How does ivabradine effect erectile dysfunction in patients with heart failure?

Erectile dysfunction (ED) is the inability or insufficiency of penile erection that causes dissatisfaction during sexual intercourse. ED is seen in patients with heart failure (HF), ranging from 56% to 81% depending on the severity. Patients usually blame their cardiovascular medications for their ED. Ivabradine is used for antianginal effects, to improve exercise intolerance, and to decrease mortality in patients with HF. Most beta-blockers are known to cause ED, but unlike beta-blockers the effect of ivabradine over ED has never been evaluated.

We investigated the effect of ivabradine on ED in patients with HF.

Thirty-one patients with HF (all men) under optimal treatment for HF (except ivabradine) were recruited. Patients were evaluated with the internationally validated Sexual Health Inventory for Men (SHIM) questionnaire before the initiation of ivabradine and at the sixth month of the treatment. SHIM scores previous to treatment and at six months were compared using Wilcoxon signed rank test. A p value < 0.05 was accepted as statistically significant.

At six months of follow-up after the initiation of ivabradine, a significant increase in patients with normal libido was found (p < 0.001).

This is a novel study that evaluates the effect of ivabradine on human with HF. Ivabradine improved libido in patients with HF.