Heart rate: a prognostic factor and therapeutic target in chronic heart failure. The distinct roles of drugs with heart rate-lowering properties.
Heart rate not only predicts outcome but may also be a therapeutic target in patients with chronic heart failure. Several classes of pharmacological agents can be used to modulate heart rate, including beta-blockers, ivabradine, digoxin, amiodarone, and verapamil. Choice of agent will depend on heart rhythm, co-morbidities, and disease phenotype. Beneficial and harmful interactions may also exist. The aim of this paper is to summarize the current body of knowledge regarding the relevance of heart rate as a prognostic factor (risk marker) and particularly as a therapeutic target (risk factor) in patients with chronic heart failure, with a special focus on ivabradine, a novel agent that is currently the only available purely bradycardic agent.
Dobre, D; Borer, JS; Fox, K; Swedberg, K; Adams, KF; Cleland, JGF; Cohen-Solal, A; Gheorghiade, M; Gueyffier, F; O'Connor, CM; Fiuzat, M; Patak, A; Piña, IL; Rosano, G; Sabbah, HN; Tavazzi, L; Zannad, F
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