Efficacy of Ivabradine and Bisoprolol Based on the Results of Flow Mediated Dilation in Patients with Coronary Heart Disease

Feruza M. Bekmetova, Ravshanbek D. Kurbanov, Alexander B. Shek, Alexander O. Kan

Republican Specialized Center of Cardiology, Tashkent, Uzbekistan

*Corresponding author: Feruza M. Bekmetova, PhD Department of Coronary Heart Disease, Republican Specialized Center of Cardiology, 4, Osiyo str., 100052, Tashkent, Uzbekistan. Tel: 998-90-3276814. E-mail: bekmetova@rambler.ru


In this article, the possible application of Ivabradine and Bisoprolol in patients with stable angina based on the results of clinical and hemodynamic indices, Flow Mediated Dilation (FMD) and exercise loading tolerance (ELD) are discussed. In this study, 60 patients with stable angina II-III FC were included. Patients were randomized into two groups and given Bisoprolol and Ivabradine as the main treatment. Patients underwent a treadmill test by Bruce protocol and FMD probe by the Celermajer method. After 10-14 days of daily treatment, the patients were switched from one medicine to another, in both groups, and the results of FMD and ELD were analyzed. After treatment with Ivabradine, an increase in the chronotropic effect in the exercise tests was observed; however, the improved endothelial function, assessed by the results of the flow mediated dilation test was quite significant.

Ivabradine, FMD, ELD
  1. Lloyd-Jones D, Adams R, Carnethon M, et al. Heart disease and stroke statistics - 2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2009; 119; 480-486.
  2. Daly CA, De Stavola В, Sendon J, et al. Predicting prognosis in stable angina - results from the Euro heart survey of stable angina: prospective observational study. Br Med J 2006; 332:262-267.
  3. Deanfield JE, Halcox JP, Rabelink TJ. Endothelial function and dysfunction: testing and clinical relevance. Circulation 2007; 115:1285-1295.
  4. Boden WE, O`Rourke RA, Teo KK, et al.  Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007; 356:1503-1516.
  5. The BARI 2D Study Group. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med 2009; 360:2503-2515.
  6. Celermajer DS, Sorensen KE, Gooch VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992; 340:1111-1115.
  7. Bernard A, Ducardonnet A, Hoffman O, et al. Exercise Testing in Cardiology. Paris: Springer, 2009.
  8. Borer JD, Fox K, Jaillon P, et al. Antianginal and antiischemic effects of ivabradine, an If inhibitor in stable angi­na. Circulation 2003; 107:817-823.
  9. Tardif JC, Ford I, Tendera M, et al. On behalf of the INITIA­TIVE study investigators group. Efficacy of ivabradine, a new selective If inhibitor, compared with atenolol in patients with chronic stable angina.  Eur Heart J 2005; 26: 2529-2536.
  10. Taddei S, Virdis A, Ghiadoni L, et al. Effects of anti­hypertensive drugs on endothelial dysfunction: clinical implications. Drugs 2002; 62(2): 265–284.
  11. Flammer AJ, Hermann F, Wiesli P, et al. Effect of losartan, compared with atenolol, on endothelial function and oxidative stress in patients with type 2 diabetes and hypertension. J Hypertens 2007; 25(4): 785-791.
  12. Brehm BR, Bertsch D, von Fallois J, Wolf SC. Beta-blockers of the third generation inhibit endothelin-1 liberation, mRNA production and proliferation of human coronary smooth muscle and endothelial cells. J Cardiovasc Pharmacol 2000; 36(5 Suppl. 1): S401–S403.
  13. Brehm BR, Wolf SC, Bertsch D, et al. Effects of nebivolol on proliferation and apoptosis of human coronary artery smooth muscle and endothelial cells. Cardiovasc Res 2001; 49(2):430–439.

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Int J Biomed. 2011; 1(3):158-162. © 2011 International Medical Research and Development Corporation. All rights reserved.