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Felodipine in severe chronic congestive heart failure: Acute effects on central hemodynamics and regional blood flow distribution

  • Congestive Heart Failure
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Summary

In order to assess the effect of felodipine, a new calcium antagonist with vascular selectivity, on regional blood flow distribution at rest in chronic congestive heart failure, ten patients were studied during an acute test. Right heart catheterization allowed the evaluation of hemodynamic parameters; renal blood flow was calculated using paraamino-hippuric acid clearance; hepatic blood flow measurement was based on indocyanine green clearance; and limb blood flow was assessed with venous occlusion plethysmography. Blood samples were collected for the analysis of plasma catecholamines, renin, and aldosterone. All parameters were recorded in duplicate under basal conditions and after felodipine infusion.

The infusion of felodipine induced a significant increase in cardiac index, stroke work index, and limb blood flow. Systemic and pulmonary arterial blood pressure, pulmonary wedge pressure, and systemic resistance underwent a significant decrease. The heart rate, pulmonary resistance, renal blood flow, and hepatic blood flow were not changed.

In conclusion, felodipine was of benefit in congestive heart failure at rest in an acute test, acting through a marked decrease in vascular resistance and a consequent improvement in cardiac output and limb blood flow. No changes in renal and hepatic blood flow were observed.

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References

  1. Fagard R, Lijnen P, Moerman E, et al. Acute haemodynamic and humoral responses to felodipine and metoprolol in mild hypertension.Eur J Clin Pharmacol 1987; 32:71–75.

    PubMed  Google Scholar 

  2. Elmfeldt D, Hedner T. Felodipine, a new vasodilator, in addition to beta-receptor blockade in hypertension.Eur J Clin Pharmacol 1983; 25:571–575.

    PubMed  Google Scholar 

  3. Leonetti G, Gradnik R, Terzoli L, et al. Felodipine, a new vasodilating drug: Blood pressure, cardiac, renal, and humoral effects in hypertensive patients.J Cardiovasc Pharmacol 1984; 6:392–398.

    PubMed  Google Scholar 

  4. Wathen CG, MacLeod D, Tucker L, et al. Felodipine as a replacement for minoxidil in the treatment of severe hypertension.Eur Heart J 1986; 7:893–897.

    PubMed  Google Scholar 

  5. Sheridan JV, Thomas P, Routledge PA, et al. Effects of felodipine on hemodynamics and exercise capacity in patients with angina pectoris.Br J Clin Pharmacol 1987; 23:391–396.

    PubMed  Google Scholar 

  6. Detry JMR, De Coster PM, Renkin J. Hemodynamic effects of felodipine at rest and during exercise in exertional angina pectoris.Am J Cardiol 1983; 52:453–457.

    PubMed  Google Scholar 

  7. Tweddel AC, Johnsson G, Pringle TH, et al. The systemic and coronary hemodynamic effects of felodipine in patients with coronary heart disease.Eur Heart J 1983; 4:699–705.

    PubMed  Google Scholar 

  8. Tan LB, Murray RG, Littler WA. Felodipine in patients with chronic heart failure: discrepant hemodynamic and clinical effects.Br Heart J 1987; 58:122–128.

    PubMed  Google Scholar 

  9. Kassis E, Amtorp O, Waldorff S, et al. Efficacy of felodipine in chronic congestive heart failure: a placebo controlled hemodynamic study at rest and during exercise and orthostatic stress.Br Heart J 1987; 58:505–511.

    PubMed  Google Scholar 

  10. Tweddel AC, Hutton I. Felodipine in ventricular dysfunction.Eur Heart J 1986; 7:54–60.

    PubMed  Google Scholar 

  11. Binetti G, Pancaldi S, Giovanelli N, et al. Hemodynamic effects of felodipine in congestive heart failure.Cardiovasc Drug Ther 1987; 1:161–167.

    Google Scholar 

  12. Daneshmend TK, Roberts LJ. Physiological and pharmacological variability in estimated hepatic blood flow in man.Br J Clin Pharmacol 1981; 11:491–496.

    PubMed  Google Scholar 

  13. Ohnaus EE. Methods of the assessment of the effect of drugs on liver blood flow in man.Br J clin Pharmac 1979; 7:223–229.

    Google Scholar 

  14. Edgar B, Regardh CG, Lundborg P, et al. Pharmacokinetics and pharmacodynamic studies of felodipine in healthy subjects after various single, oral and intravenous doses.Biopharm Drug Dispos 1987; 8:235–248.

    PubMed  Google Scholar 

  15. Sluiter HE, Huysmans FTM, Thien TA, et al. Haemodynamic, hormonal, and diuretic effects of felodipine in healthy normotensive volunteers.Drugs 1985; 29:26–35.

    Google Scholar 

  16. Ahnoff M. Determination of felodipine in plasma by gas chromatography with electron capture detection.J Pharm Biomed Ann 1984; 2:519–526.

    Google Scholar 

  17. Francis G. Neurohumoral mechanisms involved in congestive heart failure.Am J Cardiol 1985; 55:15A-21A.

    PubMed  Google Scholar 

  18. Leithe C, Margorien RD, Hermiller JB, et al. Relationship between central hemodynamics and regional blood flow in normal subjects and in patients with congestive heart failure.Circulation 1984; 69:57–64.

    PubMed  Google Scholar 

  19. Leier CV, Patrick TJ, Hermiller J, et al. Nifedipine in congestive heart failure: Effects on resting and exercise hemodynamics and regional blood flow.Am Heart J 1984; 108:1461–1468.

    PubMed  Google Scholar 

  20. Levine TB, Olivari MT, Cohn JN. Hemodynamic and regional blood flow response to captopril in congestive heart failure.Am J Med 1984; 76 (5B):38–42.

    Google Scholar 

  21. Ventura HO, Frohlich ED, Messerli FH, et al. Cardiovascular effects and regional blood flow distribution associated with angiotensin converting enzyme inhibition (captopril) in essential hypertension.Am J Cardiol 1985; 55:1023–1026.

    PubMed  Google Scholar 

  22. Cohn JN. Calcium antagonists and left ventricular function: Effects of nitrendipine in congestive heart failure.Am J Cardiol 1986; 58:27D-30D.

    PubMed  Google Scholar 

  23. Leonetti G, Gradnik R, Terzoli L, et al. Effects of single and repeated doses of the calcium antagonist felodipine on blood pressure, renal function, electrolytes and water balance, and renin-angiotensin-aldosterone system in hypertensive patients.J Cardiovasc Pharmacol 1986; 8:1243–1248.

    PubMed  Google Scholar 

  24. Schmitz A. Acute renal effects of oral felodipine in normal man.Eur J Clin Pharmacol 1987; 32:17–22.

    PubMed  Google Scholar 

  25. Timmis AD, Smyth P, Kenny JF, et al. Effects of vasodilator treatment with felodipine on haemodynamic responses to treadmill exercise in congestive heart failure.Br Heart J 1984; 52:314–320.

    PubMed  Google Scholar 

  26. Edgar B, Bengtsson B, Elmfeldt D, et al. Acute diuretic/natriuretic properties of felodipine in man.Drugs 1985; 29 (Suppl 2):176–184.

    PubMed  Google Scholar 

  27. Leonetti G, Fruscio M, Terzoli L, et al. Antihypertensive and water and sodium balance effects of felodipine, a new vasodilating calcium antagonist in hypertensive patients.Drugs 1985; 29 (Suppl 2):185–191.

    PubMed  Google Scholar 

  28. Naftilan AJ, Oparil S. The role of calcium in the control of renin release.Hypertension 1982; 4:670–675.

    PubMed  Google Scholar 

  29. Andersson OK, Granerus G, Hedner T, et al. Systemic and renal hemodynamic effects of single oral doses of felodipine in patients with refractory hypertension receiving chronic therapy with β-blockers and diuretics.J Cardiovasc Pharmacol 1985; 7:544–549.

    PubMed  Google Scholar 

  30. Elkayam U, Roth A, Hsueh W, et al. Neurohumoral consequences of vasodilator therapy with hydralazine and nifedipine in severe congestive heart failure.Am Heart J 1986; 111:1130–1138.

    PubMed  Google Scholar 

  31. Barjon JN, Rouleau JL, Bichet D, et al. Chronic renal and neurohumoral effects of the calcium entry blocker nisoldipine in patients with congestive heart failure.J Am Coll Cardiol 1987; 9:622–630.

    PubMed  Google Scholar 

  32. Fifer MA, Colucci WS, Lorell BH, et al. Inotropic, vascular and neuroendocrine effects of nifedipine in heart failure: Comparison with nitroprusside.J Am Coll Cardiol 1985; 5:731–737.

    PubMed  Google Scholar 

  33. Fakundig JL, Catt KJ. Dependence of aldosterone stimulation in adrenal glomerulosa cells on calcium uptake: Effects of lanthanum and verapamil.Endocrinology 1980; 107:1345–1353.

    PubMed  Google Scholar 

  34. Kluger J, Cody RJ, Laragh JH. The contributions of sympathetic tone and the renin-angiotensin system to severe chronic congestive heart failure: Response to specific inhibitors (prazosin and captopril).Am J Cardiol 1982; 49:1667–1674.

    PubMed  Google Scholar 

  35. Markham RV, Gilmore A, Pettinger WA, et al. Central and regional hemodynamic effects and neurohumoral consequences of minoxidil in severe congestive heart failure and comparison to hydralazine and nitroprusside.Am J Cardiol 1983; 52:774–781.

    PubMed  Google Scholar 

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Part of these data have been presented at the Second Cardiovascular Pharmacotherapy International Symposium, San Francisco, CA, 1987.

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Binetti, G., Rubino, I., Varani, E. et al. Felodipine in severe chronic congestive heart failure: Acute effects on central hemodynamics and regional blood flow distribution. Cardiovasc Drug Ther 3, 903–911 (1989). https://doi.org/10.1007/BF01869580

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