Journal of Cardiovascular Pharmacology最新文献

{"title":"Ivabradine in the Treatment of POTS Before and After COVID-19 Pandemic: A Systematic Review and Meta-Analysis.","authors":"Vicky Kumar, Syeda H Qadri, Ana B Nardelli da Silva, Andela Malaj, Syeda F Qadri, Fnu Wajeeha, Praveen Kasina, Muhammed M Jumani, Haris Muhammad","doi":"10.1097/FJC.0000000000001823","DOIUrl":"10.1097/FJC.0000000000001823","url":null,"abstract":"<p><strong>Abstract: </strong>Postural orthostatic tachycardia syndrome (POTS) is a debilitating autonomic disorder characterized by excessive orthostatic tachycardia and significant functional impairment. Conventional therapies, including beta-blockers, often provide incomplete relief or are poorly tolerated. Ivabradine, a selective If channel inhibitor, reduces heart rate without affecting blood pressure or myocardial contractility, making it a promising option, particularly in post-COVID-19 POTS. This systematic review and meta-analysis evaluated the efficacy and safety of ivabradine in patients with POTS. PubMed, Embase, and the Cochrane Library were searched through August 2025 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD420251073600). Eligible studies included randomized controlled trials, observational studies, and case series reporting ivabradine outcomes in POTS. Primary outcomes were changes in standing and supine heart rate; secondary outcomes included symptom burden, quality of life, and adverse events. A random-effects model was used, heterogeneity was assessed through sensitivity analyses, and certainty of evidence was evaluated using Grading of Recommendations, Assessment, Development, and Evaluation. Nine studies involving 245 patients were included. Ivabradine significantly reduced standing heart rate (-18.5 bpm; 95% confidence interval -23.3 to -13.8) and supine heart rate (-9.7 bpm; 95% confidence interval -13.4 to -6.1). Symptom improvement particularly palpitations, lightheadedness, and exercise intolerance was consistently reported across classic, pediatric, hyperadrenergic, and post-COVID-19 subgroups. Adverse events were infrequent and mild, most commonly transient visual disturbances, with no reports of severe bradycardia or hypotension. Heterogeneity was high, largely driven by pediatric and post-COVID-19 cohorts. In conclusion, ivabradine seems to provide meaningful heart rate reduction and symptomatic improvement in POTS with a favorable safety profile. However, evidence is limited by small, heterogeneous, predominantly observational studies, underscoring the need for large, multicenter randomized controlled trials.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"115-122"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pitfalls of Therapies Targeting the Nitric Oxide Signaling Pathway in Heart Failure With Preserved Ejection Fraction.","authors":"Skylar A Loeb, Darla L Tharp, Scott D Zawieja, Soumiya Pal, Antonio Abbate, Brant E Isakson","doi":"10.1097/FJC.0000000000001844","DOIUrl":"10.1097/FJC.0000000000001844","url":null,"abstract":"<p><strong>Abstract: </strong>Over 30 million individuals globally are afflicted with heart failure with preserved ejection fraction (HFpEF). Despite this substantial figure, treatment options for HFpEF remain limited. This is largely attributed to the variability in disease features and comorbidities with which patients present in the clinic. A common feature among patients with HFpEF is reduced nitric oxide (NO) bioavailability-a finding which prompted the use of therapeutics targeting the NO signaling pathway in HFpEF preclinical and clinical trials. Although many of these therapeutics were successful in animal models, clinical trials have yielded neutral, negative, or contradictory results. In this review, we will summarize the outcomes of HFpEF clinical trials investigating drugs that target the NO signaling pathway (nitrates, nitrites, soluble guanylyl cyclase stimulators, and phosphodiesterase 5 inhibitors) and discuss potential pitfalls underlying the neutral or negative results, as well as considerations for the design of future studies.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"71-85"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness of Somatostatin and Analogues on Chest Tube Output After Coronary Artery Bypass Grafting: A Scoping Review.","authors":"Caitlin M Gibson, Alisa K Escaño, Katherine D Hobe, Erica R Brody, Roberto Montealgre, Josue Chery","doi":"10.1097/FJC.0000000000001810","DOIUrl":"10.1097/FJC.0000000000001810","url":null,"abstract":"<p><strong>Abstract: </strong>Somatostatin and analogues may reduce chest tube (CT) output in chylothorax caused by postcoronary artery bypass grafting (CABG). However, data are limited to case reports and series. This scoping review aimed to describe the efficacy and safety of somatostatin/analogue use in post-CABG chylothorax. We retrieved from PubMed, Embase, and OVID all studies and case reports describing somatostatin/analogue use in adult patients post-CABG for resolution of chylothorax. The primary outcome was time from somatostatin/analogue initiation to daily CT output <100 mL/d. CT duration, need to repeat invasive intervention, and safety events associated with somatostatin/analogues were also analyzed. Somatostatin/analogues were associated with reductions in CT output, but one-third of patients still required pleurodesis or surgical intervention. No safety events were identified. Patients with lower daily CT outputs at the time of somatostatin/analogue initiation were more likely to avoid repeat intervention than those with higher outputs. In conclusion, somatostatin/analogues seem safe and possibly effective in management of post-CABG chylothorax. Future studies should investigate which patients are most likely to benefit from this therapy.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"155-160"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnitude of Blood Pressure Reduction in Response to Levosimendan Infusion Independently Predicts In-Hospital Mortality in Patients With Acute Heart Failure.","authors":"Gianmarco Sarto, Beatrice Simeone, Francesca Sbandi, Valentina Valenti, Maurizio Forte, Luigi Spadafora, Marco Bernardi, Michele Golino, Giacomo Tres, Gaia Cantiello, Luigi Frati, Giacomo Frati, Rachele Di Mario, Iginio Colaiori, Giuseppe Biondi-Zoccai, Francesco Versaci, Sebastiano Sciarretta","doi":"10.1097/FJC.0000000000001811","DOIUrl":"10.1097/FJC.0000000000001811","url":null,"abstract":"<p><strong>Abstract: </strong>The impact of blood pressure (BP) reduction induced by levosimendan infusion on in-hospital mortality in patients with acute heart failure (AHF) and systolic ventricular dysfunction still needs to be clarified. We conducted a retrospective cohort study involving 161 patients hospitalized for AHF and treated with a 24-hour infusion of levosimendan between 2017 and 2024, following a standard protocol. During hospitalization, biometric, clinical, laboratory, and echocardiographic parameters were assessed. The results revealed that the difference in systolic and mean BP before and after levosimendan infusion (delta-SBP and delta-MAP) was significantly associated with higher in-hospital mortality (delta-SBP in survivors: 10.1 ± 19.1 mm Hg vs. in nonsurvivors: 21.4 ± 23.6 mm Hg, P = 0.023; delta-MAP in survivors: 8.8 ± 15.8 mm Hg vs. in nonsurvivors: 17.8 ± 23.3 mm Hg, P = 0.034), regardless of baseline BP values and despite the fact that most patients had absolute values of SBP after levosimendan infusion >90 mm Hg. Multivariable analysis confirmed that a larger reduction in SBP was an independent predictor of in-hospital mortality (OR: 1.053, 95% CI, 1.015-1.092, P = 0.006). Absolute values of SBP after levosimendan infusion (post-SBP) were also independently associated with mortality (OR: 0.942, 95% CI, 0.896-0.990, P = 0.019). However, when the analysis was repeated in a subgroup of subjects with SBP after infusion >90 mm Hg, only delta-SBP remained independently associated with mortality (OR 1.051, 95% CI, 1.009-1.095, P = 0.017). In patients with AHF treated with levosimendan, larger reductions in SBP after therapy are independently associated with in-hospital mortality. Monitoring SBP changes after levosimendan infusion may improve risk stratification and guide clinical decisions.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"149-154"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Adverse Events Associated With Immune Checkpoint Inhibitors From the Perspective of Gut Microecology: Potential Roles and Research Advances of the Gut Microbiota.","authors":"Zaiyi Chen, Guo Li, Xinyi Tang, Xing Liu","doi":"10.1097/FJC.0000000000001842","DOIUrl":"10.1097/FJC.0000000000001842","url":null,"abstract":"<p><strong>Abstract: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized cancer immunotherapy by significantly improving the prognosis of patients with various malignancies. Despite their clinical benefits, ICIs are increasingly recognized for inducing cardiovascular adverse events, including severe toxicities such as myocarditis, which pose substantial challenges in oncology practice. Emerging evidence highlights the gut microbiota as a critical regulator of host immunity, potentially influencing the development and progression of ICI-associated cardiovascular toxicities. This review comprehensively examines the current understanding of the interplay between gut microbiota and ICI-associated cardiovascular adverse events. We systematically analyze the incidence, pathophysiological mechanisms, diagnostic criteria, and prognosis of major cardiovascular toxicities linked to ICIs. Furthermore, we explore the immunomodulatory functions of the gut microbiome that may underlie these adverse events, emphasizing microbiota-mediated systemic immune dysregulation and cardiovascular-specific toxicity pathways. We also discuss future research directions and the clinical implications of integrating gut microbiota modulation into the management of ICI-associated cardiovascular complications. By synthesizing multidisciplinary insights, this review aimed to provide a theoretical foundation and research framework to advance both basic and clinical studies in this emerging field.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"104-114"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-1 Receptor Antagonist Levels in Patients With Heart Failure and Reduced Ejection Fraction Treated With Anakinra.","authors":"Jazmin Kelly, Eleonora Mezzaroma, Andrea Roscioni, Chantel McSkimming, Adolfo Mauro, Pratyush Narayan, Michele Golino, Cory Trankle, Justin M Canada, Stefano Toldo, Benjamin W Van Tassell, Antonio Abbate","doi":"10.1097/FJC.0000000000001849","DOIUrl":"10.1097/FJC.0000000000001849","url":null,"abstract":"<p><strong>Abstract: </strong>Patients with heart failure and reduced ejection fraction (HFrEF) commonly show signs of systemic inflammation. Interleukin-1 (IL-1) is a proinflammatory cytokine, known to modulate cardiac function. We aimed to determine the effects of treatment with anakinra, a recombinant IL-1 receptor antagonist (IL-1Ra), on plasma IL-1Ra levels. We measured IL-1Ra levels at baseline and longest available follow-up to 24 weeks in 63 patients (44 men, 40 self-identified Black Americans) with recent hospitalization for HFrEF and systemic inflammation [C-reactive protein (CRP) levels >2 mg/L] who were assigned to anakinra [n = 42 (66.7%)] or placebo [n = 21 (33.3%)] as part of the REDHART2 clinical trial (NCT03797001). Cardiorespiratory fitness was measured as peak oxygen consumption (VO 2peak ). Baseline plasma IL-1Ra levels were 380 [290 to 1046] pg/mL. On-treatment IL-1Ra levels were significantly higher in the patients treated with anakinra versus placebo [3994 (3372 to 5000) pg/mL vs. 492 (304 to 1370) pg/mL, P < 0.001]. The longest available follow-up was 6 weeks in 10 patients (15.9%), 12 weeks in 12 patients (19%), and 24 weeks in 41 patients (65.1%). On-treatment IL-1Ra levels and interval change in IL-1Ra showed a modest inverse correlation with on-treatment CRP levels (R = -0.269, P = 0.033 and R=-0.355, P = 0.004, respectively) and no statistically significant correlations with VO 2peak values ( P > 0.05). Patients with recently decompensated HFrEF and systemic inflammation treated with recombinant IL-1Ra, anakinra, had a significant several-fold increase in plasma IL-1Ra levels. On-treatment IL-1Ra levels, however, showed only a modest correlation with CRP levels and not with VO 2peak.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"166-172"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melissa officinalis Extract Attenuates Gamma Radiation-Induced Cardiac Injury in Rats: An Integrated Bioinformatics and Experimental Study.","authors":"Ahmed Hammad, Safaa A E Abd El Wahab, Salwa Ahmed Lotfi, Mostafa A Farrag, Ragaa S M Kawara, Esraa S A Ahmed","doi":"10.1097/FJC.0000000000001845","DOIUrl":"10.1097/FJC.0000000000001845","url":null,"abstract":"<p><strong>Abstract: </strong>The detrimental effect of gamma radiation on cardiac tissue is an intricate problem in the field of nuclear medicine. Therefore, this study aimed to investigate the potential mechanism of Melissa officinalis (MO) against irradiation (IR)-induced cardiac toxicity using an integrated approach combining phytochemical profiling (HPLC and GC-MS), network pharmacology, molecular docking, and in vivo experimental validation. Phytochemical profiling, network pharmacology, and molecular docking analyses identified ellagic acid as a major bioactive constituent of MO and predicted the NRF2 and MAPK pathways as key targets. For in vivo validation, 24 male Wistar rats were divided into 4 groups: control, MO extract (75 mg/kg/day for 3 weeks), irradiated (5 Gy gamma radiation), and irradiated + MO extract. Cardiac injury was assessed by measuring serum injury biomarkers (ALT, LDH), oxidative stress markers (MDA, GSH, SOD, CAT, and GPx), lipid profile, and gene expression of PGC-1α, β3AR, Na + /K + -ATPase, NRF2, MAPK, and JNK. MO extract significantly attenuated radiation-induced elevations in serum LDH and ALT, reduced lipid peroxidation, restored antioxidant defenses, and was associated with improved transcriptional markers of cardiac metabolism. These effects were mediated through upregulation of NRF2 and downregulation of MAPK and JNK signaling pathways, consistent with network pharmacology predictions. Taken together, these results suggest that MO may represent a promising candidate for mitigating acute radiation-induced biochemical alterations associated with cardiac injury by enhancing cardiac function and mitigating impaired oxidative status. This study revealed that MO could reduce cardiac toxicity in irradiated rats through its antioxidant activity, mediated by the NRF2 and MAPK pathways.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"132-148"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 Gene Therapy Trial for Obesity and Type 2 Diabetes: Toward a New Paradigm for Chronic Disease Treatment.","authors":"Ghadir Amin, George W Booz","doi":"10.1097/FJC.0000000000001838","DOIUrl":"10.1097/FJC.0000000000001838","url":null,"abstract":"","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"69-70"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midodrine Hydrochloride as a Treatment for Postural Orthostatic Tachycardia Syndrome: A Systematic Review and Meta-Analysis.","authors":"Chun S Kwok, Soyoung Lee, Azreen Afzal, Lenny Choi, Babak Nazari, Mark Hall, Yoon K Loke, Adnan I Qureshi, Satish R Raj","doi":"10.1097/FJC.0000000000001822","DOIUrl":"10.1097/FJC.0000000000001822","url":null,"abstract":"<p><strong>Abstract: </strong>The aim of this review was to evaluate the evidence for midodrine as a treatment for patients with postural orthostatic tachycardia syndrome (POTS). We conducted a systematic review of the literature to identify studies which evaluate midodrine treatment in patients with POTS. Random-effects meta-analysis was used to determine the effect of midodrine on symptoms compared with placebo and beta-blockers. A total of 14 studies with 968 patients were included which took place between 2000 and 2017. The proportion of patients who clinically benefited from POTS from 10 studies ranged from 46.2% to 91.3%. Meta-analysis of midodrine versus control for studies of children showed that midodrine had significantly increased odds of symptom response (RR, 1.52; 95% confidence interval, 1.09-2.13, P = 0.01, I 2 = 78%, 4 studies). The pooled result comparing midodrine with beta-blockers in pediatric populations showed that there was a 1.16-fold increase in odds for symptom response compared with beta-blockers (RR, 1.16; 95% confidence interval, 1.02-1.32, P = 0.02, I 2 = 0%, 4 studies). Hypertension was reported in 3 studies to occur in 8.2% of patients (7/85). Gastrointestinal disturbance was reported in 4 studies and it occurred in 3.4% of patients (6/175). The evidence for midodrine efficacy in patients with POTS is limited, particularly in adults. Additional studies are needed to better understand which patients may benefit the most. Midodrine may be considered as a second-line or third-line therapy in patients who remain symptomatic particularly if an enhancement of vascular tone or preload is desired. The use of midodrine in older patients with hypertension should be discouraged.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"96-103"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ivabradine in Heart Transplant Recipients with Sinus Tachycardia: A Systematic Review and Meta-Analysis.","authors":"Khadeeja Ali Hamzah, Yousif Hameed Kurmasha, Waleed Mohaned Rasheed, Ali Saad Al-Shammari, Muhammad Shahzaib, Atef Akoum, Mohammedsadeq A Shweliya, Alaa Ramadan, Haider Al-Taii, Marwan M Refaat","doi":"10.1097/FJC.0000000000001840","DOIUrl":"10.1097/FJC.0000000000001840","url":null,"abstract":"<p><strong>Abstract: </strong>Sinus tachycardia is common after heart transplantation (HTx) and may worsen graft function through increased oxygen demand and remodeling. Ivabradine, a selective If channel inhibitor, lowers heart rate (HR) independently of sympathetic activity. This meta-analysis evaluates its efficacy and safety versus standard care in HTx recipients. A comprehensive search of PubMed, Embase, WoS, Scopus, and Cochrane was conducted through September 2025. Eligible studies included randomized and nonrandomized comparative trials. Data were pooled with a random-effects model to estimate mean differences for continuous outcomes and risk ratios (RR) for dichotomous outcomes. Six studies, including 852 adult HTx recipients, were included. Ivabradine consistently reduced HR across all time points. Statistical significance was reached at 24 months (MD -16.82 bpm; P = 0.04) and 36 months (MD -12.94 bpm; P = 0.04). A significant reduction was observed in left ventricular mass index (MD -11.10 g/m 2 ; 95% confidence interval -17.15 to -5.06; P < 0.05; I^2 = 0%). While left ventricular mass (LVM) and left ventricular ejection fraction (LVEF) showed trends toward improvement at the final follow-up (MD = -11.23 for LVM and +2.94% for LVEF), neither reached statistical significance ( P = 0.06 and P = 0.48, respectively). No significant differences were found between the ivabradine and control groups regarding all-cause mortality (RR 1.16 at the final follow-up; P = 0.90), graft rejection (RR 1.14; P = 0.87), or systolic blood pressure (MD 0.50 mm Hg; P = 0.83). Ivabradine lowers HR after HTx but shows no clear benefit on mortality, rejection, or ejection fraction. It does not significantly affect blood pressure, supporting its tolerability, particularly when beta-blockers are not tolerated.</p>","PeriodicalId":15212,"journal":{"name":"Journal of Cardiovascular Pharmacology","volume":" ","pages":"86-95"},"PeriodicalIF":2.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}