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[Combination therapy in chronic heart failure. Hemodynamic effects with a calcium antagonist-diuretic combination]
T h Podszus1, J H Peter, K D Völger
1Abteilung Poliklinik, Universität Marburg/Lahn.
Insights
This study found that a fixed-dose combination medication improved symptoms in patients with chronic cardiac insufficiency. The treatment effectively lowered blood pressure and pulmonary pressures without significantly altering cardiac output.
Area of Science:
- Cardiology
- Pharmacology
Context:
- Chronic cardiac insufficiency (NYHA II-III) presents significant hemodynamic challenges.
- Current treatments aim to improve cardiac function and reduce symptoms.
Purpose:
- To evaluate the hemodynamic effects of a fixed-dose combination drug (verapamil, triamterene, hydrochlorothiazide) in patients with chronic cardiac insufficiency.
Summary:
- A four-week treatment with fixed-dose combination drugs (160 mg verapamil/50 mg triamterene/25 mg hydrochlorothiazide) in twelve patients (NYHA II-III) resulted in decreased arterial blood pressure and heart rate at rest and during exercise.
- Pulmonary arterial pressure and pulmonary capillary wedge pressure were reduced.
- No clinically significant changes in cardiac output or cardiac index were observed.
- Eight patients experienced subjective symptom improvement (NYHA stage).
Impact:
- The combination treatment appears suitable for managing mild-to-moderate cardiac insufficiency.
- This regimen may offer a viable therapeutic option for improving hemodynamic parameters and patient symptoms.
Abstract:
In twelve patients with chronic cardiac insufficiency (NYHA II-III), the effect of a fixed combination of drugs (160 mg verapamil/50 mg triamterene/25 mg hydrochlorothiazide) on cardiac hemodynamics was studied over a period of four weeks. During the course of treatment, the arterial blood pressure decreased from 145 +/- 16/93 +/- 9 mmHg to 133 +/- 18/86 +/- 14 mmHg, and the heart rate from 79 +/- 13 to 75 +/- 12 beats/min. Exercise blood pressure (900 watts) decreased from 180 +/- 22/104 +/- 14 mmHg to 158 +/- 25/96 +/- 17 mmHg and the heart rate from 104 +/- 14 to 100 +/- 16 beats per min. After treatment, a decrease in pulmonary arterial pressure and resting pulmonary capillary wedge pressure (PPA:-2.3 mmHg, PPC:-1.4 mmHg) and in exercise pressure (PPA:-8.5 mmHg, PPC:-6.6 mmHg) was established. Clinically relevant changes in cardiac output and cardiac index were not observed. The subjective symptoms (NYHA stage) were improved in eight patients. Combination treatment would appear suitable for patients with mild-to-moderate cardiac insufficiency.