Safety and efficacy of off-label use of ivabradine in patients with acute heart failure.

Abbreviations 6MWD 6 minute walking distance 6MWT 6 Minute Walk Test AHF acute heart failure ATS American Thoracic Society BB beta-blockers CHF chronic heart failure EF Ejection fraction HR Heart rate HRQOL health related quality of life HS Highly significant MLWHFQ Minnesota Living with Heart Failure Questionnaire NS Non significant NYHA New York Heart Association QOL quality of life S Significant SAN sino-atrial node 1 Introduction Acute heart failure (AHF) refers to rapid onset or worsening of symptoms and/or signs of HF.

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ETHIC-AHF (Effect of early treatment with ivabradine combined with beta-blockers versus beta-blockers alone in patients hospitalized with heart failure and reduced left ventricular ejection fraction) study result showed a trend toward a better functional class observed in patients in the intervention group (ivabradine plus BB), versus the control group (BB only) who had NYHA class III or IV at 4 months [15] .

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When used, BB up-titrated as part of optimum medical therapy for AHF resulted in a significant improvement in all the studied parameters (NYHA class; 6MWT distance; HR and Borg scale dyspnea/fatigue score before and after the walk), except for the premature termination of the 6MWT that did not reach statistical significance ( Table 3 ).

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