Effect of ivabradine on exercise capacity in individuals with heart failure with preserved ejection fraction

This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and supplemented by guidance from the Coc hrane Collaboration Handbook for Systematic Reviews of Interventions. For the meta-analysis, a forest plot was used to graphically present the effect sizes and the 95% CIs. Four randomized controlled trials were included. Ivabradine did not change exercise capacity expressed by peak VO2 and 6MWT (MD  = 0.8; 95% CI − 2.5 to 4.3;P = 0.62) (Fig.4a). In our secondary analysis, the ivabradine group showed a significant resting HR reduction when compared with placebo (MD  = − 13.2; 95% CI − 16.6 to −9.8;P <  0.00001) and ivabradine showed increased values of E/e′ ratio compared with placebo (MD = 0.8; 95% CI 0.0 to 1.6;P = 0.04). Current available evidence suggests that there is no effect of ivabradine on exercise capacity in patients with HFpEF. Also, questions about negative effects on E/e′ values and adverse events associated with ivabradine treatment need to be considered in future studies.

Source: Heart Failure Reviews - July 10, 2020 Category: Cardiology Source Type: research