Effect of Ivabradine and -3 Polyunsaturated Fatty Acids on Clinical Manifestations of Heart Failure of Ischemic Genesis

Heart failure (HF) is a major public health issue with a current prevalence of over 5.8 million in the USA and over 23 million worldwide. Ischemic heart disease is known to be the most important risk factor for HF. Ivabradine is a new therapeutic agent designed to reduce heart rate at rest and during exercise by selective inhibition of a novel receptor (If channel) located on the pacemaker-cell membrane within the sinoatrial node. As such, ivabradine joins a list of rate-limiting medications already available to prescribers for the control of heart rate in coronary artery disease (CAD) and HF with systolic dysfunction. The w-3 polyunsaturated fatty acids (PUFA), such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are used for HF treatment. The objective of the research was to evaluate dynamics of clinical manifestations and symptoms of ischemic HF by treatment with ivabradine and w-3 polyunsaturated fatty acids. Material and methods. 357 patients with ischemic HF and preserved sinus rhythm were observed. All the patients were divided into four groups according to their treatment. Physical examinations were performed. The serum levels of NT-proBNP (N-terminal prohormone brain natriuretic peptide) were measured. Conclusions. 1. Heart failure treatment with ivabradine is effective to reduce the signs and symptoms of syndrome. Ivabradine was the most effective for the relief of dyspnea (OR= 1.89; 95% CI 1.04-3.40; p=0.05), decrease in heart rate (OR= 5.23; 95% CI 2.07-11.84; p< 0.001) and when relieving cardialgia (OR= 2.53; 95% CI 1.14-5.34; p=0.03). 2. Combination of ivabradine and w-3 PUFA was more effective for NT-proBNP normalization in HF patients.