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    The Effects of Ivabradine on Left Ventricular Synchronization and Tei Index in Patients with Systolic Heart Failure
    (Taiwan Soc Cardiology, 2017) Erdem, Fatma Hizal; Öztürk, Serkan; Öztürk, Selçuk; Erdem, Alim; Ayhan, Selim; Öztürk, Mustafa; Yazıcı, Mehmet
    Background: The aim of our study was to evaluate in stable outpatients with systolic heart failure (HF) the 3 months effect of ivabradine on LV synchronization and Tei index in stable outpatients with systolic HF. Methods: We evaluated prospectively 40 (30 males, 10 females) patients with HF. All patients were evaluated before and after treatment by transthoracic M mode, two dimensional (2D), pulsed-wave (PW), continuous wave (CW), color flow and tissue Doppler imaging (TDI) and tissue synchronization imaging (TSI). Standard deviation of Ts of the 12 LV segments (Ts-SD-12) is the most widely used parameter of intra-LV asynchrony. Results: Thirty men and 10 women with mean +/- SD age of 64.7 +/- 9.9 years were included in this study. Most of the patients benefitted from some degree of clinical improvement, 12/16 (75.0%) from NYHA III to II and 18/24 (75.0%) from II to I, respectively. Resting heart rate was significantly reduced after ivabradine treatment (84.3 +/- 11.4 vs. 66.5 +/- 11.5 bpm, p <0.001). E/E' and Tei index were significantly changed after ivabradine treatment (17.3 +/- 9.0 vs. 14.8 +/- 7.1, p = 0.02 and 0.86 +/- 0.74 vs. 0.81 +/- 0.69, p = 0.02). Intra-LV synchrony parameters Ts-SD-12 and Ts-12 were significantly reduced after ivabradine (46.8 +/- 13.6 vs. 42.7 +/- 13.1, p = 0.01 and 142.5 +/- 44.0 vs. 128.5 +/- 45.2, p = 0.009). Conclusions: The present study demonstrated that adding ivabradine to the standard therapy reduced HR and significantly improved LV ventricular asynchrony and Tei index in systolic HF patients.