Dr. Felipe Martinez,
The session started with an excellent update about heart rate and cardiovascular function presented by Dr. Lopez Sendon from Spain. He emphasized the consistent evidence in the relationship between heart rate and outcomes in cardiovascular trials, in particular those studies in heart failure patients, where highest is heart rate worst is the prognosis. He also showed different mechanisms used by drugs reducing heart rate, most of them linked to oxygen consumption.
Dr. Uta Hoppe, from Cologne, analysed in a very detailed way, all others pathways used and produced by heart rate reduction in coronary patients. They include vessels elasticity, plaque stability, among others, but she also agreed on the crucial role of oxygen consumption.
The following presenter was Dr. Willem Remme from the Netherlands who reviewed all groups of drugs modulating heart rate and demonstrated that beta blockers and ivabradine are the most effective. The last one is being confirmed as a “pure heart rate reduction” compound.
Finally, Jeffrey Borer from USA made a very interesting comment about the implication of recent trials using ivabradine. He presented some new results of subgroups from the Shift study, demonstrating clear benefits in cardiac haemodynamic and quality of life. In summary it was a provocative session updating the growing importance of high heart rate as a maker of poor prognosis in cardiovascular diseases, mainly ischaemic disease and heart failure.
Emerging concepts on heart rate
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