Abstract: Objective  To observe the clinical efficacy and safety of ivabradine in patients with acute decompensated heart failure with reduced ejection fraction(ADHFrEF) on the basis of conventional drug therapy. Methods  Fifty patients with ADHFrEF were randomly devided in to control  group (group C) and observation group (group O). Group C was given routine antiheart failure treatment. Group O was treated with ivabradine 5 mg orally in addition to the routine anti  heart failure treatment. Ivabradine dose was adjusted according to the heart rate response. The heart rate(HR),  blood pressure,  cardiac function indexes,  plasma biochemical parameters,  average hospital stay,  major adverse cardiovascular events and side effects of these two groups were compared before and after treatment.Results  After treatment,  the average HR  and brain natriuretic peptide(BNP)  lvevel in two groups were significantly lower than those before treatment. The 6minute walking distance (6MD) and left ventricular ejection fraction (LVEF) were significantly higher than those before treatment (both P<0.05). The left ventricular end diastolic diameter (LVEDD) and left  ventricular end systolic  diameter(LVESD) were smaller than those before treatment (both P<0.05). Compared to group C,  ivabradine could further slow HR,  and increase 6MD and LVEF (all P<0.05). Conclusion  On the basic of routine antiheart failure treatment ivabradine can further improve the cardiac function and improve the exercise tolerance of patients with ADHFrEF.

Key words: ivabradine;heart failure, , congestive, stroke volume, treatment outcome