If电流抑制剂伊伐布雷定在心血管疾病中的临床应用进展

The clinical application of If current inhibitor ivabradine

伊伐布雷定通过选择性抑制超极化激活环核苷酸门控阳离子通道(HCN)介导的I_f电流,降低窦房结4期自动去极化速率而减慢心率。此外,伊伐布雷定还能通过降低心率来改善心肌能量供应,预防心脏重构并改善远期预后,目前在心力衰竭、冠心病心绞痛和不适当窦性心动过速三方面具有明确的治疗作用。本文仅就伊伐布雷定的电生理作用特点及其在临床应用中的重要研究进展作扼要介绍。

Ivabradine can selectively inhibit I_f current by mediating hyperpolarization-activated cyclic nucleotide gated cation(HCN)channel,resulting in the decreased rate of phase 4 automatic depolarization in the sinoatrial node and consequently,the heart rate.Recent studies have found that ivabradine can not only improve myocardial energy supply by lowering heart rate,but also prevent heart remodeling and improve long-term prognosis.Currently,ivabradine has definite therapeutic effect on heart failure,angina pectoris and inappropriate sinus tachycardia.Here,we aim to introduce the electrophysiological mechanisms of action of ivabradine and the progress of salient studies that lead to its current clinical use.