PP.01.21

Abstract

Objective: To investigate the effects of Ivabradine in combination with Perindopril on exercise tolerance test (ETT), and heart rate variability (HRV) in patients with coronary artery disease (CAD) and arterial hypertension (AH). Design and method: 90 subjects with mild to moderate AH and CAD were randomized into 2 groups: Group 1 - 48 patients (mean age 56,1 ± 0,8 years) received Ivabradine (mean 10,7 ± 0,4 mg) and Perindopril (mean dose 4,8 ± 0,6 mg). Group 2 - 42 patients (mean age 54,2 ± 1,3 years) – Metoprolol (mean dose 47,5 ± 5,3 mg). Groups were matched for age, sex, office blood pressure, cardiovascular risk factors. ETT, 24-hour monitoring of blood pressure and electrocardiography with HRV program were evaluated initially and after 8 weeks of therapy. Results: At 8-week follow-up both groups showed a comparable decrease in blood pressure. In group 1 more significant decrease of heart rate especially at night time was revealed. The exercise time did not change in both groups. In group 1 revealed a decrease in the number of patients with low exercise tolerance by 9.7% and the increase in the number of patients with a high tolerance exercise by 8.6%. In group 2 increased the number of patients with a high tolerance exercise by 12.6 %. In both groups there was noted that dynamic vagosympathetic interaction in heart rate regulation increased high-frequency component and time domain PNN50% as well as SDNNind and RMSSD in group 2. Conclusions: Combination therapy with Ivabradine and Perindopril has a positive effect on ETT and HRV (like Metoprolol) however its influence on heart rate is more significant in patients with CAD and AH.