The Comparison of Effects of Ivabradine and Atenolol on Heart Rate and Symptoms in patients with Mild-to-Moderate Mitral Stenosis

Aim: To compare the effect of Ivabradine and Atenolol on heart rate and symptoms (duration of exercise) in patients with mild-to-moderate mitral Stenosis in sinus rhythm. Methods: The prospective, open-label study was performed at DHQ teaching hospital, Sargodha from April 2015 to September 2015. Patients were randomized to two treatment groups. One group was given ivabradine while other was advised antenolol. Resting mitral valve gradient as assessed by Doppler evaluation. Data was collected by proforma aand analyzed using SPSS 20. Results: There was significant reduction in baseline and peak exercise HR at the end of follow-up. Reduction of heart rate from baseline with Atenolol was 42% in resting and 27.7% during exercise. Ivabradine reduces heart rate 38.6% and 24.4% during resting and exercise respectively. Reduction in mitral valve gradient after Ivabradine was (37.7%) and with Atenolol was (39.9%). There was significant Reduction in pulmonary artery systolic pressure after both Ivabradine (29.8%) and Atenolol (32.5%), as compared with baseline. Conclusion: The study shows beneficial effects of both Ivabradine and Atenolol in patients with mildto-moderate MS in NSR in terms of improvement in symptoms, during rest and during exercise. Hemodynamic parameters like mitral valve gradient and pulmonary artery pressure were significantly improved.