Ivabradine, a selective If inhibitor already investigated for its effects in coronary artery disease and left ventricular dysfunction, significantly lowers the risk of heart failure, according to results of the SHIFT study (Systolic Heart failure treatment with the If inhibitor ivabradine Trial).
Ivabradine binds to If channels found in the sinus node, the heart's pacemaker. If channels generate an electrical impulse which causes the heart to contract so that blood can be pumped to the lungs and the rest of the body. By binding to these If channels, ivabradine thus slows the rate at which the heart beats.
Resting heart rate is known to be inversely related to prognosis in many cardiovascular diseases and is recognised to have independent prognostic value in heart failure. The SHIFT study was designed to investigate if ivabradine's inhibition of sino-atrial If current and had a beneficial effect in patients with a heart rate above 70 beats per minute.
"Heart failure is normally associated with high mortality risk", said principal investigator Professor Michel Komajda, head of Cardiovascular and Surgical departments at the Pitié Salpetrière hospital in Paris. "Approximately 50% of patients die after five years, and they endure recurrent and lengthy hospitalisations as well as a decline in the quality of life. Despite the introduction of new treatments over the last 20 years resulting from significant medical advances, the prevalence of heart failure is actually increasing worldwide, particularly as people are living to an older age."