Nemaline myopathy and heart failure: role of ivabradine; a case report

Filippo M Sarullo, Giuseppe Vitale, Antonino Di Franco, Silvia Sarullo, Ylenia Salerno, Laura Vassallo, Emanuela Petrona Baviera, Stefania Marazia, Giorgio Mandalà, Gaetano A Lanza

Nemaline myopathy (NM) is a rare congenital myopathy characterized by muscle weakness, hypotonia and the presence in muscle fibers of inclusions known as nemaline bodies and a wide spectrum of clinical phenotypes, ranging from severe forms with neonatal onset to asymptomatic forms. The adult-onset form is heterogeneous in terms of clinical presentation and disease progression. Cardiac involvement occurs in the minority of cases and little is known about medical management in this subgroup of NM patients. We report a rare case of heart failure (HF) in a patient with adult-onset NM in whom ivabradine proved to be able to dramatically improve the clinical picture.