Achieved targeted heart rate following ivabradine therapy correlates with left ventricular reverse remodeling in non-ischemic dilated cardiomyopathy.

ABSTRACT: The effect of ivabradine on left ventricular reverse remodeling (LVRR) in heart failure with reduced ejection fraction and its correlation with achieved heart rate (HR) by ivabradine in non-ischemic dilated cardiomyopathy (NIDCM) remain uncertain. A retrospective analysis of 255 sinus rhythm NIDCM patients at a tertiary center (2012-2021) were categorized into four groups based on the ivabradine use (Iva+/-) and achieved HR at 1-year (HR+/-). The HR cut-off of 70 bpm was determined via receiver operating characteristic curve analysis for LVRR, defined as an absolute ≥ 10% improvement in LV ejection fraction (LVEF) from baseline, with a final LVEF ≥ 40%. LVRR incidence at 1-year was, 46.8% in Iva-/HR70+, 46.6% in Iva-/HR70-, 62.9% Iva+/HR70+ and 71.1% in Iva+/HR70-. Ivabradine treated patients with HR < 70 bpm had higher incidence of LVRR than those without ivabradine (Iva+/HR70-vs. Iva-/HR70+, OR 4.85, 95%CI 1.97-11.96 P = 0.001; Iva+/HR70-vs. Iva-/HR70-, OR 3.60, 95% CI 1.41-9.18, P = 0.007) after adjustment for known predictors in a multivariate model. Consistent adherence to beta-blockers and ivabradine, along with guideline-directed medical therapy (GDMT) for HF, and sex were identified as independent predictors of LVRR. Ivabradine therapy achieving HR < 70 bpm correlated with increased LVRR incidence in NIDCM patients, underscoring the role of ivabradine in HR reduction adjunctive to GDMT.

SUBMITTER: Lee J 

PROVIDER: S-EPMC12475017 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature