Implementation of Guidelines for Diagnosis and Treatment of Heart Failure 2016 in clinical practice – the role of ivabradine

Czech version

Authors: F. Málek
Authors‘ workplace: Kardiocentrum, Nemocnice Na Homolce, Praha
Published in: Kardiol Rev Int Med 2017, 19(2): 123-127

Overview

We present two clinical cases documenting an application of the current Guidelines for Diagnosis and Treatment of Heart Failure issued by the European Society of Cardiology. The treatment algorithm recommends gradual use of disease modifying drug with dose titration to maximal tolerated doses. These drugs include angiotensin converting enzyme inhibitors or angiotensin receptor blockers, betablockers, mineralocorticoid antagonists, which are used together with diuretics to eliminate the symptoms of congestion. In case of persisting symptoms, ivabradin is one of possible further steps.

Keywords:
heart failure with reduced ejection fraction – ivabradine

Sources

1. Špinar J, Hradec J, Špinarová L et al. Souhrn doporučených postupů ESC pro diagnostiku a léčbu akutního a chronického srdečního selhání z roku 2016. Cor Vasa 2016; 58(5): e530– e568.

2. Swedberg K, Komajda M, Bohm M et al. Ivabradin and outcomes in chronic heart failure (SHIFT): a randomised placebo – controlled trial. Lancet 2010; 376(9744): 875– 885. doi: 10.1016/ S0140-6736(10)61198-1.

3. Borer JS, Böhm M, Ford I et al. Effect of ivabradine on recurrent hospitalization for worsening heart failure in patients with chronic systolic heart silure: the SHIFT Study. Eur Heart J 2012; 33(2): 2813– 2820. doi: 10.1093/ eurheartj/ ehs259.

4. Tavazzi L, Swedberg K, Komajda M et al. Efficacy and safety of ivabradine in chronic heart failure across the age spectrum: Insights from the SHIFT study. Eur J Heart Fail 2013; 15(11): 1296– 1303. doi: 10.1093/ eurjhf/ hft102.

5. Volterrani M, Cice G, Caminiti G et al. Effect of Carvedilol, Ivabradine or their combination on exercise capacity in patients with Heart Failure (the CARVIVA HF trial). Int J Cardiol 2011; 151(2): 218– 224. doi: 10.1016/ j.ijcard.2011.06.098.