{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:57:53Z","timestamp":1789145873085,"version":"build-2803163510"},"reference-count":73,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In patients with septic shock, compensatory tachycardia initially serves to maintain adequate cardiac output and tissue oxygenation but may persist despite appropriate fluid and vasopressor resuscitation. This sustained elevation in heart rate and altered heart rate variability, indicative of autonomic dysfunction, is a well-established independent predictor of adverse outcomes in critical illness. Elevated heart rate exacerbates myocardial oxygen demand, reduces ventricular filling time, compromises coronary perfusion during diastole, and impairs the isovolumetric relaxation phase of the cardiac cycle, contributing to ventricular-arterial decoupling. This also leads to increased ventricular and atrial filling pressures, with a heightened risk of arrhythmias. Ivabradine, a highly selective inhibitor of the sinoatrial node\u2019s pacemaker current (If or \u201cfunny\u201d current), mitigates heart rate by modulating diastolic depolarization slope without affecting contractility. By exerting a selective chronotropic effect devoid of negative inotropic properties, ivabradine shows potential for improving hemodynamics in septic shock patients with cardiac dysfunction. This review evaluates the plausible mechanisms and existing evidence regarding the utility of ivabradine in managing patients with septic shock.<\/jats:p>","DOI":"10.3390\/jcm13082338","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T06:21:12Z","timestamp":1713421272000},"page":"2338","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Ivabradine in Septic Shock: A Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Marco","family":"Pasetto","sequence":"first","affiliation":[{"name":"Department of Intensive Care, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"},{"name":"Department of Surgery, Dentistry, Gynecology and Paediatrics, University of Verona, 37129 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5389-5344","authenticated-orcid":false,"given":"Lorenzo Antonino","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1271-9034","authenticated-orcid":false,"given":"Filippo","family":"Annoni","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3709-2052","authenticated-orcid":false,"given":"Sabino","family":"Scolletta","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care Unit, Department of Medicine, Surgery and Neuroscience, University Hospital of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Labb\u00e9","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia","family":"Donadello","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dentistry, Gynecology and Paediatrics, University of Verona, 37129 Verona, Italy"},{"name":"Anesthesia and Intensive Care Unit B, University Hospital Integrated Trust of Verona, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Silvio","family":"Taccone","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, H\u00f4pital Erasme, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021","volume":"47","author":"Evans","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.yjmcc.2014.05.005","article-title":"How to Slow down Septic Hearts?","volume":"74","author":"Rozec","year":"2014","journal-title":"J. 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