Clinical observation of ivabradine in the treatment of chronic heart failure in end-stage renal disease patients undergoing maintenance hemodialysis
- VernacularTitle:伊伐布雷定治疗维持性血液透析期间合并慢性心力衰竭的终末期肾病患者的临床观察
- Author:
Gang TAN
1
;
Yongfang LI
2
;
Guangpeng ZHOU
3
Author Information
1. Dept. of Cardiology，Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital，Chengdu 610072，China
2. Endoscopy Room，Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital，Chengdu 610072，China
3. Dept. of Endocrinology，Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital，Chengdu 610072，China
- Publication Type:Journal Article
- Keywords:
ivabradine;
end-stage renal disease;
maintenance hemodialysis;
chronic heart failure;
heart function;
inflammation
- From:
China Pharmacy
2025;36(1):91-95
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the efficacy and safety of ivabradine in the treatment of end-stage renal disease patients with chronic heart failure （CHF） during maintenance hemodialysis （MHD）. METHODS End-stage renal disease patients with CHF during MHD who were treated in our hospital from May 2021 to September 2023 and met the inclusion criteria were selected as the study subjects. They were randomly divided into control group and observation group， with 60 cases in each group， using a random number table method. Both groups of patients received MHD three times a week for 4 hours each time and were anticoagulated with low-molecular weight heparin sodium. At the same time， they were treated with CHF conventional therapy； based on the above treatment， observation group was orally administered Ivabradine tablets 5 mg， twice a day （if the resting heart rate was above 60 beats/min after 2 weeks， the drug dose was increased to 7.5 mg， twice a day）. Both groups of patients were treated continuously for 6 months. The clinical efficacy of 2 groups was compared as well as vital signs， cardiac function， the levels of heart failure- related biomarkers and inflammatory factors before and after treatment， and the incidences of dialysis-related hypotension and adverse drug reactions. RESULTS The effective rate of the observation group （92.45%） was significantly higher than that of the control group （76.47%）， and the incidence of dialysis-related hypotension （20.75%） was significantly lower than that of the control group （41.18%） （P＜0.05）. The heart rate， the levels of left ventricular end-systolic diameter， left ventricular end-diastolic diameter， serum N-terminal pro-B-type natriuretic peptide， cancer antigen 125， tumor necrosis factor-α， interleukin-6， and hypersensitive C-reactive protein in observation group after treatment were significantly lower than those of control group （P＜0.05）； the left ventricular ejection fraction and cardiac output were significantly higher than those in the control group （P＜0.05）. There was no statistically significant difference in the diastolic blood pressure， systolic blood pressure， or the total incidence of adverse drug reactions between the two groups after treatment （P＞0.05）. CONCLUSIONS Ivabradine can significantly improve cardiac function， inhibit ventricular remodeling， down-regulate serum levels of serum N-terminal pro-B-type natriuretic peptide and cancer antigen 125， decrease body inflammation levels and the incidence of dialysis-related hypotension in end-stage renal disease patients with CHF during MHD， with significant clinical effects and good safety.
