Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1984 Apr;51(4):445–451. doi: 10.1136/hrt.51.4.445

Acute haemodynamic and metabolic effects of felodipine in congestive heart failure.

A D Timmis, S Campbell, M J Monaghan, L Walker, D E Jewitt
PMCID: PMC481528  PMID: 6704264

Abstract

Felodipine is a new calcium antagonist with a high degree of vascular selectivity. To examine its potential value as an afterload reducing agent in congestive heart failure 11 patients were studied. Substantial increments in cardiac index were associated with a fall in systemic vascular resistance. Left ventricular end diastolic pressure was also significantly reduced. Although left ventricular maximum dP/dt remained unchanged, maximum dP/dt/P increased. Left ventricular unloading was reflected by a reduction in cavity dimensions and a shift in the relation between end systolic pressure and dimension downwards and to the left. The myocardial oxygen supply to demand ratio was also improved: coronary sinus flow increased significantly despite a decline in myocardial oxygen consumption. These beneficial haemodynamic and metabolic effects suggest that felodipine may extend the clinical application of calcium antagonists to include the treatment of congestive heart failure.

Full text

PDF
445

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anastassiades C. J. Nifedipine and beta-blocker drugs. Br Med J. 1980 Nov 8;281(6250):1251–1252. doi: 10.1136/bmj.281.6250.1251-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Borow K. M., Neumann A., Wynne J. Sensitivity of end-systolic pressure-dimension and pressure-volume relations to the inotropic state in humans. Circulation. 1982 May;65(5):988–997. doi: 10.1161/01.cir.65.5.988. [DOI] [PubMed] [Google Scholar]
  3. Bostróm S. L., Ljung B., Mårdh S., Forsen S., Thulin E. Interaction of the antihypertensive drug felodipine with calmodulin. Nature. 1981 Aug 20;292(5825):777–778. doi: 10.1038/292777a0. [DOI] [PubMed] [Google Scholar]
  4. Braunwald E. Control of myocardial oxygen consumption: physiologic and clinical considerations. Am J Cardiol. 1971 Apr;27(4):416–432. doi: 10.1016/0002-9149(71)90439-5. [DOI] [PubMed] [Google Scholar]
  5. Braunwald E. Mechanism of action of calcium-channel-blocking agents. N Engl J Med. 1982 Dec 23;307(26):1618–1627. doi: 10.1056/NEJM198212233072605. [DOI] [PubMed] [Google Scholar]
  6. Brooks N., Cattell M., Pidgeon J., Balcon R. Unpredictable response to nifedipine in severe cardiac failure. Br Med J. 1980 Nov 15;281(6251):1324–1324. doi: 10.1136/bmj.281.6251.1324. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fleckenstein A. Specific pharmacology of calcium in myocardium, cardiac pacemakers, and vascular smooth muscle. Annu Rev Pharmacol Toxicol. 1977;17:149–166. doi: 10.1146/annurev.pa.17.040177.001053. [DOI] [PubMed] [Google Scholar]
  8. Ganz W., Tamura K., Marcus H. S., Donoso R., Yoshida S., Swan H. J. Measurement of coronary sinus blood flow by continuous thermodilution in man. Circulation. 1971 Aug;44(2):181–195. doi: 10.1161/01.cir.44.2.181. [DOI] [PubMed] [Google Scholar]
  9. Gillmer D. J., Kark P. Pulmonary oedema precipitated by nifedipine. Br Med J. 1980 Jun 14;280(6229):1420–1421. doi: 10.1136/bmj.280.6229.1420. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Gray R., Chatterjee K., Vyden J. K., Ganz W., Forrester J. S., Swan H. J. Hemodynamic and metabolic effects of isosorbide dinitrate in chronic congestive heart failure. Am Heart J. 1975 Sep;90(3):346–352. doi: 10.1016/0002-8703(75)90324-5. [DOI] [PubMed] [Google Scholar]
  11. Klugmann S., Salvi A., Camerini F. Haemodynamic effects of nifedipine in heart failure. Br Heart J. 1980 Apr;43(4):440–446. doi: 10.1136/hrt.43.4.440. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lauwerys R. R. Colorimetric determination of free fatty acids. Anal Biochem. 1969 Nov;32(2):331–333. doi: 10.1016/0003-2697(69)90093-1. [DOI] [PubMed] [Google Scholar]
  13. Livesley B., Atkinson L. Letter: Accurate quantitative estimation of lactate in whole blood. Clin Chem. 1974 Nov;20(11):1478–1478. [PubMed] [Google Scholar]
  14. Lorell B. H., Turi Z., Grossman W. Modification of left ventricular response to pacing tachycardia in nifedipine in patients with coronary artery disease. Am J Med. 1981 Oct;71(4):667–675. doi: 10.1016/0002-9343(81)90237-0. [DOI] [PubMed] [Google Scholar]
  15. Ludbrook P. A., Tiefenbrunn A. J., Reed F. R., Sobel B. E. Acute hemodynamic responses to sublingual nifedipine: dependence on left ventricular function. Circulation. 1982 Mar;65(3):489–498. doi: 10.1161/01.cir.65.3.489. [DOI] [PubMed] [Google Scholar]
  16. MAGER M., FARESE G. WHAT IS "TRUE" BLOOD GLUCOSE?A COMPARISON OF THREE PROCEDURES. Am J Clin Pathol. 1965 Jul;44:104–108. [PubMed] [Google Scholar]
  17. Mason D. T., Braunwald E., Covell J. W., Sonnenblick E. H., Ross J., Jr Assessment of cardiac contractility. The relation between the rate of pressure rise and ventricular pressure during isovolumic systole. Circulation. 1971 Jul;44(1):47–58. doi: 10.1161/01.cir.44.1.47. [DOI] [PubMed] [Google Scholar]
  18. Moskowitz R. M., Piccini P. A., Nacarelli G. V., Zelis R. Nifedipine therapy for stable angina pectoris: preliminary results of effects on angina frequency and treadmill exercise response. Am J Cardiol. 1979 Oct 22;44(5):811–816. doi: 10.1016/0002-9149(79)90202-9. [DOI] [PubMed] [Google Scholar]
  19. Pierpont G., Hale K. A., Franciosa J. A., Cohn J. N. Effects of vasodilators on pulmonary hemodynamics and gas exchange in left ventricular failure. Am Heart J. 1980 Feb;99(2):208–216. doi: 10.1016/0002-8703(80)90767-x. [DOI] [PubMed] [Google Scholar]
  20. Polese A., Fiorentini C., Olivari M. T., Guazzi M. D. Clinical use of a calcium antagonistic agent (nifedipine) in acute pulmonary edema. Am J Med. 1979 May;66(5):825–830. doi: 10.1016/0002-9343(79)91123-9. [DOI] [PubMed] [Google Scholar]
  21. Robson R. H., Vishwanath M. C. Nifedipine and beta-blockade as a cause of cardiac failure. Br Med J (Clin Res Ed) 1982 Jan 9;284(6309):104–104. doi: 10.1136/bmj.284.6309.104. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Rubio R., Berne R. M. Regulation of coronary blood flow. Prog Cardiovasc Dis. 1975 Sep-Oct;18(2):105–122. doi: 10.1016/0033-0620(75)90001-8. [DOI] [PubMed] [Google Scholar]
  23. Sagawa K. The ventricular pressure-volume diagram revisited. Circ Res. 1978 Nov;43(5):677–687. doi: 10.1161/01.res.43.5.677. [DOI] [PubMed] [Google Scholar]
  24. Stone P. H., Antman E. M., Muller J. E., Braunwald E. Calcium channel blocking agents in the treatment of cardiovascular disorders. Part II: Hemodynamic effects and clinical applications. Ann Intern Med. 1980 Dec;93(6):886–904. doi: 10.7326/0003-4819-93-6-886. [DOI] [PubMed] [Google Scholar]
  25. Stone P. H., Turi Z. G., Muller J. E. Efficacy of nifedipine therapy for refractory angina pectoris. Am Heart J. 1982 Sep;104(3):672–681. doi: 10.1016/0002-8703(82)90255-1. [DOI] [PubMed] [Google Scholar]
  26. Suga H., Sagawa K. Assessment of absolute volume from diameter of the intact canine left ventricular cavity. J Appl Physiol. 1974 Apr;36(4):496–499. doi: 10.1152/jappl.1974.36.4.496. [DOI] [PubMed] [Google Scholar]
  27. WALLACE A. G., SKINNER N. S., Jr, MITCHELL J. H. Hemodynamic determinants of the maximal rate of rise of left ventricular pressure. Am J Physiol. 1963 Jul;205:30–36. doi: 10.1152/ajplegacy.1963.205.1.30. [DOI] [PubMed] [Google Scholar]
  28. Wallenstein S., Zucker C. L., Fleiss J. L. Some statistical methods useful in circulation research. Circ Res. 1980 Jul;47(1):1–9. doi: 10.1161/01.res.47.1.1. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES