cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1464Research ArticleХРОНИЧЕСКАЯ СЕРДЕЧНАЯ НЕДОСТАТОЧНОСТЬCHRONIC HEART FAILUREИвабрадин и β-адреноблокаторы — препараты, влияющие на частоту сердечных сокращений, в лечении пациентов со стабильной стенокардией напряженияHeart rate-reducing agents ivabradine and beta-adrenoblockers in the management of patients with stable effort anginaГалееваЗ. М.GaleevaZ. M.

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maktub29@mail.ruАндреичевН. А.AndreichevN. A.

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ГОУ ВПО “Казанский государственный медицинский университет Росздрава”Kazan State Medical Academy2011200220111015965Copyright © Галеева З.М., Андреичев Н.А., 20112011Галеева З.М., Андреичев Н.А.Galeeva Z.M., Andreichev N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1464

Ишемическая болезнь сердца (ИБС) — основная причина летальности в клинике внутренних болезней. 38 % пациентов с коронарными осложнениями умирает в течение года. Назначение β-адреноблокаторов (β-АБ) не всегда обеспечивает достаточное замедление частоты сердечных сокращений (ЧСС). Для замедления ЧСС с целью достижения антиангинального эффекта необходимо применение β-АБ в комбинации с ингибитором If каналов (ивабрадином). Проводилась оценка эффективности и безопасности применения ивабрадина при лечении пациентов со стенокардией напряжения в комбинации с β-АБ. Приводится отдельный клинический случай.

Coronary heart disease (CHD) is the leading lethality cause in internal medicine. Up to 38% of the patients with coronary events die within the first year. Beta-adrenoblocker (BAB) therapy does not always provide adequate heart rate (HR) reduction. To reduce HR more effectively and, therefore, to increase anti-anginal effect, BAB could be combined with an If channel inhibitor (ivabradine). Effectiveness and safety of the ivabradine + BAB combination was studied in patients with effort angina. One clinical case is presented in detail.

стенокардия напряжениячастота сердечных сокращенийивабрадинβ-адреноблокаторыEffort anginaheart rateivabradinebeta-adrenoblockersReferencesMathers CD, Loncar D. Projections of Global Mortality and Burden of Disease from 2002 to 2030. PLoS Med 2006; 3(11): 442.Mathers CD, Loncar D. Projections of Global Mortality and Burden of Disease from 2002 to 2030. PLoS Med 2006; 3(11): 442.Steg PhG, Bhatt DL, Wilson PWF, et al. One year cardiovascular event rates in outpatients with atherothrombosis. JAMA 2007; 297: 1197-206.Steg PhG, Bhatt DL, Wilson PWF, et al. One year cardiovascular event rates in outpatients with atherothrombosis. JAMA 2007; 297: 1197-206.Gillman M, Kannel W, Belanger A, et al. Influence of heart rate on mortality among persons with hypertension: The Framingham study. Am Heart J 1993; 125: 1148-54.Gillman M, Kannel W, Belanger A, et al. Influence of heart rate on mortality among persons with hypertension: The Framingham study. Am Heart J 1993; 125: 1148-54.Kannel W, Kannel C, Paffenbarger R, Cupples A. Heart rate and cardiovascular mortality: the Framingham Study. Am Heart J 1987; 113: 1489-94.Kannel W, Kannel C, Paffenbarger R, Cupples A. Heart rate and cardiovascular mortality: the Framingham Study. Am Heart J 1987; 113: 1489-94.Kjekshus JK. Importance of heart rate in determining betablocker efficacy in acute and long-term myocardial infarction intervention trials. Am J Cardiol 1986; 57: 43F-9.Kjekshus JK. Importance of heart rate in determining betablocker efficacy in acute and long-term myocardial infarction intervention trials. Am J Cardiol 1986; 57: 43F-9.Timolol-induced eduction in mortality and reinfarction in patients surviving acute myocardial infarction / The Norwegian Multicenter Study Group. N Eng J Med 1981; 304: 801-7.Timolol-induced eduction in mortality and reinfarction in patients surviving acute myocardial infarction / The Norwegian Multicenter Study Group. N Eng J Med 1981; 304: 801-7.Hjalmarson A, Gilpin E, Kjekshus J, et al. Influence of heart rate on mortality after acute myocardial inferction. Am J Сardiol 1990; 65: 547-53.Hjalmarson A, Gilpin E, Kjekshus J, et al. Influence of heart rate on mortality after acute myocardial inferction. Am J Сardiol 1990; 65: 547-53.Benetos A, Thomas F, Bean K, et al. Resting heart rate in older people: a predictor of survival to age 85. J Am Geriart Soc 2003; 51: 284-5.Benetos A, Thomas F, Bean K, et al. Resting heart rate in older people: a predictor of survival to age 85. J Am Geriart Soc 2003; 51: 284-5.ESC Clinical Practice Guidelines. Cardiovascular Disease Prevention — Risk Assessment and Management / Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts) [электронный ресурс] / Электрон. дан. — режим доступа: www.escardio.org/guidelines-surveys/esc-guidelines//Pages/cvd-prevention.aspx, свободный. — Загл. с экрана. — Яз. англ.ESC Clinical Practice Guidelines. Cardiovascular Disease Prevention — Risk Assessment and Management / Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts) [электронный ресурс] / Электрон. дан. — режим доступа: www.escardio.org/guidelines-surveys/esc-guidelines//Pages/cvd-prevention.aspx, свободный. — Загл. с экрана. — Яз. англ.Guidelines on the management of stable angina pectoris: executive summary/The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J 2006; 27 (11): 1341-81.Guidelines on the management of stable angina pectoris: executive summary/The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J 2006; 27 (11): 1341-81.Fox K, Ford I, Steg PG, et al. Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet 2008; 372: 817-21.Fox K, Ford I, Steg PG, et al. Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet 2008; 372: 817-21.Colin P, Ghaleh B, Hittinger L, et al. Differential effects of heart rate reduction and beta blockade on left ventricular relaxation during exercise. Am J Physiol Heart Circ Physiol 2002; 282: 672-9.Colin P, Ghaleh B, Hittinger L, et al. Differential effects of heart rate reduction and beta blockade on left ventricular relaxation during exercise. Am J Physiol Heart Circ Physiol 2002; 282: 672-9.Colin P, Ghaleh B, Monnet X, et al. Contributions of heart rate and contractility to myocardial oxygen balance during exercise. Am J Physiol Heart Circ Physiol 2003; 284: 676-82.Colin P, Ghaleh B, Monnet X, et al. Contributions of heart rate and contractility to myocardial oxygen balance during exercise. Am J Physiol Heart Circ Physiol 2003; 284: 676-82.Simon L, Ghaleh B, Puybasset L, et al. Coronary and hemodynamic effects of S 16257, a new bradycardic agent, in resting and exercising conscious dogs. J Pharmacol Exp Ther 1995; 275: 659-66.Simon L, Ghaleh B, Puybasset L, et al. Coronary and hemodynamic effects of S 16257, a new bradycardic agent, in resting and exercising conscious dogs. J Pharmacol Exp Ther 1995; 275: 659-66.Ерофеева С.Б., Манешина О.А., Белоусов Ю.Б. Место ивабрадина — первого If ингибитора избирательного и специфического действия в лечении сердечно-сосудистых заболеваний. Качеств клин практ 2006; 1: 10-22.Ерофеева С.Б., Манешина О.А., Белоусов Ю.Б. Место ивабрадина — первого If ингибитора избирательного и специфического действия в лечении сердечно-сосудистых заболеваний. Качеств клин практ 2006; 1: 10-22.Tardif JC, Ford I, Tendera M, et al. Efficacy of ivabradine, a new selective If inhibitor, compared with atenolol in patients with chronic stable angina. Eur Heart J 2005; 26: 2529-36.Tardif JC, Ford I, Tendera M, et al. Efficacy of ivabradine, a new selective If inhibitor, compared with atenolol in patients with chronic stable angina. Eur Heart J 2005; 26: 2529-36.Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J 2006; 27: 1341-81.Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology. Eur Heart J 2006; 27: 1341-81.Fox K, Ford I, Steg PG, et al. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebocontrolled trial. The Lancet 372; 9641: 807-16.Fox K, Ford I, Steg PG, et al. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebocontrolled trial. The Lancet 372; 9641: 807-16.Kjekshus J Pedersen TR. Reducing the risk of coronary events: evidence from the Scandinavian Simvastatin Survival Study (4S). Am J Cardiol 1995; 76: 64C-8.Kjekshus J Pedersen TR. Reducing the risk of coronary events: evidence from the Scandinavian Simvastatin Survival Study (4S). Am J Cardiol 1995; 76: 64C-8.Effects of an Angiotensin-Converting-Enzyme Inhibitor, Ramipril, on Cardiovascular Events in High-Risk Patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000; 342: 145-53.Effects of an Angiotensin-Converting-Enzyme Inhibitor, Ramipril, on Cardiovascular Events in High-Risk Patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000; 342: 145-53.

The authors declare that there are no conflicts of interest present.