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DOI: 10.12201/bmr.202408.00002

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  Abstract: Objective? To investigate the effect of ivabradine on cardiopulmonary exercise testing parameters, heart rate variability (HRV), high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with chronic obstructive pulmonary disease (COPD) and heart failure with preserved ejection fraction (HFpEF). Methods? A total of 97 patients with COPD and HFpEF were divided into the control group (n=48, conventional symptomatic treatment combined with bisoprolol fumarate tablets) and the ivabradine group (n=49, ivabradine treatment on the basis of the treatment of control group) using the random number table method. Therapeutic effects in the two groups were compared. The changes in cardiopulmonary exercise testing parameters, HRV, hs-CRP, NT-proBNP, St. Georges Respiratory Questionnaire (SGRQ) scores, COPD Assessment Test (CAT) scores and 6-minute walking distance after treatment were observed. Adverse cardiac events and drug reactions in the two groups were compared. Results? 3 cases in the ivabradine group and 2 cases in the control group dropped out of the study. After treatment, the total effective rate of the ivabradine group (91.30%) was significantly higher than that of the control group (76.09%) (P<0.05). After treatment, there were significant decreases in peak oxygen consumption (Peak VCO2), anaerobic threshold (AT), standard deviation of RR intervals (SDNN), root mean square of successive RR interval differences (RMSSD) and percetange of adjacent RR intervals differing by more than 50 milliseconds (PNN50) in the ivabradine group and the control group. Moreover, above parameters in the former group were significantly higher (P<0.05). After treatment, there were significant decreases in ventilatory equivalent for carbon dioxide (VE/VCO2), hs-CRP, NT-proBNP, SGRQ scores and CAT scores in both groups. Meanwhile, above parameters in the ivabradine group were significantly lower (P<0.05). After treatment, 6-minute walking distance of the two groups increased significantly, and 6-minute walking distance of the ivabradine group was significantly longer (P<0.05). Compared with the control group, the readmission rate of the ivabradine group was significantly lower (P<0.05). The mortality rate and total incidence of adverse reactions in the ivabradine group were slightly lower (P>0.05). Conclusion? Applying ivabradine in the treatment of patients with COPD and HFpEF can significantly improve their cardiopulmonary exercise function, HRV, prognosis and quality of life, and significantly reducing the levels of hs-CRP and NT-proBNP and the readmission rate, with high safety.

  Key words: Chronic obstructive pulmonary disease; Heart failure with preserved ejection fraction; Ivabradine; Cardiopulmonary exercise testing; Heart rate variability

  Submit time: 1 August 2024

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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