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Updated: Mar 30, 2026
Assessing Endothelial Vasodilator Function with the Endo-PAT 2000
Published on: October 15, 2010
Effect of Ivabradine on Endothelial Function in Patients with Stable Angina Pectoris: Assessment with the Endo-PAT
Lucia Jedlickova1, Lucia Merkovska2, Lucia Jackova2
11st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Šafárik University and Louis Pasteur University Hospital, Košice, Slovak Republic. lucia.jedlickova@gmail.com.
Insights
Ivabradine treatment for stable angina significantly lowered heart rate and improved endothelial function. Further randomized trials are needed to confirm these promising findings for cardiovascular health.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Ivabradine selectively inhibits the I f current in the sinoatrial node, lowering heart rate.
- This mechanism offers new therapeutic avenues for stable angina and chronic heart failure.
Purpose of the Study:
- To investigate if heart rate reduction with ivabradine improves endothelial function.
- To assess hemodynamic changes associated with ivabradine therapy.
Main Methods:
- A study involving 30 patients with stable angina pectoris.
- Ivabradine (5 mg twice daily) was added to standard treatment.
- Endothelial function was assessed using the Endo-PAT 2000 device, measuring reactive hyperemia index (RHI) and augmentation index (AI) at baseline and after 3 months.
Main Results:
- Mean resting heart rate decreased significantly from 77 ± 7 bpm to 65 ± 6 bpm (P < 0.0001).
- Endothelial function improved significantly, with mean RHI increasing from 1.54 ± 0.30 to 1.83 ± 0.36 (P < 0.0001).
- Arterial stiffness, indicated by AI, also showed significant improvement, decreasing from 21 ± 20% to 10 ± 21% (P < 0.0001).
Conclusions:
- Adding ivabradine to standard treatment effectively lowers heart rate and enhances endothelial function in patients with stable angina.
- These findings suggest a potential benefit of ivabradine beyond heart rate reduction.
- Larger, randomized, placebo-controlled trials are necessary to validate these results.
Introduction:
Ivabradine has opened up new possibilities for treating stable angina and chronic heart failure by lowering heart rate. Ivabradine lowers heart rate by selectively inhibiting the I f current in the sinoatrial node. This study aimed to determine whether the decrease in heart rate achieved with ivabradine was accompanied by hemodynamic changes that might lead to an enhancement of endothelial function.
Methods:
Thirty patients with stable angina pectoris were included in the study. Ivabradine (5 mg bid) was added to the recommended standard treatment. Endothelial function was assessed at baseline and after 3 months of ivabradine therapy, with an Endo-PAT 2000 device (Itamar Medical, Israel). This device was recently developed for the noninvasive assessment for endothelial dysfunction. We evaluated reactive hyperemia index (RHI), which reflects endothelial function, and augmentation index (AI), which provides an indication of arterial stiffness.
Results:
The study population consisted of 25 (83.3%) men and five (16.7%) women. The mean age of the patients was 65.4 ± 6.7 years. Twenty-eight (93.3%) patients had a history of myocardial infarction (ST-segment elevation myocardial infarction or non-ST-segment elevation myocardial infarction), 23 (76.6%) had undergone revascularization (percutaneous coronary intervention or coronary artery bypass graft), 16 (53.3%) had type 2 diabetes mellitus, and 29 (96.6%) had arterial hypertension. The mean resting heart rate decreased significantly, from 77 ± 7 bpm at the start of the study to 65 ± 6 bpm after treatment (P < 0.0001). Endothelial function was found to have improved significantly after 3 months of ivabradine therapy. Mean RHI before treatment was 1.54 ± 0.30, suggesting probable endothelial dysfunction, whereas mean RHI at the end of the study was 1.83 ± 0.36 (P < 0.0001). AI also improved significantly on treatment, from 21 ± 20% to 10 ± 21% (P < 0.0001).
Conclusion:
The addition of ivabradine to the treatment regimen of patients with stable angina pectoris both lowered heart rate and improved endothelial function. However, broader, randomized, double-blind, placebo-controlled clinical trials are required to confirm these findings.
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