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Updated: Dec 24, 2025

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

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Role of Ivabradine in Patients with Heart Failure with Preserved Ejection Fraction

Muhammad Nadeem1, Mohab Hassib2, Hafiz M Aslam3

  • 1Internal Medicine, Seton Hall University, St. Francis Medical Center, Trenton, USA.

Cureus
|April 8, 2020
PubMed

Insights

Heart failure with preserved ejection fraction (HFpEF) management remains challenging. Ivabradine, a heart rate-lowering drug, has shown mixed results in HFpEF patients, necessitating further large-scale clinical trials.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Heart failure with preserved ejection fraction (HFpEF) affects 50% of heart failure patients.
  • HFpEF has similar morbidity and mortality to heart failure with reduced ejection fraction (HFrEF).
  • No current management strategy improves mortality outcomes in HFpEF.

Purpose of the Study:

  • To review the efficacy of ivabradine in patients with HFpEF.
  • To assess the impact of heart rate on HFpEF outcomes.
  • To identify the need for further clinical trials in HFpEF.

Main Methods:

  • Review of two randomized controlled trials and one cross-over study on ivabradine in HFpEF.
  • Analysis of outcomes related to heart rate reduction without negative inotropy.
  • Evaluation of existing literature on HFpEF management.

Main Results:

  • Elevated heart rate in HFpEF is linked to worse outcomes.
  • Beta-blocker trials in HFpEF showed adverse effects, potentially due to negative inotropy.
  • Ivabradine trials yielded heterogeneous results: improved exercise tolerance in some, no change in primary endpoints, and worsening outcomes in others.

Conclusions:

  • Ivabradine's role in HFpEF requires further investigation.
  • A large, randomized clinical trial in a carefully selected HFpEF population is necessary.
  • Understanding the specific patient profiles that may benefit from heart rate-lowering therapies is crucial.

Keywords:
heart failureivabradine

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