Efficacy and Tolerability of Ivabradine for Cardiomyopathy in Patients with Duchenne Muscular Dystrophy
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- Wakisaka Akiko
- Department of Pediatrics, NHO Iou National Hospital
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- Kimura Koichi
- Departments of Laboratory Medicine and Cardiology, The Institute of Medical Science, The University of Tokyo
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- Morita Hiroyuki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Nakanishi Koki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Daimon Masao
- Department of Cardiology, International University of Health and Welfare Mita Hospital
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- Nojima Masanori
- Center for Translational Research, The Institute of Medical Science, The University of Tokyo
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- Itoh Hideki
- Division of Patient Safety, Hiroshima University Hospital
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- Takeda Atsuhito
- Department of Pediatrics, Hokkaido University
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- Kitao Ruriko
- Department of Neurology, NHO Hakone Hospital
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- Imai Tomihiro
- Department of Neurology, NHO Hakone Hospital
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- Ikeda Tetsuhiko
- Department of Neurology, NHO Niigata National Hospital
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- Nakajima Takashi
- Department of Neurology, NHO Niigata National Hospital
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- Watanabe Chigusa
- Department of Neurology, NHO Hiroshimanishi Medical Center
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- Furukawa Toshihiro
- Department of Pediatrics, NHO Hiroshimanishi Medical Center
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- Ohno Ichiro
- Department of Pediatrics, NHO Iou National Hospital
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- Ishida Chiho
- Department of Neurology, NHO Iou National Hospital
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- Takeda Norihiko
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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- Komai Kiyonobu
- Department of Neurology, NHO Iou National Hospital
書誌事項
- タイトル別名
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- One Year Treatment Results in Japanese National Hospitals
抄録
<p>Duchenne muscular dystrophy (DMD) is an intractable X-linked myopathy caused by dystrophin gene mutations. Patients with DMD suffer from progressive muscle weakness, inevitable cardiomyopathy, increased heart rate (HR), and decreased blood pressure (BP). The aim of this study was to clarify the efficacy and tolerability of ivabradine treatment for DMD cardiomyopathy.</p><p>A retrospective analysis was performed in 11 patients with DMD, who received ivabradine treatment for more than 1 year. Clinical results were analyzed before (baseline), 6 months after, and 12 months after the ivabradine administration.</p><p>The initial ivabradine dose was 2.0 ± 1.2 mg/day and the final dose was 5.6 ± 4.0 mg/day. The baseline BP was 95/64 mmHg. A non-significant BP decrease to 90/57 mmHg was observed at 1 month but it recovered to 97/62 mmHg at 12 months after ivabradine administration. The baseline HR was 93 ± 6 bpm and it decreased to 74 ± 12 bpm at 6 months (P = 0.011), and to 77 ± 10 bpm at 12 months (P = 0.008). A linear correlation (y = 2.2x + 5.1) was also observed between the ivabradine dose (x mg/day) and HR decrease (y bpm). The baseline LVEF was 38 ± 12% and it significantly increased to 42 ± 9% at 6 months (P = 0.011) and to 41 ± 11% at 12 months (P = 0.038). Only 1 patient with the lowest BMI of 11.0 kg/m2 and BP of 79/58 mmHg discontinued ivabradine treatment at 6 months, while 1-year administration was well-tolerated in the other 10 patients.</p><p>Ivabradine decreased HR and increased LVEF without lowering BP, suggesting it can be a treatment option for DMD cardiomyopathy.</p>
収録刊行物
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- International Heart Journal
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International Heart Journal 65 (2), 211-217, 2024-03-30
一般社団法人 インターナショナル・ハート・ジャーナル刊行会