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Abstract
Diastolic dysfunction (DD) is common in COPD patients and can be responsible for worsening of functional capacity. Increased sympathetic tone secondary to hypoxia as well as the use of bronchodilators can accelerate heart rate leading to increased severity of DD leading to aggravation of symptoms and worsening of functional capacity. To study the short term effect of heart rate lowering drug ivabradine on clinical status and exercise capacity in COPD patients. COPD patients with sinus heart rate {u2265} 90 beats/min who were receiving inhaled bronchodilators± inhaled corticosteroids were included in the study. All patients with objective evidence of coronary artery disease, uncontrolled hypertension, left ventricular systolic dysfunction, left ventricular hypertrophy, significant valvular heart disease, significant tachyarrhythmia or bradyarrhythmia or unable to sign informed consent were excluded. All included patients were subjected to complete history and clinical examination including subjective assessment of dyspnea using modified Borg scale, electrocardiogram, chest X - ray, transthoracic echocardiogram, pulmonary function tests (PFT) and six minute walk distance 6MWD