Ivabradine in pulmonary arterial hypertension: can we delay the need for parenteral prostanoid therapy?

Abstract

Most patients with pulmonary arterial hypertension (PAH) in combination therapy suffer from depression or live alone, in absence of any at home assistance or caregiver; so, their compliance in the case of therapy with continuous infusion with epoprostenol, is actually limited. An alternative therapeutic approach for the treatment of severe PAH is therefore needed. Ivabradine, a selective inhibitor of the sinus node If channels, may be of help in improving the hemodynamics of patients with PAH and higher sinus rates. We therefore sought to verify the safety and feasibility of ivabradine and high-dose sildenafil in such patients, who often refuse continuous infusion with prostanoids.