Haemodynamic effects of felodipine in congestive heart failure

The acute and long term central haemodynamic effects of felodipine were studied in 9 patients with severe congestive heart failure (NYHA III-IV). A felodipine dose of 5 to 15 mg tid was individually titrated during a 24 to 48 hour catheterisation period. One patient received 5mg tid, 5 patients 10mg tid and 3 patients 15 mg tid. At rest the individual maximal dose was associated with a significant fall in systolic and diastolic blood pressure, pulmonary artery diastolic pressure, heart rate and systemic vascular resistance, while stroke volume was significantly increased. During upright submaximal (30-50 watts) bicycle exercise, the changes were principally the same with the addition of a significant increase of cardiac index. Six patients were re-evaluated after 30 days of continuous treatment. Their resting haemodynamics had returned to the control level but during exercise the significant changes in cardiac index, stroke volume and vascular resistance persisted. The results indicated a beneficial effect of felodipine in the treatment of heart failure, but further studies are needed.