Ten-year results of a single-center trial investigating heart rate control with Ivabradine or Metoprolol succinate in patients after heart transplantation
Aims: Sinus tachycardia after heart transplantation (HTX) due to cardiac graft denervation is associated with reduced post-transplant survival and requires adequate treatment. We analyzed the long-term effects of heart rate control with ivabradine or metoprolol succinate in HTX recipients. Methods:...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
1 August 2025
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| In: |
Journal of cardiovascular development and disease
Year: 2025, Volume: 12, Issue: 8, Pages: 1-20 |
| ISSN: | 2308-3425 |
| DOI: | 10.3390/jcdd12080297 |
| Online Access: | Resolving-System, kostenfrei, Volltext: https://doi.org/10.3390/jcdd12080297 Verlag, kostenfrei, Volltext: https://www.mdpi.com/2308-3425/12/8/297 
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| Author Notes: | Fabrice F. Darche, Alexandra C. Alt, Rasmus Rivinius, Matthias Helmschrott, Philipp Ehlermann, Norbert Frey and Ann-Kathrin Rahm |
| Summary: | Aims: Sinus tachycardia after heart transplantation (HTX) due to cardiac graft denervation is associated with reduced post-transplant survival and requires adequate treatment. We analyzed the long-term effects of heart rate control with ivabradine or metoprolol succinate in HTX recipients. Methods: This observational retrospective single-center study analyzed the ten-year results of 110 patients receiving ivabradine (n = 54) or metoprolol succinate (n = 56) after HTX. Analysis included comparison of demographics, medications, heart rates, blood pressure values, echocardiographic features, cardiac catheterization data, cardiac biomarkers, and post-transplant survival including causes of death. Results: Both groups showed no significant differences concerning demographics or medications (except for ivabradine and metoprolol succinate). At 10-year follow-up, HTX recipients with ivabradine showed a significantly lower heart rate (72.7 ± 8.5 bpm) compared to baseline (88.8 ± 7.6 bpm; p < 0.001) and to metoprolol succinate (80.1 ± 8.1 bpm; p < 0.001), a significantly lower NT-proBNP level (588.4 ± 461.4 pg/mL) compared to baseline (3849.7 ± 1960.0 pg/mL; p < 0.001) and to metoprolol succinate (1229.0 ± 1098.6 pg/mL; p = 0.005), a significantly lower overall mortality (20.4% versus 46.4%; p = 0.004), and mortality due to graft failure (1.9% versus 21.4%; p = 0.001). Multivariate analysis showed a significantly decreased risk of death within 10 years after HTX in patients with post-transplant use of ivabradine (HR 0.374, CI 0.182–0.770; p = 0.008). Conclusions: In this single-center trial, patients with ivabradine revealed a significantly more pronounced heart rate reduction, a lower NT-proBNP level, and a superior 10-year survival after HTX. |
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| Item Description: | Gesehen am 08.01.2026 |
| Physical Description: | Online Resource |
| ISSN: | 2308-3425 |
| DOI: | 10.3390/jcdd12080297 |