[Clinical efficacy of ivabradin and nebivolol addition in combined treatment of ischemic heart disease patients with left ventricular dysfunction].

Aim: To assess ivabradin and nebivolol efficacy in combined treatment of ischemic heart disease patients with chronic heart failure (CHF) of functional class (FC) II-III by NYHA, impact of these drugs on quality of life, circadian indices of myocardial ischemia (CMI), left ventricular (LV) contractility.

Material And Methods: A total of 92 patients with CHF of FC II-III (mean age 57.3 +/- 4.5 years) were randomized into 3 groups. Patients of group 1 (n = 30) received combined basic therapy: inhibitors of ACE, diuretics, aspirin, statins, on demand nitrates. Patients of group 2 (n = 33) received basic combined treatment plus nebivolol (nebilet, Berlin-Chemie/Menarini) in a dose 5.0 mg/day. Group 3 (n = 29) was given basic therapy plus ivabradin (coraxan) in a mean dose 7.5 mg.

Results: The addition of ivabradin and nebivolol to combined treatment of ischemic heart disease with LV dysfunction brought about control over heart rate (HR), improved quality of life, reduced severity of CHF, CMI, number of episodes of painful and painless ischemia. In reduced by nebivolol HR addition of ibavradin improved systolic and diastolic LV function. The analysis of HR variability in ivabradin administration showed enhancement of parasympathic activity in the vegetative balance. Administration of nebivolol produced modulated attenuation of sympathic activity.

Conclusion: Addition of ivabradin and nebivolol to combined treatment of ischemic heart disease with LV dysfunction raises efficacy of treatment.