Acute effects of ivabradine on dynamic obstruction of the left ventricular outflow tract in cats with preclinical hypertrophic cardiomyopathy

J Vet Intern Med. 2014 May-Jun;28(3):838-46. doi: 10.1111/jvim.12331. Epub 2014 Mar 5.

Abstract

Background: Ivabradine is a negative chronotropic drug with minimal effects on central hemodynamics. Its effect on dynamic obstruction of the left ventricular outflow tract (LVOT) in cats with hypertrophic cardiomyopathy (HCM) remains unknown.

Hypothesis/objectives: Ivabradine reduces dynamic obstruction of the LVOT in cats with HCM.

Animals: Twenty-eight client-owned cats with preclinical HCM and dynamic LVOT obstruction.

Methods: Randomized, double-blind, active-control single dose study. Cats received a single dose of either ivabradine (0.3 mg/kg PO) or atenolol (2 mg/kg PO). Heart rate, echocardiographic variables, and systolic blood pressure (SBP) were recorded before and 3 hours after drug administration. Statistical comparisons were made using ANCOVA.

Results: Peak velocity in the LVOT was significantly decreased compared to baseline for both drugs; however, the effect was more prominent with atenolol (mean reduction 2.53 m/s; 95% CI 2.07-3.13 m/s) compared to ivabradine (mean reduction 0.32 m/s; 95% CI -0.04 to 0.71 m/s; P < .0001). Echocardiographic indices of systolic function were largely unchanged by ivabradine, but significantly reduced by atenolol.

Conclusions and clinical importance: A single dose of ivabradine decreases dynamic LVOT obstruction in cats with HCM, but the clinical effect is negligible and inferior compared to that achieved by atenolol.

Keywords: Atenolol; Feline; If current; Systolic anterior motion.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Animals
  • Atenolol / therapeutic use
  • Benzazepines / therapeutic use*
  • Cardiomyopathy, Hypertrophic / drug therapy
  • Cardiomyopathy, Hypertrophic / physiopathology
  • Cardiomyopathy, Hypertrophic / veterinary*
  • Cardiotonic Agents / therapeutic use*
  • Cat Diseases / drug therapy*
  • Cat Diseases / physiopathology
  • Cats
  • Double-Blind Method
  • Echocardiography / veterinary
  • Female
  • Ivabradine
  • Male
  • Ventricular Dysfunction, Left / drug therapy
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / veterinary*

Substances

  • Adrenergic beta-Antagonists
  • Benzazepines
  • Cardiotonic Agents
  • Ivabradine
  • Atenolol