Heart Rate Reduction by If-Channel Inhibition and its Potential Role in Heart Failure with Reduced and Preserved Ejection Fraction

Reil, Jan‐Christian; Reil, Gert‐Hinrich; Böhm, Michael

doi:10.1016/j.tcm.2009.09.002

Cited by 29 publications

(13 citation statements)

References 39 publications

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“…144, 146 Experimental data in mice with obesity and diabetes 147 found reduced aortic stiffness and fibrosis and improvement in LV function from 4 weeks of ivabradine therapy. 147, 148 Kosmala et al recently published findings from a 7-day randomized clinical trial of ivabradine versus placebo in 61 HFpEF patients. 149 Patients had improved peak oxygen consumption, exercise capacity, and decreased exercise-induced E/E’ ratio (index of diastolic pressure).…”

Section: New Therapeutic Avenues For Hfpefmentioning

confidence: 99%

Heart Failure With Preserved Ejection Fraction

Sharma

Kass

2014

Circulation Research

426

227

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The clinical syndrome comprised of heart failure symptoms but with a left ventricular ejection fraction that is not diminished, e.g. heart failure with a preserved ejection fraction (HFpEF), is increasingly the predominant form of HF in the developed world, and soon to reach epidemic proportions. It remains among the most challenging of clinical syndromes for the practicing clinician and scientist alike, with a multitude of proposed mechanisms involving the heart and other organs and complex interplay with common co-morbidities. Importantly, its morbidity and mortality is on par with heart failure and a reduced ejection fraction, and as the list of failed treatments continues to grow, HFpEF clearly represents a major unmet medical need. The field is greatly in need of a more unified approach to its definition and view of the syndrome that engages integrative and reserve pathophysiology beyond that related to the heart alone. We need to reflect on prior treatment failures and the message this is providing, and re-direct our approaches likely with a paradigm shift in how the disease is viewed. Success will require interactions between clinicians, translational researchers, and basic physiologists. Here, we review recent translational and clinical research into HFpEF, give perspectives on its evolving demographics and epidemiology, the role of multi-organ deficiencies, potential mechanisms that involve the heart and other organs, clinical trials, and future directions.

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Section: New Therapeutic Avenues For Hfpefmentioning

confidence: 99%

Heart Failure With Preserved Ejection Fraction

Sharma

Kass

2014

Circulation Research

426

227

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“…More close correlations at low thresholds (≥70 bpm) to risk have been established in heart failure. [5][6][7][8] One beat increase of baseline heart rate and five beats increase of resting heart rate is associated with an increase of cardiovascular death and heart failure hospitalisation of 3% and 16%, respectively. 6 Therefore, it was tempting to speculate that heart rate reduction reverses risk, in particular in heart failure, where the association of heart rate and risk is very close.…”

mentioning

confidence: 99%

Heart rate: surrogate or target in the management of heart failure?

Böhm

Reil

2012

Heart

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Section: Relationship Between Sv and Pp During Volume Perturbationmentioning

confidence: 99%

“…In theory, TPR and the heart rate (the inverse of heart period) are altered by the autonomic baroreflex in response to alterations in V ed [41, 42]. Specifically, an increase in end-diastolic volume results in a decrease in TPR and heart rate, whereas they increase to a decrease in end-diastolic volume [41, 42]. Therefore, the arterial elastance decreases during an increase in end-diastolic volume, which then yields a decrease in end-systolic pressure (with respect to its value predicted under constant arterial elastance) via a decrease in E S E A /( E S + E A ).…”

Section: Relationship Between Sv and Pp During Volume Perturbationmentioning

confidence: 99%

Relationship between Stroke Volume and Pulse Pressure during Blood Volume Perturbation: A Mathematical Analysis

Bighamian

Hahn

2014

BioMed Research International

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Arterial pulse pressure has been widely used as surrogate of stroke volume, for example, in the guidance of fluid therapy. However, recent experimental investigations suggest that arterial pulse pressure is not linearly proportional to stroke volume. However, mechanisms underlying the relation between the two have not been clearly understood. The goal of this study was to elucidate how arterial pulse pressure and stroke volume respond to a perturbation in the left ventricular blood volume based on a systematic mathematical analysis. Both our mathematical analysis and experimental data showed that the relative change in arterial pulse pressure due to a left ventricular blood volume perturbation was consistently smaller than the corresponding relative change in stroke volume, due to the nonlinear left ventricular pressure-volume relation during diastole that reduces the sensitivity of arterial pulse pressure to perturbations in the left ventricular blood volume. Therefore, arterial pulse pressure must be used with care when used as surrogate of stroke volume in guiding fluid therapy.

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Heart Rate Reduction by If-Channel Inhibition and its Potential Role in Heart Failure with Reduced and Preserved Ejection Fraction

Cited by 29 publications

References 39 publications

Heart Failure With Preserved Ejection Fraction

Heart Failure With Preserved Ejection Fraction

Heart rate: surrogate or target in the management of heart failure?

Relationship between Stroke Volume and Pulse Pressure during Blood Volume Perturbation: A Mathematical Analysis

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