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Published on: April 8, 2013
Amlodipine in ischaemic left ventricular dysfunction with mild to moderate heart failure
G P Perna1, G Valle, N Cianfrone
1Department of Cardiology, IRCCS ‘Casa Sollievo della Sofferenza', San Giovanni Rotondo (FG), Italy.
Clinical Drug Investigation
|March 29, 2008
Summary
Amlodipine improved heart failure symptoms, left ventricular function, and exercise capacity in patients with ischaemic left ventricular dysfunction (LVD) and heart failure. This suggests amlodipine is beneficial for LVD patients without angina.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Ischaemic left ventricular dysfunction (LVD) with heart failure presents a significant clinical challenge, particularly for non-surgical candidates.
- Standard treatments like ACE inhibitors, digitalis, and diuretics are common, but the role of calcium antagonists, such as amlodipine, remains debated.
Purpose of the Study:
- To evaluate the effectiveness of amlodipine in patients with ischaemic LVD and mild to moderate heart failure without current angina.
- To assess amlodipine's impact on heart failure symptoms, left ventricular function, and exercise capacity.
Main Methods:
- A study involving 33 patients with ischaemic LVD (ejection fraction <40%) and NYHA class II-III heart failure, treated with standard therapy plus amlodipine 5mg daily for 8 weeks.
- Measurements included heart failure score, radionuclide left ventricular ejection fraction (rLVEF), peak aerobic capacity (VO(2max)), exercise time (ET), and total work load (TWL).
- Coronary angiography and thallium myocardial scintigraphy were performed.
Main Results:
- Amlodipine treatment significantly improved heart failure scores (p < 0.02), rLVEF (p < 0.001), VO(2max) (p < 0.003), ET (p < 0.02), and TWL (p < 0.01) compared to baseline and washout.
- Increased VO(2max) correlated with systolic blood pressure and the presence of viable/ischaemic myocardium.
Conclusions:
- Amlodipine, as an adjunct to standard therapy including ACE inhibitors, effectively reduces symptoms and enhances exercise capacity and ventricular function in patients with ischaemic LVD and heart failure.
- The drug is useful for patients with ischaemic LVD and heart failure but without angina.
- Further multicentre trials are warranted due to study limitations, including its open-label nature and small sample size.
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