The aim of study was to assess the efficacy of ivabradine (I, up to 15 mg) therapy on prognosis, right ventricular (RV) and atrial (RA) functional parameters, BNP, NT-pro-BNP and high sensitivity С reactive protein (CRP) levels in patients (pts) with III- IV NYHA FC systolic CHF. Methods. 76 pts with DCM (age 57.4) were randomly assigned to groups A (n=38, non receiving ivabradin, I) and group В (n=38, receiving I, 15 mg) in addition to ACEIs, diuretics, beta-blockers and digoxin. 1-, 2- and З-year mortality were 34.2, 39.5 and 50% in group A and 21.1, 28.9 and 39.5% in group B. Survival analysis revealed lower probability of 1-year, 2-year and З-year mortality (RR reduction at 38.3,26.8 and 21%) in pts, treated with I (p50%, hsCRP>40% and HR>40% and increase of RV EF and E/A at >25%, TAPSE>50% and RA functional index >60% after 1 year identified pts with cardiac events reduction. 2) Prognostic benefit, associated with I use, seems to be related to improvement of right heart parameters, neurohormonal and inflammation status and HR reduction.