Effect of ivabradine in the treatment of acute exacerbation of chronic obstructive pulmonary disease with heart failure

Résumé fourni par la source

Objective: To observe the effectiveness and safety of ivabradine in patients with acute \nexacerbation of chronic obstructive pulmonary disease (AECOPD) and heart failure. Methods: \nPatients who were admitted to hospital with AECOPD during the period from August 2017 \nto July 2018. Then those both had heart failure with reduced ejection fraction(HFrEF) and \na resting heart rate>70 beats/min were enrolled. A total of 86 cases were screened and \ncompleted, which were randomly divided into two groups for treatment. The control group(41 \ncases) received standard treatments, such as oxygen, anti-infection, anti-spasmodic, hormone, \ndiuretic, ACEI/ARB, recombinant human brain natriuretic peptide (rhBNP), etc. The \nbisoprolol was given 2.5~5 mg orally once a day to control heart rate, and the test group(45 \ncases) was further treated with ivabradine 2.5~5 mg orally twice a day on the basis of the \ncontrol group. The average heart rate, cardiac function, lung function, and 6-minute walking \ntest were compared between the two groups. Results: After treatment, the average heart rate \nof the test group was lower than the control group, and the heart rate control rate(<70 beats/ \nmin%) of the test group was superior to the control group. The level of N-terminal B-type \nnatriuretic peptide(NT-proBNP) in test group was significantly lower than that in control \ngroup. The distance of the 6-minute walking test in e test group was significantly longer than \nthat in control group. Conclusion: Ivabradine combined with bisoprolol could help patients \nwith AECOPD and heart failure to further reduce the heart rates, improve heart function and \nexercise tolerance. Moreover, the therapeutic safety was acceptable during the short term.

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