Ivabradine in a Neonate With Severe Hypertrophic Cardiomyopathy.

Yaa S Karikari, Genevieve Baxter, Hugo R Martinez, Kaitlin Ryan, Karine Guerrier

Abstract readCase Reports

In one paragraph

Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yaa S KarikariThe University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee, USA. Electronic address: ykarikar@uthsc.edu.

Genevieve BaxterThe University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee, USA.

Hugo R MartinezTexas Center for Pediatric and Congenital Heart Disease, The University of Texas at Austin, Austin, Texas, USA.

Kaitlin RyanThe University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee, USA.

Karine GuerrierThe University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, Tennessee, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertrophic cardiomyopathy (HCM) affects approximately 20% of patients with Noonan syndrome and contributes significantly to mortality, particularly in neonates with severe HCM and left ventricular outflow tract obstruction, where controlling heart rate (HR) and maintaining systemic vascular resistance can be challenging. CASE SUMMARY: A full-term neonate with an Raf-1 proto-oncogene, serine/threonine kinase mutation and severe HCM developed diastolic heart failure requiring high-dose esmolol for rate control and phenylephrine for systemic vascular resistance support. After inadequate HR response and associated vasodilation due to esmolol, off-label ivabradine was started at 20 days of life, achieving HR control within 48 hours and allowing weaning of vasoactive agents and respiratory support. DISCUSSION: Standard therapies-β-blockers, nondihydropyridine calcium channel blockers, and sodium-channel blockers-can worsen left ventricular outflow tract obstruction. Ivabradine selectively inhibits the I(f) current via hyperpolarization-activated cyclic nucleotide-gated channel 4 in sinoatrial tissue, providing HR reduction without compromising contractility or hemodynamics. TAKE-HOME MESSAGE: Ivabradine provides durable HR control without negative inotropy or hypotension, supporting its use in symptomatic pediatric HCM.

Indexed as

hypertrophic cardiomyopathyivabradineleft ventricular outflow obstructionNoonan syndrome

Identifiers

PMID42213003

DOI10.1016/j.jaccas.2026.108559

PMCPMC13464245

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.