetin E, Vertesich M at al. Ivabradine versus metoprolol for heart rate reduction before coronary computed tomography angiography. Am J Cardiol 2012; 109: 169–73.
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1. Bocchi EA, Böhm M, Borer JS et al on behalf of SHIFT investigators. Effect of combining ivabradine and b-blockers: Focus on the use of carvedilol in the SHIFT population. Cardiology 2015; 131: 218–24.
2. Swedberg K, Komajda M, Bohm M et al on behalf of the SHIFT investigators. Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet 2010; 376: 875–85.
3. Di Franco A, Sarullo FM, Salerno Y et al. Beta-blockers and ivabradine in chronic heart failure: from clinical trials to clinical practice. Am J Cardiovasc Drugs 2014; 14: 101–10.
4. Yancy CW, Jessup M, Bozkurt B et al. 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure. J Am Coll Cardiol 2016. DOI: 10.1016/j.jacc.2016.05.011
5. Fox K, Ford I, Steg G et al, for the BEAUTIFUL investigators. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial. Lancet 2008; 372 (9641): 807–16.
6. Tardif JC, Ponikowski P, Kahan T, for the ASSOCIATE study investigators. Efficacy of the If current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial. Eur Heart J 2009; 30 (5): 540–8.
7. Fox K, Ford I, Steg PG et al, for the SIGNIFY investigators. Ivabradine in stable coronary artery disease without clinical heart failure. N Engl J Med 2014; 371 (12): 1091–9.
8. Martin R, Pogoryelova O, Santibáñex Koreg M et al. Atrial fibrillation associated with ivabradine treatment: meta-analysis of randomized controlled trials. Heart 2014; 100: 1506–10.
9. Syrov A.V., Sturov N.V. Idiopaticheskaia sinusovaia takhikardiia. Trudnyi patsient. 2015; 7: 21–4. [in Russian]
10. Hersi AS. Potentially new indication of ivabradine: treatment of a patient with postural orthostatic tachycardia syndrome. Open Cardiovasc Med 2010; 4: 166–7.
11. Raj SR. Postural tachycardia syndrome (POTS). Circulation 2013; 127: 2336–42.
12. Benezet-Mazuecos J, Rubio JM, Farre J et al. Long-term outcomes of ivabradine in inappropriate sinus tachycardia patients: appropriate efficacy or inappropriate patients. PACE 2013; 36: 830–6.
13. Calo L, Rebecchi M, Sette A et al. Efficacy of ivabradine administration in patients affected by inappropriate sinus tachycardia. Heart Rhythm 2010; 7: 1318–23.
14. Cappato R, Castelvecchio S, Ricci C et al. Clinical efficacy of ivabradine in patients with inappropriate sinus tachycardia: a prospective, randomized, placebo-controlled, double-blind, crossover evaluation. J Am Coll Cardiol 2012; 60: 1323–9.
15. Retegui G, Quintero M, Ruiz-Borrell M, Revello A. Ivabradine as a treatment option for inappropriate sinus tachycardia. Rev Esp Cardiol 2009; 62: 576–88.
16. Babu K, Gadzik F, Holgate S. Absence of respiratory effects with ivabradine in patients with asthma. BJ of Clin Pharm 2008; 66: 96–101.
17. Kim BH, Cho KI, Kim SM et al. Heart rate reduction with ivabradine prevents thyroid hormone-induced cardiac remodeling in rat. Heart Vessels 2013; 28 (4): 524–35.
18. Celik O, Atasoy MM, Ertürk M et al. Single dose ivabradine versus intravenous metoprolol for heart rate reduction before coronary computed tomography angiography (CCTA) in patients receiving long-term calcium channel-blocker therapy. Acta Radiol 2014; 55: 676–81.
19. Pichler P, Pichler-Cetin E, Vertesich M at al. Ivabradine versus metoprolol for heart rate reduction before coronary computed tomography angiography. Am J Cardiol 2012; 109: 169–73.
Авторы
А.В.Сыров
ГБУЗ «Консультативно-диагностический центр №6» Департамента здравоохранения г. Москвы. 127474, Россия, Москва, Керамический пр., д. 49б syrman2002_1@yahoo.com
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A.V.Syrov
Advisory-Diagnostic Center №6 of the Department of Health of Moscow. 127474, Russian Federation, Moscow, Keramicheskii pr., d. 49b syrman2002_1@yahoo.com