Felodipine in patients with chronic heart failure: discrepant haemodynamic and clinical effects.

Tan, LB; Murray, R G; Littler, W. A.

doi:10.1136/hrt.58.2.122

Cited by 61 publications

(23 citation statements)

References 25 publications

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“…Simi-larly, the use of felodipine, a new calcium antagonist vasodilator, also failed to improve exercise capacity in patients with CHF of moderate severity. 46 Although the present study population is larger than those of previously published trials evaluating long-term effect of calcium entry-blocking agents in patients with CHF, the total number of patients is limited. This limitation is partially corrected by the crossover design of the trial, which allows direct comparison of all three treatments in the same patients.…”

Section: Treadmill Exercise Timementioning

confidence: 70%

A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure.

et al. 1990

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Section: Treadmill Exercise Timementioning

confidence: 70%

A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure.

et al. 1990

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“…Results of study with long-acting dihydropyridines also showed disparities among the hemodynamic variables evaluated [16][17][18][19][20] . the authors were unable to categorically define the effects of calcium antagonists on exercise capacity and on the functional class of the patients with heart failure [21][22][23][24][25][26] (table I).…”

Section: Clinical Resultsmentioning

confidence: 99%

Why are calcium antagonists still being used in heart failure in the era of calcium sensitizers?

Martins¹,

Villacorta²,

Mady³

2000

Arq. Bras. Cardiol.

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“…At each subsequent visit (every 2 weeks), the score increased or decreased cumulatively, depending on the degree of change from the previous visit. 7 The baseline clinical scores were recorded on the first day of the first and second treatment phases. The clinical scores at the end of both treatment periods were recorded for comparison.…”

Section: Efficacy Assessment Symptomatic Assessmentmentioning

confidence: 99%

“…5 First-generation CCBs are associated with adverse effects (AEs) in patients with HF mainly due to their negative inotropic effects and reflex neurohumoral activation. [6][7][8] The second-generation CCBs were expected to be beneficial for patients with HF, but studies have shown conflicting results. 5,7 Second-generation CCBs appear to be a rational option for the treatment of HF, because up to 70% of patients with HF have ischemia and/or hypertension as the underlying cause.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8] The second-generation CCBs were expected to be beneficial for patients with HF, but studies have shown conflicting results. 5,7 Second-generation CCBs appear to be a rational option for the treatment of HF, because up to 70% of patients with HF have ischemia and/or hypertension as the underlying cause. 5 However, it is not known whether secondgeneration CCBs are suitable for patients with nonischemic HF and normal blood pressure (BP).…”

Section: Introductionmentioning

confidence: 99%

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Effects of low-dose treatment with felodipine versus fosinopril in Chinese patients with nonischemic heart failure and normal blood pressure: A double-blind, randomized, crossover study

Lin¹,

Chan²,

Wang³

et al. 2004

Current Therapeutic Research

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Background: Two second-generation calcium channel blockers, felodipine and amlodipine besylate, have been associated with similar high mortality rates in patients with ischemic heart failure (HF) but not in patients with nonischemic causes of HF. In patients with nonischemic HF, amlodipine might have a beneficial effect on survival. However, no difference in mortality rates was found between felodipine and placebo in a nonischemic HF group. Felodipine 10 mg/d was used in 1 large study, a dose considered high for nonischemic HF usually associated with normal blood pressure (BP).Objective: The aim of this study was to compare the effects of 12-week, low-dose treatment with felodipine versus those of an angiotensin-converting enzyme inhibitor, fosinopril sodium, in patients with nonischemic HF and normal BP.Methods: This double-blind, randomized, crossover trial was conducted at Taipei Medical University Hospital (Taipei, Taiwan). Patients aged Ն18 years with angiographically proved, nonischemic HF and normal BP who were being treated with an optimal regimen of digitalis and diuretics were enrolled. After a 2-week run-in period, patients were randomized to first receive 12 weeks of treatment with felodipine tablets (2.5 mg/d) or fosinopril tablets (7.5 mg/d) and, after a 2-week washout period, were crossed over to the opposite treatment. Efficacy analysis was performed before (baseline) and after treatment and inAccepted for publication January 28, 2004. Reproduction in whole or part is not permitted.0011-393X/04/$19.00 cluded symptomatic assessment using a 7-grade clinical scale; 2-dimensional echocardiography (2-D echo); exercise tests; and neurohumoral data, including plasma renin activity, plasma aldosterone, and 24-hour urinary epinephrine (E) and norepinephrine (NE) measurements. The primary end point was death due to HF, and the secondary end point was hospital admission due to worsening HF. Compliance was measured using a pill count at the end of each treatment period. No hospital admission or cardiac death due to HF occurred during 12 weeks of treatment. Twenty-seven patients were included in the felodipine assessment, and 30 patients were included in the fosinopril assessment. Significant improvement in clinical score was noted in both treatment groups (both P < 0.01). The clinical scores did not differ significantly between the 2 treatments. No significant differences were found in 2-D echo parameters between treatments or within groups after treatment versus baseline. Significant improvement in exercise duration was noted with both study drugs after treatment versus baseline (both P < 0.01). No significant difference in exercise duration was found between the 2 treatments. Urinary E and NE were not significantly different between treatments or after treatment with either study drug compared with baseline. C U R R E N T T H E R A P E U T I C R E S E A R C H ாVConclusion: The present findings suggest that, in Chinese patients with moderate to severe HF who have normal BP and insignificant corona...

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Felodipine in patients with chronic heart failure: discrepant haemodynamic and clinical effects.

Cited by 61 publications

References 25 publications

A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure.

A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure.

Why are calcium antagonists still being used in heart failure in the era of calcium sensitizers?

Effects of low-dose treatment with felodipine versus fosinopril in Chinese patients with nonischemic heart failure and normal blood pressure: A double-blind, randomized, crossover study

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