The authors present the case of a patient developing septic cardiomyopathy during a septic shock in whom the initiated dobutamine induced tachycardia without improvement in cardiac function. The addition of ivabradine to dobutamine... more
The authors present the case of a patient developing septic cardiomyopathy during a septic shock in whom the initiated dobutamine induced tachycardia without improvement in cardiac function. The addition of ivabradine to dobutamine restored cardiac function consistent with the septic shock situation. The authors take the opportunity to present a narrative review on the combination of dobutamine and ivabradine.
Background: A large myocardial infarction (MI) initiates progressive cardiac remodeling that leads to systolic heart failure (HF). Long-term heart rate reduction (HRR) induced by the I f current inhibitor ivabradine (IVA) ameliorates left... more
Background: A large myocardial infarction (MI) initiates progressive cardiac remodeling that leads to systolic heart failure (HF). Long-term heart rate reduction (HRR) induced by the I f current inhibitor ivabradine (IVA) ameliorates left ventricular (LV) remodeling and improves systolic performance in young post-MI rats. However, the beneficial effects of chronic IVA treatment in middle-aged rats remain to be determined. Methods: A large MI was induced in 12-month-old rats by left coronary artery ligation. Rats were treated with IVA via osmotic pumps intraperitoneal in a dose of 10.5 mg/kg/d (MI þ IVA) and compared with MI and sham-operated animals 12 weeks after MI. Results: Heart rate in MI þ IVA rats was on average 29% lower than that of rats in the MI group. Left ventricular remodeling was comparable between post-MI groups, although MI þ IVA rats did not show the compensatory thickening of the noninfarcted myocardium. Chronic HRR had no effect on transverse cardiac myocyte size and capillary growth, but it reduced the collagen content in noninfarcted myocardium. Left ventricular systolic performance remained similarly impaired in MI and MI þ IVA rats. Moreover, abrupt IVA withdrawal led to worsening HF and reduction of coronary reserve. Conclusion: Our data reveal that chronic IVA-induced HRR does not provide sustainable benefits for LV systolic performance in middle-aged rats with post-MI HF.
