Mohsen Hajiqasemi, Mandana Ebrahimzade, Zahra Ghelichkhan, Xena Huang, Demyana Morkos, Douglas Jennings, Azita H Talasaz
{"title":"伊伐布雷定在临床实践中的批准用途和其他用途:系统综述","authors":"Mohsen Hajiqasemi, Mandana Ebrahimzade, Zahra Ghelichkhan, Xena Huang, Demyana Morkos, Douglas Jennings, Azita H Talasaz","doi":"10.1097/fjc.0000000000001609","DOIUrl":null,"url":null,"abstract":"Heart rate (HR) stands as a prognostic indicator of cardiovascular disease and a modifiable risk factor in heart failure (HF). Medication intolerance can curtail the application of conventional HR-lowering β-blockers to the optimum target dose. Ivabradine (IVA), a specific negative-chronotropic agent, selectively inhibits If current in pacemaker cells of the sinoatrial node without depressing myocardial contractility or comprising hemodynamics. This review summarized ivabradine’s clinical labeled and off-label uses, and mechanism of action focusing on the clinical outcomes. PubMed was searched up to January 2024 using the main keywords of IVA, coronary artery disease (CAD), HF, postural orthostatic tachycardia syndrome (POTS) and tachyarrhythmia. To comprehensively review IVA’s clinical indications, mechanisms, and therapeutic effects, all studies investigating treatment with IVA in humans were included, comprising different types of studies such as randomized controlled trials (RCTs) and longitudinal prospective observational studies. After screening, 141 studies were included in our review. A large number of reviewed articles were allocated to HFrEF and CAD, suggesting IVA as an alternative to β-blockers in case of contraindications or intolerance. The beneficial effects of IVA as premedication for coronary computed tomography angiography, HR lowering in POTS, and inappropriate sinus tachycardia constituted most studies among off-label uses. Promising results have been reported on the efficacy of IVA in controlling HR, especially in patients with inappropriate sinus tachycardia or POTS. Due to the unique mechanism of action, IVA has the potential to be used more frequently in future clinical practice.","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ivabradine approved and other uses in clinical practice: a systematic review\",\"authors\":\"Mohsen Hajiqasemi, Mandana Ebrahimzade, Zahra Ghelichkhan, Xena Huang, Demyana Morkos, Douglas Jennings, Azita H Talasaz\",\"doi\":\"10.1097/fjc.0000000000001609\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Heart rate (HR) stands as a prognostic indicator of cardiovascular disease and a modifiable risk factor in heart failure (HF). Medication intolerance can curtail the application of conventional HR-lowering β-blockers to the optimum target dose. Ivabradine (IVA), a specific negative-chronotropic agent, selectively inhibits If current in pacemaker cells of the sinoatrial node without depressing myocardial contractility or comprising hemodynamics. This review summarized ivabradine’s clinical labeled and off-label uses, and mechanism of action focusing on the clinical outcomes. PubMed was searched up to January 2024 using the main keywords of IVA, coronary artery disease (CAD), HF, postural orthostatic tachycardia syndrome (POTS) and tachyarrhythmia. To comprehensively review IVA’s clinical indications, mechanisms, and therapeutic effects, all studies investigating treatment with IVA in humans were included, comprising different types of studies such as randomized controlled trials (RCTs) and longitudinal prospective observational studies. After screening, 141 studies were included in our review. A large number of reviewed articles were allocated to HFrEF and CAD, suggesting IVA as an alternative to β-blockers in case of contraindications or intolerance. The beneficial effects of IVA as premedication for coronary computed tomography angiography, HR lowering in POTS, and inappropriate sinus tachycardia constituted most studies among off-label uses. Promising results have been reported on the efficacy of IVA in controlling HR, especially in patients with inappropriate sinus tachycardia or POTS. 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Ivabradine approved and other uses in clinical practice: a systematic review
Heart rate (HR) stands as a prognostic indicator of cardiovascular disease and a modifiable risk factor in heart failure (HF). Medication intolerance can curtail the application of conventional HR-lowering β-blockers to the optimum target dose. Ivabradine (IVA), a specific negative-chronotropic agent, selectively inhibits If current in pacemaker cells of the sinoatrial node without depressing myocardial contractility or comprising hemodynamics. This review summarized ivabradine’s clinical labeled and off-label uses, and mechanism of action focusing on the clinical outcomes. PubMed was searched up to January 2024 using the main keywords of IVA, coronary artery disease (CAD), HF, postural orthostatic tachycardia syndrome (POTS) and tachyarrhythmia. To comprehensively review IVA’s clinical indications, mechanisms, and therapeutic effects, all studies investigating treatment with IVA in humans were included, comprising different types of studies such as randomized controlled trials (RCTs) and longitudinal prospective observational studies. After screening, 141 studies were included in our review. A large number of reviewed articles were allocated to HFrEF and CAD, suggesting IVA as an alternative to β-blockers in case of contraindications or intolerance. The beneficial effects of IVA as premedication for coronary computed tomography angiography, HR lowering in POTS, and inappropriate sinus tachycardia constituted most studies among off-label uses. Promising results have been reported on the efficacy of IVA in controlling HR, especially in patients with inappropriate sinus tachycardia or POTS. Due to the unique mechanism of action, IVA has the potential to be used more frequently in future clinical practice.
期刊介绍:
Journal of Cardiovascular Pharmacology is a peer reviewed, multidisciplinary journal that publishes original articles and pertinent review articles on basic and clinical aspects of cardiovascular pharmacology. The Journal encourages submission in all aspects of cardiovascular pharmacology/medicine including, but not limited to: stroke, kidney disease, lipid disorders, diabetes, systemic and pulmonary hypertension, cancer angiogenesis, neural and hormonal control of the circulation, sepsis, neurodegenerative diseases with a vascular component, cardiac and vascular remodeling, heart failure, angina, anticoagulants/antiplatelet agents, drugs/agents that affect vascular smooth muscle, and arrhythmias.
Appropriate subjects include new drug development and evaluation, physiological and pharmacological bases of drug action, metabolism, drug interactions and side effects, application of drugs to gain novel insights into physiology or pathological conditions, clinical results with new and established agents, and novel methods. The focus is on pharmacology in its broadest applications, incorporating not only traditional approaches, but new approaches to the development of pharmacological agents and the prevention and treatment of cardiovascular diseases. Please note that JCVP does not publish work based on biological extracts of mixed and uncertain chemical composition or unknown concentration.