Acute and chronic efficacy of felodipine in congestive heart failure.

Abstract	In 13 patients with congestive heart failure we tested the acute hemodynamic effects of 5 vs. 10 mg felodipine tablets, in a double-blind, cross-over study. One hour after felodipine 5 mg, echocardiographic ejection fraction (%), cardiac index (thermodilution-ml/min/m2), and pulmonary wedge pressure (mm Hg) significantly changed (from 21 +/- 2 to 26 +/- 2, 2350 +/- 150 to 2790 +/- 160, 24 +/- 4 to 17 +/- 4) while they remained steady after felodipine 10 mg. The greatest stroke index increases were associated with felodipine 5 mg in 12 patients and 10 mg in 1 patient. Therefore we evaluated (open study) the long-term (2 months- 1 year) clinical and hemodynamic efficacy following the treatment with the acutely most effective dose (twice daily). After 2 months ejection fraction, cardiac index and pulmonary wedge pressure were respectively 24 +/- 2, 2550 +/- 150, and 18 +/- 4 (12 hours after the last drug administration, n = 11, P less than 0.02 from baseline). These parameters further increased one to two hours after the following administration of felodipine. Clinical improvement (reduction of 1 functional class, according to the New York Heart Association) was observed in 8/13 patients. These 8 patients participated to the one year follow-up. In 5 patients follow-up was interrupted because of acute cardiovascular events. However, before study interruption (5 patients) or ending (3 patients) clinical status did not worsen and ejection fraction remained higher than in the pretreatment period. Therefore, low dose felodipine might be used in the treatment of congestive heart failure.
Authors	P Agostoni, E Doria, S Riva, A Polese
Journal	International journal of cardiology (Int J Cardiol) Vol. 30 Issue 1 Pg. 89-95 (Jan 1991) ISSN: 0167-5273 [Print] Netherlands
PMID	1991673 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References	Felodipine
Topics	Double-Blind Method Felodipine (administration & dosage, therapeutic use) Female Follow-Up Studies Heart Failure (drug therapy, physiopathology) Hemodynamics (drug effects) Humans Male Middle Aged Time Factors

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